In reading the oped article by Terence W. Starz, president of the Allegheny County Medical Society ("Quick Health Care Is Not the Same as Primary Care," Nov. 1), one might think the current health care system in the United States adequately serves all Americans. The reality is the U.S. health-care system is broken. Take Care Health Systems, which operates health clinics across the country and inside Eckerd pharmacies in Pittsburgh, was created to fulfill a critical need for accessible, high-quality and affordable health care.

Hal Rosenbluth is chairman of Take Care Health Systems (patientsfirst@takecarehealth.com).

At Take Care Health, we have two core tenets: focus on the patient and work in partnership with the local medical community. Clinics are staffed by highly qualified nurse practitioners, who, in collaboration with physicians, provide treatments for ailments in a convenient setting, with no appointments.

Dr. Starz said we view "patients as customers and health care as a commodity" and that "one of the primary motivations is to generate business for the outlet and its pharmacy." Nothing could be further from the truth. We provide patients the opportunity to make educated decisions about quality medical care and encourage them to fill their prescriptions wherever they choose. Patients are not our patients or your patients; they have options and their own rights.

There are 46.6 million uninsured Americans without access to health care. Primary-care physicians are being asked to do and know more while earning less. We have overcrowded emergency rooms that now serve as primary-care centers, where a four-hour wait for a child's ear infection is commonplace.

Since opening our first clinic, we have treated 50,000 patients across the country with a 98 percent satisfaction rating. Roughly 30 percent of those patients do not have a regular health-care provider; 40 percent do not have insurance. More than 50 percent say that if it weren't for our clinic, they would've gone to the ER or urgent care, or would not have sought treatment at all.

Take Care Health is a solution for many patients who otherwise would not receive medical care. We're an entry point, not an ending point. Take Care Health provides concierge-like service to everyone, helping to close the socioeconomic divide.

We encourage patients to have a medical home and refer them to their primary-care provider should they need follow-up care. If they do not have a provider, we give them a list of local physicians and facilitate referrals -- our collaborating physicians see patients within 24 to 48 hours, and nurse practitioners call patients back within 24 hours to check in. With our electronic medical record technology, patients can take visit records to their providers to ensure continuity of care.

Dr. Starz asks, "Is this movement an indication of declining access to quality care?" Yes it is. In the Aug. 31 edition of The New England Journal of Medicine, Dr. Thomas Bodenheimer wrote of the decreasing number of primary-care physicians and the excessive demands placed on physicians that have contributed to "long waiting times and inadequate quality of care for patients." By 2010 the United States will experience a shortage of 50,000 physicians. Take Care Health didn't cause the problem; we are helping to solve it.

Nurse practitioners are highly qualified to treat many preventative and acute conditions. Taking nurse practitioners out of a "setting where a physician is not present to examine patients" does not present risks. An accurate diagnosis is not a function of a physician's presence but of the provider's attention to detail, level of experience and thoroughness with a patient.

To those in the Pittsburgh region -- rest assured, we are not here to replace your regular primary-care provider or to fragment the current system. Rather, we're responding to the need for accessible, affordable, quality health care across the country.