A different care

by Dr. Lazowski

In an article from Time Magazine, March 2015, “ A Different Prescription”, Eliza Gray talks about the increasing role that CVS pharmacy plays in our healthcare. CVS has 7,800 stores and is the second largest drugstore chain in the US. Last year it filled more than 700 million prescriptions and administered 5 million flu shots. The original name of the chain was Consumer Value Store and it used to be part of the Melville Corporation. Later it changed name to CVS Corporation in 1996 after Melville sold off many of its non-pharmacy stores. Larry Merlo, 59, who is CVS Health’s CEO, has a grand vision for the company- to diagnose patients, decide on their treatments and then sell them pills they need to get well. He feels that America’s changing health care system will lead to the “retailization” of health care which means that patients are becoming more like consumers and health care is becoming more like any ordinary consumer product. CVS has introduced Minute Clinics where a nurse practitioner treats routine conditions such as allergies and strep throat. Vaccinations are administered and routine screening for blood glucose levels and cholesterol tests are being performed. This can have a positive effect when patients need to be seen after-hours or when they do not have a primary care physician. This can also be dangerous when patients complain of chest pain and come for a visit to a Minute Clinic instead of to the Hospital’s Emergency Room. Lack of record exchange with the primary care doctor and underestimation of the severity of a complaint might also pose a serious problem. CVS wants to monitor more closely if patients take medications as prescribed, but also wants to influence the decision about which medicine is being prescribed. They hope to manage medications over the phone and use telemedicine to allow the Minute Clinic Nurse to evaluate the patient on the computer screen. While taking care of your health needs, the CVS store wants to sell you toothpaste, a carton of milk, or a shampoo among other products. I have talked to patients who were told by a pharmacist what medications they should be on, what doses should be prescribed and what medications the patient should try to avoid. It might be dangerous when pharmacies take over care, which they are not trained to do.