Map of life expectancy at birth from Global Education Project.

Tuesday, June 26, 2007

Step Right Up!

One of the (questionable) perks of blogging is that I get all sorts of press releases. This one is worth sharing:

For Immediate Release

Neil Shroff, Vice Chairman
ExpressCare No Wait. Feel Great!T

Mobile: (201) 410-3625
Fax Number: (609) 409-3637

ExpressCare Announces Grand Opening in ShopRite's Neptune, NJ Supermarket
Special Guests to Include Phil Simms and Frank Bisignano
Cranbury, New Jersey, June 22, 2007 -ExpressCare, located in the ShopRite supermarket at 2200 State Highway 66 in Neptune, NJ, will hold its grand opening on June 30, 2007 from 10:00 am-3:00 pm.

The official "ribbon cutting" will take place at 11:00 am and will include local dignitaries, in addition to a special guest appearance by Phil Simms, CBS Sports Commentator, Super Bowl XXI MVP and 15-year NFL veteran. Neil Shroff, Vice Chairman, is pleased to announce that Frank Bisignano, Chief Administrative Officer at JP Morgan Chase, has joined the Executive Advisory Board for ExpressCare.

"Mr. Bisignano, who is well known in the investment community, will provide strategic advice and expertise to the ExpressCare team" states Mr. Shroff. ExpressCare, which has signed agreements with three multi-store ShopRite supermarket store owners, plans to open retail health care centers in as many as 42 locations. ExpressCare will open in six supermarkets in New Jersey and southeast Pennsylvania this summer. Twelve ExpressCare locations in ShopRite supermarkets are expected to be operational by March of 2008.

ExpressCare believes that these health care centers address two health care issues facing most communities - access and affordability. ExpressCare clearly posts its scope of services and prices to make it simple for people to understand. Most services are under $39.00, and all locations will be open seven-days-week including holidays.

It goes on a bit but that's the gist of it. No, it isn't satire. You can visit Express Care's website if you are in doubt. At this point they seem more interested in attracting investors than customers, but it's for real.

Now, you probably think I'm all outraged and bent out of shape and so forth, but actually I'm ambivalent about this. There won't be an M.D. there -- nurse practitioners provide the service. The NPs will only treat simple complaints like rashes and common minor infectious diseases, give you your shots, and do school and sports physicals, that sort of thing. They are trained to act appropriately in more serious cases, whether it be by calling 9-1-1 or referring you to a physician.

We all know that it's next to impossible to get in to see most primary care docs on short notice for minor complaints. This way, you can get your kid's sore throat checked out while you pick up the milk and corn flakes, even on Sunday and Columbus Day. For people without insurance, alas, this is an affordable deal.

In fact, the New England Journal of Medicine recently featured a fairly accepting commentary on this. There are some worries, and there may be unintended or perverse consequences, but supporters argue that these services meet a need and can even help relieve the pressure on primary care providers, who are in increasingly short supply.

Still, a lot of people don't like it. The blatant commercialism of it all doesn't feel quite right, but there are also more substantive issues. There may very well be some value in the serendipitous contact that people have with their physicians when they come in for minor complaints or wellness services. These clinics threaten to disrupt the continuity of care and relationships that people have with primary care providers. And there is always the possibility that a rare condition could be missed by an NP using a rigid protocol intended to identify and treat a minor problem.

Whether these turn out to be legitimate problems, or whether others will emerge, remains to be seen. I don't think I would use one of these clinics, but I'm willing to wait and see what happens with them. I would rather, however, that community health centers and physician practices set up such services, incorporate your visits into your medical record, and alert primary care providers about them. The free standing model is certainly inferior in that regard. But until that happens, it's hard to argue that people shouldn't have access to these services.

By the way, speaking of blatant commercialism, I had to delete a spam comment from a drug company. Yup, I got a comment touting a prescription drug. It met FDA standards for DTC advertising -- including mentioning side effects and giving a link to a web site where you could read the package insert -- and it happened to be for a drug I don't have a particular problem with. Nevertheless, that is not allowed here -- especially if you aren't paying me.

The nerve of these clowns.


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