New Kind of Clinic in Supermarkets, Stores Offering Swift Treatment for Simple Illnesses

When Ann Theisen's 6-year-old daughter, Hannah, had a sore throat, she didn't take the little girl to the family doctor. Instead, she went to the Cub Foods store down the street from her house, lured by the prospect of faster treatment at a MinuteClinic tucked into a corner of the supermarket. Within about 15 minutes -- no appointment necessary -- they were seen and had the results of a rapid strep test: negative. "It's the convenience factor," Theisen said.

MinuteClinic, based in Minneapolis, is on the leading edge of a new kind of clinic that offers swift treatment for simple illnesses. MinuteClinic operates in 22 locations in the Twin Cities and Baltimore, most of them in Target Corp., the nation's second-largest discount department store chain; Cub Foods, operated by grocery retailer Supervalu Inc.; and CVS Corp. stores. The company has big plans to open more than 80 clinics in 12 major metropolitan areas east of the Rockies by year's end, and to push westward next year. "The demand for this is so amazingly consistent," said chief executive Michael Howe, the former Arby's head who joined the company earlier this month. "It's really something we've all been looking for -- making health care a little more convenient and affordable for everyone."

At the quick-service clinics, nurse practitioners diagnose and treat strep throat, pink eye, bronchitis and other common ailments. Howe and other MinuteClinic executives say their business is to health care what ATMs are to banks -- making ordinary transactions easier while freeing up traditional providers for more complicated cases. It is a low-tech, low-cost innovation that could catch on, said Matt Eyring of Innosight, a consulting company that tracks health care trends. The average MinuteClinic visit does not require an appointment and costs the patient less than $50, Howe said. The cost can be shaved down to the same co-payment as a doctor visit under several major health insurance plans. "This is something that makes medicine much more available to consumers," Eyring said. "This kind of service will spread."

MinuteClinic was founded five years ago. Its competitors include MediMin, which operates in the Cleveland area, FastCare in Louisville, Ky., and QuickClinic in Akron, Ohio. Howe would not disclose MinuteClinic's annual sales or profit. Each clinic treats an average of 30 to 35 patients a day, he said. More than three-quarters of those who visit the clinics have health insurance. Major plans -- including Blue Cross Blue Shield, UnitedHealth Group and Medicare -- include MinuteClinics in their networks in the Twin Cities.

Some employers have lowered insurance co-payments for MinuteClinic visits because they cost less than traditional doctor visits, Howe said. And some companies -- including electronics retailer Best Buy Co., Carlson Cos. and medical device maker Guidant Corp. -- host MinuteClinic operations at their corporate locations in the Twin Cities.

The American Medical Association and the American Hospital Association are wary of the trend. What is best for patients, they say, is an ongoing relationship with a doctor. "We don't want to see nursing care substituted for physician care," said Dr. Edward Hill, president-elect of the AMA. "This type of clinic might not lend itself very well for continuity."

But Mai Pham, a senior researcher at the nonpartisan Center for Studying Health System Change, said the clinics could provide a better alternative for patients who might otherwise go to an emergency room for care or skip it altogether. "It's clearly meeting a market need, but there's also concerns about why it is there is such a need," Pham said.

Howe said MinuteClinics limit their work to common illnesses and are quick to send patients to emergency rooms or back to their primary doctors if other symptoms turn up. The clinics also pass records on to patients' doctors and help those who do not have a physician find one. Strep tests are the most common procedure performed at the clinics. That's what Theisen, a nurse who lives in the Minneapolis suburb of Maple Grove, wanted for her daughter in a hurry. "If we would have gone to our doctor, it would take an hour longer," she said.

The trip to the MinuteClinic cost Theisen an insurance co-payment -- the same amount she would have paid to see their regular doctor. "I grocery-shopped while I was waiting," she said.


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