The future of health care clinics:

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Clinics like this one are opening in retail centers around the country.

Wal-Mart shopping list:
milk
Band Aids
shampoo
cholesterol check-up
A number of companies are pushing to put health care clinics inside retail stores.
MinuteClinic, RediClinic, Take Care, The Little Clinic and SmartCare are among those companies creating “convenient care” clinics.
There were 250 convenient care clinics in the United States at the end of 2006, according to the Convenient Care Association. And despite questions about the safety of the clinics, the numbers are predicted to reach 700 by the end of 2007.
Most of the clinics are staffed by nurse practitioners, who usually are licensed to diagnose ailments and prescribe medication under American Academy of Family Physicians standards.
Treatments include minor acute illnesses and minor acute injuries such as a sore throat, cough or cold, or a sprained wrist or ankle. The clinics also offer basic health services such as flu shots, vaccines, school and employment physicals and cholesterol screenings.
“We do lab work and immunizations and health prevention, which is really a key focus for nurse practitioners,” said Rebeca Imgrund, chief nurse practitioner of Denver-based SmartCare Family Medical Centers.
There are 15 in-store clinics in Colorado, all inside Wal-Marts, but none are located in Colorado Springs.
“I can say that we would very much like to be open in the Colorado Springs market and we are working toward that end right now,” said Lawrence Hay, chief business development officer and president of Rocky Mountain Region for SmartCare.
“We are not exclusive to Wal-Mart,” he said. “We have announced on our Web site an agreement with Kroger.”
Take Care Health Systems was acquired by Walgreens in May. All but 10 of its locations are inside Walgreens’ drugstores. The company has plans for 400 by the end of 2008.
“Prior to the acquisition, our contracts with the retailers determined our expansion plans,” said Lauren Tierney, Take Care Health Systems spokeswoman.
Hay said the clinics have become more than an after-hours or emergency clinics because a large part of what they do is health awareness education.
The second customer they had was a 45-year-old female who said she hadn’t been to the doctor since she was a kid. Blood tests and screenings found that her cholesterol was high.
“We helped her find a medical home in the community,” Hay said.
Imgrund said her company establishes a relationship with several family care providers in an area and has a referral program if a patient doesn’t have a primary care provider.
“We always want to make sure that their primary care provider is involved in their care, that is why we call it convenient care compliment,” she said.
Mary Furman, a mother of two sets of twins, ages 7 and 9, described her recent visit to a SmartCare clinic in Wal-Mart as convenient.
“All four – and me – came down with strep one day,” she said. “I lived at that clinic for a week. The school is three miles away and it is right between my house and the school. It is about 30 minutes to get to my pediatrician.”
But, the clinic isn’t replacing Furman’s regular visits to the doctor’s office.
“It is not taking over my pediatrician’s job in my mind,” she said.
Imgrund said they use an out-of-scope referral. For example, for abdominal pain they would refer the person to an emergency room or for other pains, perhaps an ear/nose/throat doctor or a dentist.
“We’ve had to call 911 on several occasions which went very smoothly,” she said. “We’ve had fingers lacerated, and that’s more than we could take care of.”
Only children 12 months and older are treated at the clinics.
Visitors to the centers are treated as guests instead of patients. The typical wait time is about 15 minutes, she said, and if it is longer, the guest can take a pager around while shopping that will light up and vibrate.
SmartCare’s average visit costs $65. Hay said that if you went to an emergency room for an illness such as strep throat, the price in Colorado averages $325. An urgent care visit costs about $175.
SmartCare accepts insurance from more than 30 companies, as well as Medicare and Medicaid.
“The co-pay is the same as an office visit, so it would have cost me the same if I would have waited,” Furman said.
Hay said the clinics don’t have the overhead costs such as X-ray machines, so they are able to keep costs relatively low.
Joan.Johnson@csbj.com