[NPInfo] Re:NP PA answers to MD attacks

[Thiem]

"MSSNY is very concerned that the kiosks will not be subjected 
to the same scrutiny as a physician's office."
What scrutiny? What standards?  

Didn't someone mention knowing/knowing of Goldberg, DO in previous posts?

Laura, NP, Missouri


SGrtWhite at aol.com wrote:
  Hello all,

I wanted to share this posting (read below) that I came across on the NY 
medical society's website re: retail clinics, written by its president. As an 
FNP I am infuriated, as all other NP's should be, at the derogatory attacks on 
advanced practice clinicians. Please understand that this is as much of an 
attack on advanced practice clinicians as it is on retail health. This rhetoric 
is trying to set back our profession 30 years. I am not about to let that 
happen since our NP pioneers have fought so hard to attain the practice as we 
know it today.

Let's keep the dialogue open and educate the uninformed. We are above the 
mudslinging as apparently our physician counterparts are not. I know that there 
are a lot of NY advanced practice clinicians that read this listserve and we 
cannot let Dr. Goldberg and his self-serving comments stand. 

Thanks for listening, 
Steve, NP

And now, here that posting: 

This week, I was interviewed by Channel 11 News regarding the latest topic 
of the moment — minute-clinics, mini-clinics, drop-in clinics. They have 
different names for what I call one name only —“nurse kiosks.” By the news 
reporters own admission, the Manhattan CVS pharmacy that she visited, while doing 
her research, was no bigger than 6’ x 6’ and the kiosk was located in the 
middle of the pharmacy. That is like conducting an exam in a closet. It had no 
toilet. How do you take a urine sample without a toilet? What happens when the 
cup overflows? She did not mention an examination table either, come to 
think of it…. 

One of the selling points of these kiosks is convenience. In my world, 
doctors start practicing by 8 am. Most close their office when the last patient 
has been seen, whatever the time, not when the store closes. 

I have never met a physician who said he became a doctor just to make money. 
However, I never met anyone who opened a retail store for any other reason 
than to make money. These kiosks are not about patient care, so let’s just 
call this aspect what it is — a way to make a profit filling prescriptions, 
while “customers drops another $20 buying merchandise as they wait for their 
scrip. Representatives of these kiosks say that the customer has no obligation to 
fill their prescriptions where they are “examined.” How can someone, 
particularly someone in discomfort, look eye-to-eye with a pharmacist five feet 
away and leave? Might this not be an example of “undue influence?” In the same 
vein, have you ever seen anyone exit a doctor’s office through a pharmacy? 
They are using the same mentality that casinos employ. No matter where you want 
to go in a Las Vegas hotel, you have to walk through the casino. 

Another problem is government oversight. MSSNY is very concerned that the 
kiosks will not be subjected to the same scrutiny as a physician’s office. MSSNY
’s General Counsel, Don Moy, is in continuous contact with the DOH regarding 
the financial aspects of corporate practice of medicine, referral of 
services, as well as hygiene standards and the use of electronic health records. 

The AMA is also seeking a ban on a practice where health insurers offer to 
waive or reduce co-payments for members who seek care at these kiosks. Ever 
notice how managed care companies reduce our payments by the co-pay amount if we 
neglect to write down that we collected the co-pay? Supposedly, these 
outlets will only service people between the ages of 18 and 65. They will leave the 
truly ill, young and old, for us. Really, who are they kidding? Where is the 
societal reinvestment into healthcare? Do not all patients know that all of 
us treat many patients in need without regard for our fee? What will the 
nurse in the kiosk do? I do not think they can “let it slide” like we do time 
and again. 

In the early 1980s, urgent care centers bloomed, but those “clinics” had a 
short-lived popularity. I wonder why. Today, I can almost smell the trial 
lawyers who are ready and waiting to pounce on their first “kiosk catastrophe!” 
Who knows, it may be a slip on the wet stuff on the floor! 



Robert B. Goldberg, DO 
President



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