HealthAccessRI (see "Scituate doctor tours a cheaper approach for health-care," News, This Just In, August 6) allows patients to join a doctor's practice by paying a sign-up fee ($15-$80, depending on the practice), and then a monthly stipend ($25 to $30). In exchange, they get unlimited access to primary care, with only a small per-visit fee ($5-$15), plus 24/7 phone access and even some evening and weekend hours.

So far, nine practices with 26 doctors, including Fine's Hillside Family and Community Medicine, have joined the program. In addition, HealthAccessRI has deals with East Side Laboratories, three imaging providers, a podiatrist, the Rhode Island Rehabilitation Center, and Nursing Placement Inc., a home care provider, that provide steep discounts for services.

The program is growing slowly; only about 600 patients have signed up so far, but those who join stick with it, says Kimberly McHale, executive director of the Rhode Island Academy of Family Physicians, which helps run the program.

Emily Lisker, a painter and illustrator in Woonsocket, was among the first to join, and she says it works well for her, especially since she needs monitoring for her allergies and asthma, and this makes it affordable to see her doctor regularly. Before, office visits cost "a scary amount of money," she says, though she did manage to barter with Fine to help cover the cost. "His office in Pawtucket has my artwork in the hallway."

For details, go to healthaccessri.org.

 

phx-ins-bw-pres-INSIDE.jpg

PRESCRIPTION DRUGS
You have to hand it to Wal-Mart. When, two years ago, the retail giant announced it would sell generic drugs for $4, it started a trend, and consumers now have their pick of pharmacies offering similar deals — from Target and to Rite Aid to Walgreens and, starting this month, CVS/pharmacy.

The details vary; Wal-Mart, for example, offers some $4 over-the-counter drugs as well; CVS has a $10 sign-up fee and offers 90-day supplies for $10 (also available at Target and Wal-Mart), but not 30-day supplies for $4. And while all the programs cover a wide range of commonly used drugs — from allergy meds to antidepressants — the lists don't fully overlap.

Birth control, for example, isn't on the Wal-Mart, Target, or CVS lists, while Rite Aid offers several choices, but for $19.99 per 28-day supply, and Walgreens has two options for $12.

The key is to take generic drugs. Some doctors prescribe brand-name drugs by default, and if there's a generic version, the pharmacist will offer it to you. But many drugs — especially the ones likely to be stocked in the doctor's free-sample cabinet — are not available as generics, though other drugs in the class are: Zocor, say, instead of Lipitor.

If you need a drug that's not available as a generic, ask your doctor or health center for help, or check out RxforRI, which helps patients get free drugs from the manufacturers. Go to RxforRI.org or call 877.743.6779.

HOSPITAL CARE
A lot of problems for which people go to emergency rooms, doctors will tell you, can be handled by a primary care physician or by an urgent-care center. But when there's no choice, and you do have to go to the ER, they'll take care of patients, insured or not.

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