Health clinics may see tougher rules

By Shari Rudavsky
http://www.indystar.com

Health clinics located in retail businesses would be subject to greater state scrutiny, have to install separate entrances and train all staff in cardiopulmonary resuscitation under proposed legislation that aims to set new standards for the facilities.

Among other measures, the state Senate bill also would mandate that a patient’s primary-care physician receive a detailed report of the clinic visit and that prices be displayed outside the clinic’s exam room.

The clinics, often located in pharmacies or big-box stores, offer patients a less expensive and more accessible alternative to emergency room care. In the past decade, more than 1,000 such clinics have opened across the country.

State Sen. Patricia Miller, R- Indianapolis, who sponsored the bill, said the legislation is not meant to put these clinics out of business.

“We’re just trying to make sure that they meet standards like other physicians have to do,” she said.

Currently, the Indiana State Department of Health does not license retail store-based health facilities but regulates them through the license of the doctor in charge.

And state health officials say they have little interest in changing that.

“We’re opposed to it. It’s overkill,” said Brian Carnes, legislative director with the State Health Department.

The state estimates that it could take as much as $600,000 a year to start licensing Indiana’s approximately 300 retail health clinics.

Many physicians groups say retail health clinics interfere with the concept of the “medical home” — a doctor’s office that serves as the focal point of care.

When patients visit a retail health clinic for immunizations, annual physicals or to obtain prescriptions to treat strep throat, for example, that means one less time they see their own doctors, said Dr. Richard Feldman, a former state health commissioner who helped Miller with the bill.

“It fragments the care,” he said. “But as much as we dislike our patients going there, retail clinics are a reality. They’re not going away. . . . Let’s better ensure the quality of care they’re providing.”

The bill would impede a clinic’s ability to deliver quality affordable care, said Dan Zacchei, a spokesman for Take Care Health, a subsidiary of Walgreens, which has 10 clinics in the Indianapolis area.

“We believe that our clinics are an answer to a general shortage of primary-care physicians,” he said.

About 30 percent of Take Care customers do not have primary-care physicians, he said.

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