The collection site may be a physician's office, an
emergicenter or other free-standing facility, or a hospital.
The emergicenter, which offers no-wait prescriptions to doctor shoppers who can pay with cash or major credit card, embodies the for-profit orientation favored by Reagan.
Upon closer examination, however, its proposals turn out to embody a familiar reliance on the "magic of the marketplace." The Administration expects big business to provide efficient low-cost care through for-profit hospitals, renal dialysis units and "emergicenters," corporate clinics which advertise treatment for everything from sore throats to broken bones.
The laboratory now serves about 75 physicians, 25 nursing homes, a hospital-run emergicenter, and several veterinarians.
Next come nursing homes, potential markets for 56 per cent; emergicenters and primary care clinics, 31 per cent; veterinarians, 26 per cent; and assorted other clients, 23 per cent.
The clientele for these marketing efforts was substantially the same as in 1984: 87 per cent of the laboratories marketed tests to physicians' offices, 65 per cent to nursing homes, 40 per cent to
emergicenters or other clinics, 32 per cent to veterinarians, and 25 per cent to a variety of other customers.
Where do ACCs, originally known as emergicenters or urgent care centers, fit into the overall health care system?
To bring some uniformity to ACC operations and ward off regulatory moves, NAFAC recently affiliated itself with the Accrediting Association for Ambulatory Health Care to develop guidelines for defining distinct functions for ambulatory care centers, urgent care centers, and emergicenters. (Three centers have been accredited in the young program.) The program offers some guidelines for ACC laboratory operation, but they are general rules for record keeping, quality control, and staffing that allow individual centers substantial latitude.