I've received a couple of thoughtful e-mails from Dr. Thomas Davis (the Missouri physician, not the legendary basketball coach) concerning my earlier post criticizing the American Medical Association for wanting to rein in the emergence of retailer-based health care clinics. With Dr. Davis's permission, I'm posting a few of his comments for readers' consideration.
First, lest anyone want to straw man Dr. Davis as a pro-regulation, anti-market, rent-seeking weasel, he writes:
I would prefer a world where a patient can get any medication over the counter without a prescription, where doctors are not licensed, there is no insurance and patients paid cash at the time of service. Health care would be far more efficient and transparent in such a world.
He also stresses that he is not a member of the AMA and that he has some serious qualms with the organization.
Dr. Davis raises three concerns with the in-store clinics:
- If they are operating without direct physician supervision, the clinics lack important medical expertise, and many customers could suffer unnecessary medical expenses (not to mention pain and suffering) from undetected or misdiagnosed afflictions.
- If the clinics siphon off customers who are seeking annual checkups or treatments for minor problems, traditional MD practices will become financially strapped, affecting the care of patients with more complex medical problems.
- The in-store clinics' business model could create perverse incentives for their employees and for tort lawyers, who may likely see the major retailers' clinics as deep-pocketed malpractice suit targets.
Readers can make up their minds on these points. As with most thoughtful arguments, I believe there is some merit to each, but not enough to change my opinion that the clinics are a welcome addition to the health care marketplace.
Indeed, a comment Dr. Davis makes in his second e-mail supports this idea better than anything I could write:
My point is not that these clinics are "bad." The competition in the short run is probably a good thing, and I can out-compete Wal-Mart on the delivery of high quality health care any day.
That, I take it, is a sentiment we all want to hear from health care providers.