MinuteClinic, a CVS Caremark Corp. subsidiary opened the state's first clinic in a CVS store in Medway, Massachusetts with 27 other such planned clinics to open in the coming months statewide and 100 overall. The state's first retail-style health clinic aims to provide quality care at low costs for minor ailments and vaccinations and currently the company has nearly 500 in-store clinics in 25 other states.

Opposed by the Massachusetts Medical Society, for patient safety, the clinics, feel critics pull patients away from their primary care physician who regularly coordinates their treatments. Questions have also been raised about maintenance of public health in a store as well as the disposal of medical waste and supervision of the medical practioners at these clinics. State officials fear misdiagnosis could be possible for the people coming into such clinics since the personnel here would be nurse practitioners and not qualified doctors. A fear echoed by the Mayor Thomas M. Menino who fears that the clinics could fragment healthcare and affect quality.

Donna Haugland, MinuteClinic's chief nursing officer said, "I think we need to do whatever we can as a society to make healthcare as accessible and convenient as possible. We nee to come to where people are," she said. The aim of the clinics she added is to "help with access and fragmentation of health care at a low price where people live and work."

MinuteClinic was the first to get a license after a lengthy review by state public health officials and now Walgreens has also applied to open its subsidiary Take Care Health Systems, in Massachusetts though both companies already operate in other states.  

People leaving the store gave mixed reviews to the concept clinic with some appreciating the benefits and convenience it offered while others did not like the idea of shopping in a pharmacy with an in house clinic.

Haugland said the clinics have uniform standard for patient care and all patients without a primary care physician are given a referral to local practices. Patients who already have their medical records with them would get the visit's records forwarded to their doctor's office so the doctor is aware of the treatment. "Because our scope of services is focused, we know when we come to a new state people come in and we need to refer them to appropriate care," said Haugland.

The clinics aim to cover all minor ailments such as strep throat, minor skin conditions such as ringworm and vaccines for adults. Children younger than the age of 2 years would not be treated at the clinic. Made up of two patient rooms and a very small waiting area of four chairs by the pharmacy and computers for patients to enter their medical condition, the clinic has a kiosk listing prices with most treatments ranging between $59 to $ 110, and the lab fees.

MinuteClinic accepts most private health insurance and Medicare and the clinic is in the process of receiving Medicaid approval. Harvard Pilgrim and Tufts Health insurance providers have already signed off on the clinics while Blue Cross Blue Shield is close to signing off.

Richard P. Gulla, a spokesman for the Massachusetts Medical Society, said the society has created a task force to look into the impacts of this retail health care on physicians. Two major concerns, he said, are ensuring that information from a visit is relayed to doctors and the "conflict of interest selling prescriptions that may be written in the store."