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By Gintautas Dumcius
Reporter
Correspondent
Community health center leaders are just as
opposed to CVS stores opening mini-clinics as Mayor
Thomas Menino, but that isn't the end of it.
Regional leaders are exploring opening their own
versions.
State regulators last week approved rules
establishing "limited service clinics," which they
said would allow for quick, convenient care for
minor ailments.
Menino blasted the decision, saying in a
statement: "People need continuous care, and this
type of for-profit facility is ignoring the
standards and measures needed for quality
care."
The regulations apply to any retail company or
non-profit, including CVS Corp., which plans to
open some 30 clinics in Greater Boston in the next
year.
While community health centers raised concerns
about setting up retail clinics, echoing fears that
the new clinics would lead to a greater fracturing
of primary care and patient records, the centers
are poring over the regulations to see where they
could fit in.
"The regulations that extend clinic licensure
certainly would have an attraction to community
health centers" who are interested in expanding are
to their patients, according to James Hunt Jr.,
president and CEO of the Mass League of Community
Health Centers. The league is an association of 185
community health center sites, serving 700,000
state residents a year.
Community centers would take a different tack
than the for-profit clinics, emphasizing a
continuity of care for the patients, he said.
"If in fact we were to look at these, and we
certainly are, we'd look at them from the
perspective of how we can best create the
connectivity...rather than retail," he said.
Hunt said he wouldn't rule out health centers
also running retail clinics in a for profit manner,
but with the aim of funneling back funds to the
non-profit.
The health centers could also team up with other
retailers or organizations, he said.
The number of limited service clinics that could
crop up in Dorchester is unclear.
MinuteClinic, which is a subsidiary of CVS
Corp., had planned to start in Weymouth before
expanding to Boston, and eventually build over 100
statewide.
Visits tend to take about 15 minutes and cost
about $59, and the stores provide flu shots and
other vaccines, treatment for allergies,
bronchitis, and sinus, eye and skin infections.
Local health centers however, see no silver
lining on the limited service clinic cloud.
Ed Grimes, head of the Uphams Corner Health
Center, pointed to the shortage of nurse
practitioners, who under the rules would staff the
limited service clinics, as the main factor in
opposing the clinics.
"Once CVS does this, then you will have Target,
Wal-Mart, perhaps the supermarket chains doing the
same things," he said. "They'll watch, and if it's
good business, they'll be doing it."
The arrival of the clinics could launch a salary
war, which would be detrimental to primary
caregivers, he said.
His own health center is trying to fill three
nurse practitioner positions. "Once this enterprise
gets underway, it's going to be all that more
difficult and it's going to have a potentially
negative impact on the health and wellbeing of a
significant number of community residents," he
said.
Bill Walczak, CEO of the Codman Square Health
Center, said his center has already had an urgent
care center for 10 years. The center has x-ray and
lab services, he said.
The facilities that state regulators approved
are "extremely limited" he said, and could lead to
misdiagnoses.
"It muddies the water of the health care system
that's already pretty damn muddy," he said.
If there was a community need that wasn't being
met, and we had the capacity, maybe," he added.
"The cost of doing it the right way probably would
only make sense if it were in a place that was far
from other care centers."
Walczak said he and the other clinics are
supporting Menino's efforts to exclude the pharmacy
clinics through regulations.
Menino has called on the Boston Public Health
Commission to explore its authority in limiting the
sale of tobacco products in retail stores with the
clinics. Menino and others argue that the clinics
shouldn't be in the same area where harmful tobacco
products are being sold.
The commission's legal counsel will report back
as soon as possible, possibly Feb. 14 at the
earliest, according to a commission spokeswoman.
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