Retailer-based clinics rare in state
Posted on Sunday, October 5, 2008
ROGERS — Inside the Wal-Mart Supercenter in south Rogers, the staff at the RediClinic at the front of the store is preparing for the flu season — shots for the well, treatment for the sick — after finishing up the busy back-toschool sports physical examinations season.
Judy Tevebaugh, nurse practitioner and clinic manager, expects the patient load to jump to about 60 a day, up from 40 who typically come to the clinic for treatment of common ailments such as sore throats, earaches and sinus infections, as well as screenings for blood sugar, cholesterol and allergies.
The walk-in, no-appointmentneeded clinic with two examination rooms is part of a growing trend of retail store-based clinics providing quick, inexpensive treatment for those who don’t have a primary-care doctor or don’t want to wait for an appointment.
Tevebaugh, working this day with fellow nurse practitioner Frank Hefner, is quick to point out the limits of the clinic’s role.
“Our job is not to take the place of primary care,” she said.
Instead, she said, the clinic is set up to provide quick care to those who may want to seek treatment after normal business hours or on weekends, or simply haven’t established a relationship with a primary-care doctor.
Retail clinics are back on a growth trend after a brief pause in expansion early in the summer. The number of retail clinics across the nation stood at 1, 066 as of Wednesday, up 38 from a month earlier, said Tom Charland, who runs Merchant Medicine consulting and market data service in suburban Minneapolis.
“I think we’re going to see another sharp increase, and typically we see the sharpest increases in the fall,” he said.
From a clinic and patient standpoint, Arkansas is only a bit player with two retail clinics in Northwest Arkansas Wal-Mart stores and one in a USA Drug store in Pine Bluff. But the state also is home to one of the champions of the format, Wal-Mart Stores Inc., which says it is com- mitted to expanding the number of clinics despite setbacks as partners in some markets folded. Wal-Mart’s clinic count stood at 43 last week, barely more than 10 percent of the 400 the Bentonville-based retailer says it hopes to have open by 2010. “We’re still committed to our goals,” spokesman Christi Gallagher said.
ST. VINCENT PACT In February, Wal-Mart and St. Vincent Health System in Little Rock announced plans to open, in April, four co-branded clinics under the name The Clinic at Wal-Mart. Though the partners missed that target, they say they’re still committed to the endeavor. “The contract negotiations have been completed, and we’re finalizing the legal documents now,” Alan Winkler, St. Vincent’s vice president for clinic operations, said recently in an e-mail. “I am anticipating execution of the contract within the next few weeks, with construction dates set shortly thereafter. Wal-Mart has been extraordinarily collaborative in our joint efforts at establishing retail clinics in central Arkansas.” Wal-Mart and partners Piedmont Hospital and RediClinic have opened two co-branded clinics in Atlanta, the other project Wal-Mart announced in February, Gallagher said, and the company expects the Little Rock effort to succeed.
“We really feel like there’s a strong connection that those hospitals and health systems have with their local communities,” she said.
Plans for clinics in three Little Rock-area USA Drug stores fell through when the company’s partner in the project, MedBasics of Irving, Texas, filed for bankruptcy.
Web Golinkin, chief executive officer of Houston-based Redi-Clinic LLC, said such setbacks are not surprising, given that it’s a new and quickly growing healthcare format.
“Even though some small companies have failed — and that’s to be expected in a new industry — the number of clinics continue to grow,” said Golinkin, who also serves as president of the Convenient Care Association, a retail clinic trade group.
“We’re one of the few healthcare providers today that is increasing access and reducing costs in a way that consumers are very receptive to,” he said.
PROGRESS SLOWS According to Charland’s data, the retail clinic business is dominated by two national pharmacy chains: CVS Caremark Corp. with 535 MinuteClinic locations, and Walgreen Co. with 245 TakeCare clinics. That’s 73 percent of the total retail clinics. Wal-Mart trails far behind with 43, and its clinic count shrank with the collapse of former partner SmartCare in Colorado, which pulled out of 15 stores when it lost its financial backing. CVS does not operate in Arkansas. Walgreen has 40 Arkansas stores, but none with clinics. Retail clinics don’t necessarily turn a profit for the host retailers on their own, Charland said, but they likely draw additional business — akin to loss leaders used by other retailers to attract customers. “Eventually, they see these as profitable on their own,” he said. Wal-Mart, he said, is struggling with the local-hospital connection in part because few health-care providers, if any, use the eClinicalWorks platform for electronic health records that the company requires. That means building an interface, a costly proposition, Charland said. “The bottom line is this hospital initiative is moving much more slowly than they anticipated,” he said.
BRAVE NEW WORLD Paul Keckley, executive director of the Deloitte Center for Health Solutions research group in Washington, foresees the number of retail clinics doubling over the next two years as new entrants learn from the successes and failures of those who pioneered the format. “It’s obviously not a fad, it is a trend and it’s a growth trend,” he said. Deloitte’s 2008 survey of health-care consumers found that one in six had already tried a retail clinic and one in three were receptive to the idea. Common characteristics among those who favored the clinics: better-than-average health; less trusting of doctors and hospitals; and more suspicious of medications that doctors prescribe. As the retail model evolves, Keckley said, companies such as Wal-Mart are well-positioned to use Web-based tools to help clinic patients stay on track with their treatment via reminders and alerts. He said studies have shown that only one in three patients take medications as directed, which might be improved with electronic messages. Or patients might be advised that it’s time to renew maintenance drugs that haven’t been refilled. “This whole area of medication management is potentially a sweet spot for retail clinics as an extension of their service line,” he said. Taken even further, Keckley said, supermarket retailers with clinics might have an upper hand over doctors who rely on what patients tell them about issues such as their eating habits. Food retailers could check customers ’ grocery purchases against their medical records — a prospect sure to raise privacy concerns. Government regulators and policymakers already are raising those questions, he said, adding, “That caution is necessary.” To contact this reporter: spainter@arkansasonline. com
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