Flu Shot at the Minute Clinic

CVS came through for me. The pharmacy's walk-in clinic not only saw me after a 2-minute wait, it also took my Blue Cross insurance. That means my flu shot cost $0 out of pocket.

I cannot report on other clinics appearing in neighborhood pharmacies, but if they are half as good as the CVS Minute Clinic I visited today, I'll be happy to use them.

Walk-in clinics typically invite criticism as costly and potentially harmful to our health. Yet they continue to get our business. (They're open more hours than most doctor's offices. They're faster. And, frankly, they're friendlier.) Having had my share of minor ailments, I feel confident that if I can walk in and state my symptoms, I can probably walk out no worse for wear.

That said, I asked the responsible question of the Nurse Practitioner in the Minute Clinic: "How many people do you refer to a doctor or hospital?" She had an immediate answer, "Two or three a day. The most common reason is age. We don't treat babies."

I was also curious about the work load (not in a negative sense as this is the age of moonlighting in many professions). The N.P. smiled broadly, "This is my only practice. I love it. Weekends are busiest but we open another room. But I like every day." I couldn't resist asking, "No occasional shift at a hospital?" And she got serious, "This is where I belong."

The clinic is small but fully stocked. Patients sign-in on an electronic pad and enter basic information "typing" with a stylus on a touch-screen. The waiting list is published (no last names) and the mood is calm and quiet. Visits appear to be naturally short. Maybe the N.P. is timing everything (a feature at my doctor's office, to be sure), but it's not obvious or off-putting. Record-keeping is computerized and whatever database the Clinic is using, it checked my insurance coverage in about 20 seconds and produced a billing screen. (That's the $0 part of my story.) I declined the offer of an email about online health records because I'm just not ready for an electronic PHR (personal health record). But I suspect that's the direction we're heading across all health facilities.

© 2008 Mary Bold, PhD, CFLE. The content of this blog or related web sites created by Mary Bold (www.marybold.com, www.boldproductions.com, College Intern Blog) is not under any circumstances to be regarded as professional, legal, financial, or medical advice. Or education advice. Or marital advice. Or even a tip.

Personal Heatlh Record: A PHR at Google

Boomers will live long enough to see the Internet transform most aspects of our lives. That includes our health care or, pertinent to this blog, our health care records. The 2008 launch of an online personal health record (PHR—that's a standard bit of nomenclature that's been around since the late 1970s) will spur that transformation. It's from Google, of course.

Google Health requires a log-in with a Google account (which is handy for all Google apps, anyway). The site carries the designation of BETA, indicating that some parts are still being developed. Google's history of taking web sites through a beta phase is strong—don't mistake the disclaimer for a warning of shaky software. Nothing shaky here in terms of the technology itself.

But on the subject of disclaimers, you will note that accessing Google Health requires acceptance of policies. We've all become accustomed to checkmarking "I Agree" clauses for web sites but the terms of service should remind users to enter data cautiously. The purpose of this site is data recording, with expectation that users will upload personal and health-related data. The site may suit your purpose along these lines, but we don't have any real sense of how successful this site will be in managing information. I see the data collection aspect as a harbinger for consumer relations with medical providers but, frankly, I'm still looking for a doctor's office that simply will let me make appointments online. Placing my medical records on the web is not yet my priority.

The efficiency of web-based personal records is unquestioned. Just as we have become comfortable with online banking, we'll probably soon become comfortable with online health tracking. If you've thought of the HIPAA consideration, good thinking! As the Google Health site says, HIPAA does not mandate how patients handle their own records. Google conscientiously puts the user in charge of every aspect of the data entered and that includes the user's power to limit access by others. So, if you elect to link your online profile with a pharmacy partner, you will decide if the pharmacy has "write-only" access (pharmacy can add information for you to read, but cannot see any information you have stored in your profile) or "read/write" access (pharmacy can both read your profile and also add to it).

Google Health is not the first online PHR but it certainly could be the biggest (soon). Its growth will depend on how many and what partners emerge from the health community. The number is small enough now that there's plenty of room on screen to display corporate logos. Maybe our indicator of progress past Gen 1 will be when the interface reduces partner listings to text only.

On a personal note: I liked seeing Walgreens and QuestDiagnostics on the Google Health partner list. Those are two outfits that I sometimes use. Yes, I'll track Google Health's progress in signing partners, especially hospitals and doctors and insurance providers. ~ Lida

© 2008 Mary Bold, PhD, CFLE. The content of this blog or related web sites created by Mary Bold (www.marybold.com, www.boldproductions.com, College Intern Blog) is not under any circumstances to be regarded as professional, legal, financial, or medical advice. Or education advice. Or marital advice. Or even a tip.

Good Medical Memories

Good memories escape us. As a general rule of thumb, we humans remember the bad times more vividly than the good times. Evolutionary psychologists explain it handily: the bad memory will keep you alive. The good one? It doesn't carry the same protective power. Might make you feel good. Probably isn't essential to survival.

And most medical memories fall into the bad category. Our conversations with physicians, nurses, and technicians are typically either mundane and forgettable or... upsetting. Even the occasional good news, "The results are negative," pales in comparison to the first warning, "We need to check out...." It's no wonder that so many people put off trips to doctors.

But I have a Good Medical Memory: It emerged during a season of tests and treatments and eventual surgery. Amid many visits, my family physician once said, "Are you taking vitamins?" I groaned and said, "No, I quit taking everything." And she replied, "I don't blame you."

That's all she said. No lecture, no prescription. She left me alone. It was certainly the response I needed at the time.

What event reminded me of this Good Medical Memory? That would be the insurance notification that the physician is no longer in-network.

© 2008 Mary Bold, PhD, CFLE. The content of this blog or related web sites created by Mary Bold (www.marybold.com, www.boldproductions.com, College Intern Blog) is not under any circumstances to be regarded as professional, legal, financial, or medical advice. Or education advice. Or marital advice. Or even a tip.