Debra Geihsler: MinuteClinics are a Band-Aid, not a cure

Debra Geihsler

When state regulators decided to allow CVS’s MinuteClinics into Massachusetts last week, it might have seemed a difficult choice to reconcile. Consumers can have more access and shorter wait times for routine care, but they’ll have to sacrifice ongoing relationships with their doctor.

When the vote was tallied, CVS won and it was the patient-doctor relationship that lost. While it’s clear that consumers are looking for quicker and more access to health care providers, episodic visits to a retail clinic are a Band-Aid and not an adequate substitute for access to quality coordinated care provided by physicians.

A CVS in Weymouth is slated to be the first location to launch a MinuteClinic this fall, followed by 20 to 30 others in Greater Boston.

The Boston Public Health Commission is looking for ways to block the clinics from coming to pharmacies in the city. This is a decision that other cities and towns will have to grapple with as CVS decides on which of its stores will house the clinics.

Advocates for the clinics argue that they fill a gap in the health care delivery system by relieving overbooked primary care physicians and eliminating unnecessary emergency room visits.

But detractors, who include Boston Mayor Thomas Menino, see the decision to allow the clinics to operate as a significant threat to patient safety and effective coordinated care.

Without knowledge of a patient’s full medical record history, the discovery of serious conditions could be missed and could worsen over time without the proper intervention.

The mayor also points out that retail clinics add another layer of care that is not integrated with a patient’s existing medical team, and another layer of expense to an already cost-inflated health care system.

The debate surrounding CVS’s MinuteClinic is healthy for the Massachusetts health care community because it forces us to recognize the necessity of providing patients the care they want and deserve. But the answer won’t be found with limited-service medical clinics operating in retail stores throughout the state.

Health care providers need to continue finding ways to make high-quality, coordinated care accessible to our patients when they need it. Retail clinics may provide easier access to care for people who choose not to wait to see their primary care doctor, but consumers shouldn’t have to make this decision in the first place.

Rather, new and better approaches to enhance convenience in Massachusetts’s primary care system should be created and implemented.

At Atrius Health, we are exploring different avenues to improve access, including convenient scheduling, shared patient visits, performing lab tests prior to a patient’s annual physical, and giving patients access to an online portal where their questions can be answered by members of their coordinated care team.

Access to a primary care doctor is critical, and hospitals, physicians groups and other health care providers need to seek innovative ways to keep up with our patients’ evolving needs.

The larger problem behind health care accessibility is the shortage of primary care physicians in our state and across the country. More than half of our community hospitals are facing a shortage of primary care practitioners, while the wait time to see a doctor has increased in many places.

Health care providers must do their part, but state and national government play a crucial role in implementing policies that will help attract and retain qualified health professionals. These policies need to include improved primary care reimbursement and increased funding for primary care training.

Regardless of which side of the MinuteClinic debate one falls on, across the medical profession it is our utmost priority to make safe, high-quality care readily available to our patients, and to listen and respond to their needs.

The decision on MinuteClinics should serve as a resounding call that something needs to be done now to give our patients access to the quality care they seek from their physicians.

Debra Geihsler is president and CEO of Atrius Health and Harvard Vanguard Medical Associates.