Justin Wilson, a pharmacist in Midwest City, Oklahoma, recently saw a 25-year-old patient who’d been referred by her doctor. The woman, a diabetic, was referred to the diabetes clinic that Wilson runs at his pharmacy when her physician found her blood sugar readings were continuing to spike. “Her doctor thought she would benefit from more intense diabetes education and monitoring,” explains Wilson. “She and her husband had been trying to get pregnant, but had struggled with multiple miscarriages, likely due to her lack of blood sugar control.”
The young woman was enrolled in the independent pharmacy’s diabetes monitoring program, where staff reviewed proper blood sugar levels with her; put her on a diet and exercise plan; and worked with her physician to get her started using an insulin pump. Within three months, the patient’s blood sugar had dropped significantly; the couple now has a healthy baby boy. “By working together with the patient and her physician, we were able to optimize her therapy,” says Wilson.
It’s nothing new for an independent pharmacist to have a patient-management practice like that, but now you can find the same kind of care on a much larger scale: Earlier this month Walgreens, the biggest pharmacy chain in the country, announced that its 380 Take Care clinics, which are retail clinics that treat patients for conditions like sore throats and minor injuries, will expand to offer customers help in managing chronic diseases like asthma and diabetes. No more schleps to a germ-filled waiting room and interminable waits to be seen—at least that’s the hope. Plus, you can pick up toilet paper and toothpaste while you’re getting your blood sugar checked.
It’s a smart move on Walgreens’ part. Many health insurers cover all or most of the cost of a visit to a retail clinic because it’s cheaper than an emergency room visit. And when millions of people who are currently uninsured get healthcare coverage starting in January 2014, under the Affordable Care Act (also known as Obamacare), they’ll all become even more likely to use a Take Care clinic.
But having ready, easy-to-access care for a variety of conditions that aren’t emergencies is an equally good idea for anyone with a chronic condition who’s struggling to keep it in check. A recent study in Pediatrics by researchers at the Harvard Medical School found that adults over age 18 were more likely to use the emergency room and have problems accessing medical care and medications because of cost. And since the number of young adults with diabetes, asthma, high blood pressure, high cholesterol, and other chronic concerns is growing, more people are going to need care, but are likely to be stuck when it comes to how to pay for it. According to the Centers for Disease Control and Prevention, the percentage of kids and adolescents with a chronic health condition increased from less than 2 percent in the 1960s to more than 7 percent in 2004. Ten years later, those kids with chronic health problems are now young adults with chronic health problems, but they may not have insurance coverage or a regular doctor, or maybe can’t make the time to see a doctor during typical office hours. Retail clinics, which other major pharmacy chains like CVS also offer, are often open seven days a week and open daily for 12 hours or more.
These clinics are typically staffed with nurses and physician assistants and it’s easy to find out how much a service will cost beforehand (it’s on their websites too, in most cases). Take Care/Walgreens hasn’t yet posted fees for the new chronic disease management visits, but they’re likely to range from $50 to $100 based on similar services at other chain pharmacies. Short visits—say, for a simple blood pressure check—could be less expensive.
Convenience isn’t the only important feature, says Tine Hansen-Turton, executive director of the Convenient Care Association, the trade association for retail health clinics. Hansen-Turton says that retail clinics that offer disease management services do so in conjunction with—not instead of—a physician so, if you don’t have a regular physician the clinics can recommend those they work with, sometimes through a community health center, which can make the cost free or very low if you’re not insured.
Jim Cohn, a spokesman for Walgreens, underscores the point that the new services at the Take Care clinics are not meant to supplant a patient’s relationship with a physician. “Take Care Clinics strongly encourage all patients to have a primary care physician for ongoing medical needs and routine exams,” said Cohn in an email to TakePart. “With this new service expansion, our objective is to support and complement the traditional healthcare system, provider practices, and patients’ medical homes by offering expanded access and convenience to patients seeking healthcare services,” wrote Cohn.
Use of retail clinics is on the rise, according to a recent study by the Rand Corporation that found a 10-fold increase in use over the past two years. Estimates for the industry have found that one in three patients who use the clinics don’t have a regular doctor.
Would you use a Take Care clinic to manage a condition? Have you used a drugstore/pharmacy clinic before for medical care?
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Fran Kritz is a freelance writer specializing in health and health policy and lives in Silver Spring, Maryland. Takepart.com