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Coming to a Retailer Near You: Health Clinics

Staffed by nurse practitioners, they're designed to treat routine problems

SATURDAY, March 18, 2006 (HealthDay News) -- Running low on cookie dough? Got your eye on home improvement supplies? Yet also keen on the flu vaccine?

Not to worry. Increasingly, major American merchandisers are blazing new power-shopping trails by bringing health care and hardware together under one roof, partnering with health-clinic chains to provide routine medical services in a mall-like setting.

This retail health care trend -- led by conglomerates such as Wal-Mart and Target; national pharmacy chains like Brooks-Eckerd, Rite Aid, Osco Drug and CVS; and even regional grocers such as Albertson's -- is already well under way.

For both logistical and legal reasons, the retailers do not own, operate or directly profit from the clinics that open on their premises.

Instead, outside medical providers -- including InterFit Health Services (operating the "RediClinic" chain), Solantic, Quick Quality Care, MinuteClinic, and Take Care Health Care Systems -- rent in-store space from their brand-name landlords.

Such independent clinics -- now operating in states like Arkansas, Florida, Georgia, Indiana, Maryland, Minnesota, New York, North Carolina, Oklahoma, Rhode Island, Tennessee and Texas -- typically charge a $25 to $60 up-front fee (only some clinics take insurance) to address a limited range of 25 to 30 acute medical conditions.

Most offer standard care for common ailments -- such as allergies; bronchitis; colds; flu; eye, ear, skin and sinus infections; headaches and gastrointestinal issues -- on an appointment-free basis.

Preventative care needs are also covered, such as blood pressure, cholesterol and body fat exams; vaccinations; physicals; weight management; asthma and diabetes testing; and prostate cancer and heart disease screenings.

Both retailers and health-care tenants say the clinic-within-a-store concept can be a win-win for everyone.

"We're a very customer-focused company, and they're so very busy, and this will just add one more thing on their shopping list that they can do," said Sharon Weber, a spokeswoman for Wal-Mart, the world's largest retailer with more than 3,600 stores in the United States alone.

"And these facilities will be open the same hours as our pharmacies," she added. "This means including Sundays. So when Junior needs a physical for the football or basketball team, the family can drop by the Wal-Mart on a Sunday afternoon and get that taken care of."

This ease-of-use approach has the potential to reshape the American medical landscape by establishing a store -- rather than a doctor's office -- as a patient's first point of medical contact.

And therein lies the rub. Many physicians' groups have expressed concern that not only are patients not being cared for in a doctor's office, but they are -- in most instances -- not being cared for by doctors at all.

With the exception of the Solantic organization, which staffs all its clinics with on-site board-certified physicians, clinics are typically operated by registered nurse practitioners and physician assistants -- with physician advice limited to phone consultation.

"There's certainly no place for these clinics in complicated diagnoses, long-term management, or even a second visit for the same problem," said Dr. Larry Fields, president of the American Academy of Family Physicians. "Certainly, if any of these situations arise, patients should be sent to a physician," he stated.

"It's not a solution, or even a part of the solution, for a lack of insurance," Fields added. "In most cases, for what these places will be charging, you can see a family physician for the same problem. But, of course, these clinics are going to be open nights and weekends when the doctor's office is not open. So it's a convenience factor."

Michael Howe, chief executive officer of Minneapolis-based MinuteClinic, which currently operates 51 clinics across the United States, agrees with Fields that in-store clinics are best viewed as a convenient supplement to, rather than a replacement for, the medical establishment.

"We make it very clear to our patients that this is not a medical home," he said. "The medical home is a critical part of managing their health on an ongoing basis. We gather a list of primary-care providers in the area who are accepting new patients, and we actually are involved in establishing medical homes for our patients outside of MinuteClinic.

"There is resistance to change," Howe added. "But as we move to more consumer-managed health care, you're going to see more and more the role that these retail-based health clinics will play."

More information

To learn more, visit the California HealthCare Foundation.

SOURCES: Sharon Weber, spokeswoman, Wal-Mart, Bentonville, Ark.; Larry Fields, M.D., president, American Academy of Family Physicians; Michael Howe, chief executive officer, MinuteClinic, Minneapolis
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