You're sick, They're quick

You're sick. They're quick.

That's the big idea behind putting small health clinics inside retail stores ranging from Wal-Mart to H-E-B.

And with more than half of walk-in clinic patients saying they will return again because of extended hours and short wait times, the battle for customers with minor ailments, such as strep throat, earaches and bladder infections, is heating up in Houston.

By year's end, the number of so-called "convenient care" clinics located inside drug stores and supermarkets is set to double in the area.

This week, CVS and Walgreen Co. announced they would each install eight in-store clinics around town by the end of 2007. RediClinic, the Houston-based outfit funded in part by AOL co-founder Steve Case, is adding three more locations inside H-E-B grocery stores by Thanksgiving.
"It's for busy people. We're not here to take the place of a primary-care physician, but sometimes people call a doctor and cannot get in for two or three days. They need fast treatment so they can get back to work," said Marcy Sawyer, manager of Houston operations for CVS's MinuteClinic concept.

The four MinuteClinics that opened in Spring, Pearland and Missouri City this week give the chain 320 locations in 24 states.

How fast is MinuteClinic multiplying? Two months ago there were only 200 locations. Within three months there will be 400 across the U.S.

MinuteClinic CEO Michael Howe can see a time when 2,500 MinuteClinics in CVS stores will blanket the nation.

No appointments

Wal-Mart CEO Lee Scott has a similar vision for his stores. Last spring he announced his intention to roll out 2,000 in-store clinics over five to seven years.

Typically, clinics of this sort don't take appointments, stay open late, offer weekend hours and are geared toward sinus infections and pink eye, not broken bones or heart failure. A menu posted in the clinic lists all services and price transparency for those paying in cash.

But it's insurance companies that are driving the expansion of in-store clinics as much as consumer demand.

Two short years ago, most store-based clinics catered to a cash-only crowd. Today, 80 percent of MinuteClinic's visits are from people with health insurance, Howe said.

A recent study by Forrester Research showed only 3 percent of people surveyed have used store-based health clinics, but that group tended to be younger, more affluent and had children.
"Moms want a place to get their kids treatment fast. They don't want to wait around in a doctor's office for something minor," said Sawyer, a nurse practitioner who used to work in private practice.

The clinics in Walgreens, CVS and H-E-B all have contracts with major insurers such as Cigna, Humana, United Healthcare and Aetna. Medicare has also signed on. While the typical walk-in visit runs around $60 out of pocket, those with insurance frequently get a discount. The clinics say they bring affordable care to the uninsured.

Oppostion lines up

But many doctors see drawbacks, even though some medical professionals view the clinics as an essential relief valve on overburdened emergency rooms that end up practicing primary care.
The American Medical Association has sounded the alarm over the cozy nature that exists between some clinics and some insurance companies.

In Minnesota and Alabama, Blue Cross/Blue Shield and other providers lowered — and in some cases waived entirely — copayments for insured workers who sought primary care from a store-based clinic instead of a regular doctor's office. The AMA is lobbying to have that practice outlawed.

The group has also questioned the clinics' underlying business model of using nurse practitioners and physician assistants to prescribe medication. Those prescriptions then get filled just a few feet away at the pharmacy counter.

The AMA calls it a conflict of interest. The industry calls it synergy.

MinuteClinic's Howe says he understands consumers' obsessions with speed and affordablity. (He used to be CEO of Arby's.) Howe also takes issue with critics who imply clinics abuse prescriptions to gin up a store's sales numbers.

"We don't get many complaints — six for every 10,000 visits — and most of those are because the nurse practitioner wouldn't write a prescription," he said, adding MinuteClinic's personnel encourage everybody to get established with a primary care physician in case more complicated health matters arise.

Traditional Urgent Care vs the Retail Clinic

Traditional Urgent or Immediate Care Centers are just as quick, and just as inexpensive, but they have a huge advantage over retail clinics for the consumer because they are staffed by board certified physicians, and have an on site lab, and X-Ray which means they can treat a wider rangle of symptoms much more effectively. remember, there is no substitute for seeing a board ceritfied physician.