Ever get knocked in the shins by a shopping cart while you’re waiting for a medical treatment? These days, it’s becoming more of a distinct possibility. Retail health clinics are quietly sprouting up around the nation at local drugstores and supermarkets, often tucked in a corner just past the mouthwash and Flintstones Vitamins.

With the battered economy putting more pressure on people’s ability to cover health costs, and the ranks of primary-care physicians dwindling, analysts say these clinics could become a nifty niche for U.S. drugstores (CVS pharmacy, Walgreens), supermarkets (Kroger, Cub Foods) and big-box chains (Wal-Mart, Target), which have shoehorned about 1,100 of them into stores. Indeed, while their growth has slowed lately, the number of clinics shot up tenfold between 2006 and 2008 alone, drawing nearly four times as many customers over the same time period.

One major drawing card, of course, is price: They’re cheaper than doctors. (A handful of store-based clinics are staffed by physicians; more typically, it’s nurse-practitioners, masters-educated nurses with the ability in most states to write prescriptions.) The Deloitte Center for Health Solutions recently found that a typical clinic visit costs between $50 and $75, compared with $55 to $250 for a physician. One clinic even recently announced that it would waive sick-visit fees through 2009 for anyone who can prove that they are both unemployed and uninsured.

The main reason people go this route, though, is to save time. With names like MinuteClinic and Curaquick, these facilities promise vaccines, simple screenings and treatment for routine illnesses, like ear infections or pinkeye, with Jiffy Lube speed and convenience. In fact, while most doctors still live by the 9-to-5 credo, retail clinics offer evening and weekend hours that work better with Americans’ hectic schedules. And most take major insurance.

Still, despite promises of shorter waits, some clinics can have long lines or such strict treatment limitations that patients often leave frustrated. Physicians have raised concerns about whether store clinicians can know enough about their patients’ medical histories with such brief contact, especially those with multiple chronic conditions, like diabetes and depression.

And with only about half of U.S. in-store clinics currently profitable—and some drug chains deriving nearly 70 percent of their revenue from the pharmacy counter—critics wonder whether the clinics might lean toward overprescribing meds, a charge the chains deny. CVS pharmacy’s MinuteClinics, for one, says its protocol is not to prescribe antibiotics unless a patient meets a strict list of preconditions; for a sinus infection, for instance, you’d need to have been sick with symptoms like “yellow or green drainage” for seven days and unresponsive to over-the-counter drugs.

Clinic champions, however, remain bullish. “Years from now,” says Tine Hansen-Turton, head of the Convenient Care Association, an industry trade group, “we’ll say the clinics made Americans healthier because they let patients get care earlier in their illnesses, on their schedules.” Unsure what to expect, we decided to give this new trend a tryout, shopping our own minor ailments around these minuscule medical facilities.

As we pull into the strip mall in Riverside, Conn., we have no trouble finding the large MinuteClinic sign above the CVS pharmacy entrance. But inside is another story. The clinic is stashed in a far corner of the store; even standing 10 feet away, we miss it—until the pharmacist points out a nondescript door and, next to it, a small check-in kiosk.
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Nearby, a flat-screen TV displays something we’ve never seen in a lifetime of doctor visits: a price list for the clinic’s 30-plus services. There are treatments for routine ailments like strep throat ($77), bladder infections ($67) and swimmer’s ear ($62), as well as wellness offerings like camp physicals ($59) and cholesterol screening ($45).

Checking in on a quiet weeknight around 7 p.m., we have the place to ourselves, so the nurse-practitioner ushers us right in for our flu shot. The clinic turns out to be roughly the size of a small kitchen pantry (85 square feet), with few trappings of a medical office—no visible exam table and no eye charts. Instead, there are a few plastic chairs, a supply cabinet and a desk, on which sit a computer and a bottle of hand sanitizer.

And while this location has a small sink, not every MinuteClinic does. Donna Jeskey, then operations manager for MinuteClinic’s New Jersey locations, says, “Using hand sanitizer between each visit, like our nurses do, is just as safe—if not safer—for the patient.” Still, the company says it is currently in the process of retrofitting all of its clinics with sinks.

As our nurse gives the syringe a preparatory flick, she tells us how busy she’s been, administering 50 flu shots alone the day before. Turns out, the majority of the company’s fall and winter business comes from flu shots—a service it aggressively promotes in stores with frequent loudspeaker ads and cardboard placards hanging over nearly every aisle.

To our delight, she also informs us that our insurance fully covers the $30 vaccine. “Nice insurance,” she says. “Do you work for a hedge fund?” Then she flits over to the pharmacy to chat up customers waiting for prescriptions. “I can take a look at your cold,” she offers.

At Take Care Clinics, tucked inside more than 340 Walgreens drugstores, CEO Peter Miller says the biggest challenge is long lines, sometimes stretching almost two hours at popular locations. And it turns out he isn’t kidding. Having developed a sore throat and fever the day after a major holiday, when most doctors’ offices are clamped up tight, we drive to the nearest Take Care Clinic, located on a busy commercial strip in suburban St. Louis. When we get there, the check-in kiosk announces a full two-and-a-half-hour wait.

Had we known that we could, we’d have called ahead to the company’s toll-free number to get the wait time and put our name in the queue. The company says it also staffs some clinics with a “concierge” to manage backups, but on this day there’s none in sight—just a nurse-practitioner pulling double duty. Between patients, she comes to the reception desk, takes our cell phone number and offers to call 15 minutes before she can see us (which she does). At least we don’t end up trapped with the usual collection of magazines.

Once inside the clinic, it feels like a doctor’s office. We find ourselves oddly comforted by the front-and-center exam table, the standing scale and wall-mounted blood-pressure cuff. After taking a fairly detailed history and examining us, the nurse asks what antibiotics we usually take, since we get frequent sinus infections; she then prescribes a different one, explaining that it will keep us from developing a drug resistance.

Two days later, following Take Care protocol, she calls to see how we are feeling and ask if we need additional information or a doctor referral. (The company’s clinicians get bonuses, in part, based on customer satisfaction ratings.) That follow-up is one way that, CEO Miller says, “we’re putting the patient first during every part of the process.” Of course, the company’s not above a little up-selling. Before we leave the office, the nurse suggests we consider a neti pot—one of Oprah’s favorite sinus remedies, she says. “It’s in aisle 10C.”

Source: SmartMoney