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The clinics I was discussing are not free standing entities but are
ususally part of one of the larger teaching hospitals. As a major
hospital, services under its jurisdiction are usually covered by the
contract that an HMO makes with that hospital. It is really just
interdisciplinary gathering of certain members of the staff around
certain problems. Many hospitals have multitudes of such clinics. For
example, Children's Hospital has clinics for Developmental Disabilities,
School Functions, Nutrition and Eating Disorders, Cranial Facial problems
etc.,etc.,etc. I just have not heard of any for Celiac.
 
I think that, probably, if one were to demonstrate that a clinic approach
would provide cost saving, over people just running thither and yon and
not geting effective treatment, HMOs would probably support it. The
advantage is centered around the more effective use of knowledge, faster
communication of results, group problem solving and the opportunity to
see patients with a center focus to their problems which would allow
for more refining of procedures. It would also allow for better
accountability studies which HMOs love.
 
I didn't mean that all the list of people would be involved in every case
just that they might be linked in some way and involved when appropriate.
It would of course be under the leadership of a the gastroenterologist.
 
Just my opinion, I could be all wet.
Irma Debruyn