Walk-in health clinics at pharmacy retailers operate with conflict of interest, charges AMA

Tuesday, January 08, 2008 by: David Gutierrez, staff writer
Tags: health clinics, pharmacies, health news

(NewsTarget) The American Medical Association (AMA) has passed a resolution asking federal and state agencies to investigate whether walk-in health clinics at retail stores are operating with a conflict of interest that may put patients at risk.

Retail, or store-based, clinics are walk-in offices inside large retail outlets, including pharmacies, supermarkets and mega-stores such as Wal-Mart. Customers can see a nurse practitioner or physician assistant without an appointment, and pay a relatively low price for basic medical procedures such as injections. A full physician must supervise the clinic, but is not required to be on site.

But the medical professionals at these clinics are also authorized to write prescriptions, which is where the alleged conflict of interest comes into play. Because the clinics are not totally independent of the pharmacies that house them, the AMA detects a conflict-of-interest in the writing of prescriptions.

The AMA says that it first became concerned about comments by retail stores that having walk-in clinics boosts sales, helping to "drive additional store traffic."

"There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics," said Peter Carmel, a member of the AMA board. "The nation's physicians want the AMA to ensure [that] these incentives do not compromise the basic obligation of store-based health clinics to provide patients with quality care."

The association has also expressed concern that the clinics disrupt the relationship between physician and patient, and complicate decisions about who is responsible for the patient's welfare.

The AMA also passed a resolution demanding that insurance companies apply the same rules to doctors and walk-in clinics; currently, insurers allow retail clinics to waive patients' co-payments but prohibit physicians from doing so. This creates a financial incentive for patients to visit clinics over doctors. But some newspaper editorials have accused the AMA of targeting the retail clinics less from concern for patients and more from fear of lost profits.

There were more than 200 store-based clinics in the United States in 2006, and the number is expected to reach 1,000 by the end of the year.