Risky rewards?

David Harlow, a health care consultant and lawyer in Newton, says the shortage of primary care physicians, coupled with patients’ desire for quick, convenient and cheap care, is the big driver behind the clinics.

Despite myriad concerns, professionals acknowledge that the clinics could help relieve an overtaxed primary care system.

“I think limited-service clinics are a bad answer to a primary-care supply problem, but they’re better than the current answer, which is the emergency room,” says Robert M. Hartley, medical director of the Brookside Community Health Center in Jamaica Plain.

Barbara H. Buell, a med-mal defense lawyer in Boston who practices with Bloom & Buell, agrees.

“If a place like CVS can properly take care of a person’s medical problem for $59 where an emergency department would have had to bill $1,000 or more, it’s all to the good,” she says. “But it all depends on the triaging of the problem and the judgment of the first medical person the patient encounters.”

That’s a huge caveat, says Boston plaintiffs’ lawyer Paul Sugarman, a partner with Sugarman & Sugarman, who says that supervising physicians must be aware that they could be liable for any negligence that arises from care in the clinic.

One major concern is the clinic’s “reliance on nurse practitioners some distance away making their own decisions and diagnoses, unlike in a doctor’s office or hospital where the physician is available on site,” he says.

Supervising doctors should also know that if they recommend proper treatment, but a nurse practitioner improperly executes it, they might still get sued, says Heather Beattie, a malpractice defense lawyer in Springfield who also has 25 years’ experience as a registered nurse.

“I could see someone … suing the nurse and then trying their darndest to show the doctor knew something and should have done something,” says Beattie, who practices with Morrison Mahoney.

But Sara Ratner, senior counsel for MinuteClinic, says these bad scenarios are highly unlikely and this type of arrangement is nothing new.

“There are other types of clinics that operate primarily with nurse practitioners and MinuteClinic is really no different from the way they practice in other settings,” she says.

Next: Errors Treating Kids