Medical clinics inside retail stores opening in state

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Published: December 11,2006

Before long it may be routine to get a flu shot, a strep throat culture or other medical procedures while picking up a loaf of bread or shopping for new jeans. In-store clinics are the latest trend in healthcare and a possible solution for time-stretched consumers and the uninsured and under-insured.

Staffed by nurse practitioners, the clinics are opening in discount retail chains, supermarkets and drug stores across the country. They offer primary-care services that include immunizations, routine pediatric care, blood screenings and treatment for urinary tract, ear and sinus infections — all without long waiting room time. In most cases, patients can shop while waiting their turn and are summoned by beepers given to them when they register.

Mississippi’s first in-store clinic was opened by CheckUps in a Wal-Mart store in Forest six weeks ago. Four more are on the way in stores in Jackson, Madison, Pearl and Brookhaven in early 2007.

According to CheckUps chief executive officer Jack Tawil, the retail-based, non-emergency walk-in medical facility will have 23 clinics spread across four states by the end of January 2007. The states are Alabama, Florida, Mississippi and Louisiana.

“We are focusing on those four for now,” he said. “We did research and found there are quite a few residents using emergency rooms for primary care in this region. There are not enough physicians, especially in rural areas, and residents are not able to get them on weekends.”

Tawil feels residents are looking for quality healthcare and CheckUps may be a solution that offers time and cost advantages. With in-store clinics taking care of sore throats and other minor ailments, busy emergency room staffs can use their time for real traumas.

He said Wal-Mart stores were chosen because of their appeal to affordable living. “Many of their shoppers are under and uninsured and need healthcare,” he said. “Also, people living around them consider them town centers and some go in to find out what’s going on.”

CheckUps is in negotiations with other major retail chains for more possible locations, including some in Mississippi. The concept is spreading to Target, Walgreens and CVS in some areas although Tawil says CheckUps is not talking with pharmacies at this time.

Other in-store medical providers opening around the country include RediClinic, MedPoint Express and Solantic. Like CheckUps, RediClinic and MedPoint Express rely on nurse practitioners to treat patients while Solantic employs physicians.

Acceptance of the in-store clinic in Forest started slowly but is moving. Tawil expects it to grow, based on data from clinics in other states. “The major factor coming in is convenience,” he said. “They’re received well and we know new locations will improve. Acceptance across the board is good. The elderly and lower income especially like it.”

The biggest factors are saving time and money. Methods of payment include cash, private insurance, Medicare and Medicaid.

“The cost is about one-tenth of the cost of an emergency room visit,” Tawil said. “All costs are posted on a board. You never see that in a doctor’s office. People know up front what it will cost and that’s comforting at all income levels.”

Asked about any negative feedback from the medical industry, Tawil said healthcare providers are always fearful of anything new.

“They can consider in-store clinics an industry disrupter,” he said. “Family doctors are dwindling, especially in these four states. We’re looking at that and at the training of nurse practitioners. Initially, there was quite a bit of resistance but they recognize the system needs help, and are recognizing this is a way to help the problem.”

While each clinic is staffed by nurse practitioners, each location has a local overseeing physician because Tawil says it’s important to have that connection. When needed, nurse practitioners will refer patients to local physicians.

Nurse practitioners are authorized to write prescriptions, including those for controlled substances. “They’ve made great advances and have federal Drug Enforcement Agency numbers, but as a company we don’t want to be involved in controlled substances and so they won’t write prescriptions for those,” Tawil said.

He considers nurses great caregivers because they’re trained in total care and will spend time explaining things to patients. It’s being proven that people like the convenience of combining healthcare with shopping.

“I strongly believe in what we’re doing and expect it to continue to grow,” he added. “We’re sure it’s the wave of the future. Combining retail with nurse practitioners and a lack of physicians is part of the solution of not having enough physicians to support the population.”

The most requested services at clinics are flu shots, blood pressure checkups and treatment for the common cold. The clinics also have a needle-free injection system, a technology that injects medications without using a needle to penetrate the muscle.

Ken Scalia is director of operations for CheckUps and is responsible for getting all the clinics up and running. He says the biggest challenge is following certain guidelines of a business within a business.

“Because we’re doing medical service, we must work within the scope of practice, responsible for liability and must provide for that,” he said. “We’re positioning the clinics as an alternative to traditional healthcare. The traditional is not always possible in rural areas. We’re providing a level of access that is in no way replacing what a family doctor does.”

The clinics have liability insurance coverage for the individual nurses, the company and each location.
Scalia says a lot of large companies are looking at the new concept and he expects retail medicine to become bigger. A licensed respiratory therapist who’s spent 35 years in healthcare, he says the only downside would be if walk-in clinics become something they’re not designed to be.

“They’re designed for basic things and need to stay within the limits of what they’re capable of providing,” he said.

Contact MBJ contributing Lynn Lofton at llofton656@aol.com.

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