Walgreen Co. has expanded the reach of its drugstore clinics beyond treating ankle sprains and sinus infections to handling chronic diseases such as diabetes, asthma and high blood pressure.
The company, based in Deerfield, Ill., said Thursday that most of its 370 in-store Take Care Clinics now will diagnosis, treat and monitor patients with some chronic conditions that are typically handled by doctors.
Drugstore clinics, which are run by nurse practitioners or physician assistants, have grown popular in recent years as a convenient way for patients to get immunizations, physicals and treatment for relatively minor illnesses when their regular doctor is unavailable. But the clinics have been broadening their scope of care: Walgreen's decision follows a move by CVS Caremark Corp. a few years ago to handle chronic conditions at most of its 640 MinuteClinics.
Drugstores say they don't aim to replace doctors, but rather to provide more people with access to health care and work with physicians as part of a team treating patients. But the move to provide more complex care has drawn concern from doctors who say that can disrupt their relationships with patients and lead to fragmented care.
Dr. Jeffrey J. Cain is president of the American Academy of Family Physicians, one of the nation's largest medical organizations. He said doctors know their patients, and that makes them better suited for doing things like helping a patient with diabetes develop an exercise plan or learn how to eat better.
He also said that transferring records or test results between health care providers can be difficult if computer systems don't communicate well. That can lead to test duplications.
"It's not about telling somebody what they have to do, it's helping them make choices in their life to move toward a healthier lifestyle," he said.
Dr. Alan E. London, chief medical officer for the Take Care Clinics, said that the clinics can help coordinate a patient's care. If a patient has a doctor and a treatment plan for a condition such as high cholesterol, the patient can use the clinics for blood tests and then have the results sent back to the doctor.
But nearly half of the patients who receive treatment at Walgreen clinics don't have a primary care doctor, London said. In those cases, the clinics will diagnose a chronic illness, get the patient started on some medication and then help them connect with a doctor.
"We're filling a niche for patients who need access," London said. "When we uncover gaps in care and we're capable of closing those gaps, it's the right thing to do."