OMAHA, Neb. — Fearing bad news as her son suffered with a cough, aches and a sore throat, Donna Bultez found help in the most common of places — her neighborhood grocery store.
Just feet from the beeping cash registers, a few steps behind the frosted-glass door, Bultez was relieved to find that her son Trevor Belmont wasn’t suffering from strep throat. That she saved money by avoiding a trip to the emergency room was good news, too.
More and more stores — from small-scale chains like Bultez’ local Hy-Vee to megamarkets like Wal-Mart and Target — have started trial runs with in-store medical clinics.
The concept is so new that analysts weren’t sure how many clinics currently exist. They said retailers appear to be trying clinics as a way to increase foot traffic in their stores, rather than rely on the clinics as an entirely new revenue stream.
Except for a 20-minute wait, Trevor’s visit to the Hy-Vee clinic seemed convenient at every turn. His pediatrician was out of his office this day and, without the walk-in service, Bultez might have considered an expensive trip to an emergency room to seek treatment.
“This cost and convenience trend is coming to a head and that’s what is driving this trend. My prediction is that it will move quite rapidly,” said Matt Eyring, managing director of Innosight, a Watertown, Mass., consulting firm.
The business model is simple — a medical clinic operated by an outside company, and generally staffed by nurses or physician assistants, offers a limited range of basic tests and treatments at a lower cost than a doctor’s office.
Case invested heavily in Revolution Health Group, a company that, among other things, is buying stakes in clinic operators. Its backers and board include former Secretary of State Colin Powell, former Hewlett-Packard CEO Carly Fiorina and former Fannie Mae Chairman Franklin Raines.
Seattle-based health care analyst Kathleen O’Connor said it’s difficult to say how many in-store clinics exist because the trend is so new and it is not clear whether anyone is tracking it. These clinics are different from the stand-alone sites sometimes referred to as a “doc in a box.”
Emphasis on convenience
The in-store clinics hope to evoke the idea of convenience with their very names — Quick Care at the Omaha Hy-Vee; RediClinic, controlled by Revolution and one of four providers for Wal-Mart; and MinuteClinic, which has 70 clinics in CVS pharmacies, Target Stores and Cub Foods supermarkets.
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Patients never need an appointment and can drop by after regular business hours. Many times, a patient might be heading to the store anyway for groceries and find it convenient to ask about that nagging cough or persistent headache.
Bultez knew her visit with Trevor, 9, was all about convenience.
“I will stay with my doctor. But if this works out good, I’d use it for a second alternative,” said Bultez, 35, who stopped in the households aisle to buy laundry detergent while at the Hy-Vee.
Typically run by an outside source — in Omaha’s case, a state-wide health group called Alegent — the clinics usually offer diagnoses and treatment for a predefined set of minor illnesses, from ear infections to strep throat to bladder infections. Most offer vaccinations.
Often, the price for care is listed on a message board, much like today’s special on carrots or tomatoes. Quick Care will treat the flu or mononucleosis for $53. Treatment for bronchitis, colds and seasonal allergies costs $45.
The MinuteClinic will treat cold sores, ear infections and minor burns for $49 in Minneapolis, but in Atlanta those ailments will be treated for $59.
The RediClinic at Wal-Marts in Arkansas and Oklahoma and others, mainly in Texas, will not accept copays but will provide a detailed receipt for submission to insurance providers. Others readily accept insurance plans and will charge only the co-payment.
Eyring said the clinics can operate at a lower cost to patients because there is less overhead for medical office equipment. Cotton swabs, tongue depressors and simple lab work are all that’s needed to diagnose strep throat.
That low overhead, of course, means there are limits on what the clinics can do.
“The biggest hazard is that people could get the impression that these things could be a usual source of care, which they can’t be,” said Dr. Larry S. Fields, the president of the American Academy of Family Practitioners.
Fields, who practices in Ashland, Ky., said clinics are a positive step because they expand access — as long as the clinics can tell the difference between a minor ailment and something that needs a doctor’s attention.
He said many of his patients have gone to walk-in clinics but still wind up with him because they don’t sense a continuity of care. “They realize there’s not that history. They’re not familiar,” he said.
But for the quick fix, clinics can generally see patients much quicker at a lower cost, Eyring said. When a patient’s only alternatives are expensive visits to a doctor or an emergency room, he might forgo treatment altogether.
So far, the clinics are run mainly by local and regional startup companies. Kroger and CVS are testing clinics in select markets, as are large retailers Wal-Mart and Target.
“Wal-Mart is the kind of player that has the power to do it in a big way if it pans out for them and their test mode is successful,” said Sandra J. Skrovan, head of food, drug and mass retailing research at consultant Retail Forward Inc. in Columbus, Ohio.
Eight Wal-Mart stores have set up clinics since September and another four are scheduled to open by mid-March.
“We’ll certainly grow this business if it makes sense,” Wal-Mart spokeswoman Sharon Weber said. “I can tell you the customers have been very pleased.”
With the number of Americans without health insurance at 45.8 million in 2004, the clinics hope to reach consumers who have to pay out of pocket for doctor’s visits — even for simple problems.
“Is this a trend that is here to stay? Yes,” Eyring said.
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