Illinois bill proposes stricter requirements for retail clinics

The state medical society says the regulations are needed for patient safety, but the clinic industry says it already has appropriate guidelines in place.

By Doug Trapp, AMNews staff. March 26, 2007.

Washington -- A new bill in Illinois would require retail health clinics to have more physician supervision and limited advertising.

The Retail Health Care Facility Permit Act would allow doctors to supervise no more than two advance practice nurses. Right now the state has no limits, said Illinois State Medical Society spokeswoman Laurie Peacock.

Peter Eupierre, MD, the society's president, said the bill is focused on preventing harm. "Medicine is not something that you can practice through a drive-in kind of approach," said Dr. Eupierre, an internist in Melrose Park, near Chicago.

Take Care Health Systems, which operates 13 Illinois clinics in Chicago-area Walgreens, says the legislation goes too far.

The firm allows one physician to supervise four or five nurse practitioners, said company spokeswoman Lauren Tierney. Doctors must be available by phone at all times nurse practitioners are working.

The company's physicians review at least 10% of patient records, which are 100% electronic. Up to 20% of its Chicago-area patients have been referred to a primary care physician or specialist for follow-up care, said Take Care's chair, Hal Rosenbluth.

The firm complies with in-store clinic guidelines outlined by the American Academy of Family Physicians and the American Medical Association, Tierney said.

The AMA principles call for clinics to use a well-defined, limited scope of clinical services and a referral system to ensure continuity of care with doctors in the community. Patients should be informed of the staff's qualifications, the clinic's treatment limitations and where follow-up treatment is obtainable. The AAFP has similar guidelines. Both call for using electronic medical records compatible with physicians' offices.