Health Care Moves to Walk-In Clinics

The trend of walk-in health clinics began years ago in neighborhood pharmacies, department stores and malls. Some health care analysts see store-based clinics as a natural evolution in health care delivery. The clinics are also money-making opportunities for investors. From member station KQED in San Francisco, Sarah Varney reports.

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Here's a change in the way you might treat that smoker's cough.

Walk-in health clinics started opening several years ago in neighborhood pharmacies and shopping malls. Sarah Varney, of member station KQED in San Francisco, reports on their increasing popularity.

SARAH VARNEY: The entrance to the Wellness Express Clinic in Davis, California, is in the back of a Longs Drug Store, between a wall of Depend undergarments and the pharmacy. The tiny clinic is staffed by nurse practitioners and physician's assistants, seven days a week, including evenings and holidays.

Today, PA Roger Bickford(ph) is seeing patients, and answering the phone, and handling insurance and cash payments.

ROGER BICKFORD: There are all kinds of things that we do here at the Wellness Express Clinic. I mean, we see acute minor illness visits for sore throat, bladder infection, bronchitis, certain rashes. We also do lots of vaccinations, things for travel vaccines, flu shots during the flu season.

VARNEY: If there's a waiting line, patients can take a pager with them and walk around the store filling up their shopping cart. When the pager beeps, they head back to the clinic.

A menu of services and prices are listed on the wall in the waiting room: $59 for a strep test, $38 for a cholesterol screening. And since Longs staffs a pharmacy, if they want patients can fill their prescriptions about ten paces away.

Minute clinics are still a novel retail concept in the U.S. Few Americans have even seen one. But investors are betting these clinics will sprout up like Starbucks over the next few years.

Tom Salemi, editor of the Venture Capital Analyst Newsletter on Healthcare, says the clinics are cheaper to run than doctor's offices, urgent care centers, and ERs, because they have lower labor, equipment, and billing costs.

TOM SALEMI: The combination of the lower overhead, the lower salary, and the opportunity to really tap into a steady flow of foot traffic could make these very profitable enterprises.

VARNEY: Salemi says investors see store-based clinics as a natural evolution in healthcare delivery.

SALEMI: The larger theme that they're following is consumer driven healthcare, which is the idea that patients want to have more control over their healthcare and over their healthcare dollars.

VARNEY: That's because, as health insurance costs rise, employers are forcing workers to pay higher deductibles and premiums. Investors, says Salemi, are betting those strapped workers will turn to store-based clinics for their lower prices.

Insurers like the retail clinics for the same reason. They can save 30 to 80 percent off the cost of an urgent care, ER, or doctor's visit. In some cases, insurance companies will waive co-pays for customers who take their infected bladder to their closest Wal-Mart.

But physicians are more apprehensive. The American Medical Association recently passed guidelines that call on store-based clinics to offer only limited services and encourage patients to keep up with their primary care physician.

That's the model the stores are following anyway, says medical doctor Arnold Milstein, a well-known expert on managed care. Milstein says, while storefront clinics won't solve the country's current healthcare crisis, they do fill a need currently unmet by established medical providers.

ARNOLD MILSTEIN: It may turn out that you can more efficiently address the full range of patients' non-hospital needs with seven or six or five different discreet levels of care. And we're just at the beginning of, through trial and error, exploring what levels would be useful to the customer, at prices that the customer would be willing to afford.

VARNEY: Whether these store-based health clinics survive will depend on whether they can pay their rent for their highly competitive floor space. Chains like Walgreen's and Wal-Mart expect the clinics to drive up sales at the cash register and pharmacy counter. If they don't, the retailers will look for other renters who can.

For NPR News, I'm Sarah Varney in San Francisco.

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