Health Care on the Run

Retail clinics save money, time and lives

Story by Jessica La Plante-Wikgren

What if visiting the doctor’s office was as convenient, affordable and carefree as visiting a beauty salon or barbershop for a haircut? Walks-in would be welcomed. The clinician or health care provider would personally greet you at the front desk or reception area with a smile. The cost would be affordable and advertised up-front. The wait-time would be minimal to non-existent; the environment would be relaxing and casual; and best of all, the location would be readily accessible, located near your favorite shopping mall, retail store or supermarket. 

In many cities throughout the United States, this patient-centered model of health care is no longer a mere figment of consumers’ imagination. Retail store “convenience clinics” are now a very real option for cost-sensitive, time-conscious patients. Minor illness and injury clinics such as ThedaCare’s FastCare, Agnesian’s EZ Care, Aurora’s QuickCare or Walgreen’s Take Care Health clinics are revolutionizing the economics and dynamics of health care delivery in northeast Wisconsin.

Offering treatment for a limited range of common illnesses and injuries at a fixed price seven days a week, retail clinics save consumers time and money while also freeing up emergency rooms to provide more specialized care to those patients who are truly in need. The model offers tangible benefits for all stakeholders – patients, employers, insurance companies, health care providers and small business owners. 

Short-term savings include reduced employee absenteeism during work hours, reduced out-of-pocket costs, and limited loss of productivity due to prompt diagnosis and treatment. Long-term savings include reduced health insurance rates for consumers and employers, as well as early detection of potentially serious, debilitating illnesses.

Quick, convenient & cost-efficient
Perhaps the most obvious benefit of retail store clinics is a clearly defined pricing structure and cost transparency. Patients with high deductibles or co-payments will sometimes procrastinate a visit to the doctor’s office for financial reasons. By charging a flat fee for all-inclusive services at a cost comparable to purchasing a new pair of jeans or a dress, retail clinics offer a low-risk option for patients who are worried about the economic consequences of seeking medical care.

At ThedaCare’s Fox Cities-based FastCare centers – housed within the Northland Mall Shopko and Darboy’s Shopko Express – patients can get high-quality health care for routine illnesses and injuries for only $39 per visit, a price that includes diagnostic tests such as throat cultures.

For many patients, “The cost (factor) is huge,” said FastCare Nurse practitioner Michelle Lehr, who practices out of the Northland Avenue site.

“The Fox Cities Community Health Center serves so much of our underserved population,” she said, adding that the discount community clinic’s caseload may result in three-week waits. “Sometimes, they send patients with acute symptoms over to us.”

From referring physicians and clinics to FastCare patients, “I’ve had such great feedback,” Lehr said. “People will say, ‘Oh my gosh, I can’t believe how fast I got in and out; I didn’t have to take off any work.’”

As health care costs climb, the ranks of the uninsured and underinsured continue to swell and include many entrepreneurs and self-employed professionals.

“We have a large population of people who are independent business persons,” Lehr said. Small business owners benefit from the convenience of retail clinics in two ways. In addition to paying low out-of-pocket costs, flexible hours is another big advantage.

“If you’re in charge of your business, you can’t just leave,” Lehr said, noting that FastCare’s walk-in clinic is open during evening hours, weekends and holidays. “Being able to come in at 8 p.m. and get taken care of and get back to work the next day is monumental.”

The most common illnesses treated at FastCare are upper respiratory tract infections, such as ear and sinus infections. Other common ailments treated at the clinic include sore throats, fevers, bronchitis, insect bites, urinary tract infections, and asthma and allergies. The clinic is able to perform basic laboratory tests on site, including cultures for strep throat and mono, pregnancy tests, and urinalysis.

A third dimension of convenience which retail clinics offer consumers is a central, easily accessible location. On a regular
basis, Lehr will encounter patients who were inspired to seek treatment on the spur of the moment for a condition they’ve suffered from for several days. Encountering an inviting, boutique clinic in one’s favorite shopping center or retail store makes a trip to the doctor’s office for an acute illness a casual affair that requires no special planning.

“I will frequently hear, ‘Gosh, I was shopping and I didn’t know you guys were here. I saw the sign so I thought I’d stop in,’” Lehr said, noting that retail clinics cause minimal disruption to people’s busy schedules and daily routines. 

A balancing act
The secret of retail clinics’ success is finding the right balance between level of care and cost, said Bobby Smith, director of Growth and Support Services for ThedaCare Physicians. Retail clinics offer consumers low-priced medical services by using lean operating principles to keep overhead to a minimum.

“We keep staffing to a level that is supported by the volume of activity,” Smith said. “Most of the time, we have the facilities staffed with a nurse practitioner or physician assistant.”

Likewise, supplies and equipment are kept to a minimum by limiting the scope of the practice to certain conditions.
“We run (the clinic) as efficiently as possible,” Smith added. “If a patient is in need of an additional service, then we refer them to our primary care providers.”

ThedaCare’s two retail clinics have treated 4,500 people since the first site opened on Nov. 19, 2007 in Appleton’s Northland Mall, a testament to the clinic’s success. The clinics have averaged 18 patients per day, well above the convenience care industry’s national average of 12 patients per day.

The clinics’ target audience is cost-sensitive consumers, Smith said. For that reason, price transparency is one of FastCare’s most attractive features.

Health care is one of “the few places where consumers can go to buy a product and not know what the product is going to cost until the bill arrives,” Smith said. “There’s great work going on within ThedaCare and the health care industry to deal with that but in particular within the FastCare model.”

Patients want to know “here’s what it’s going to cost; here’s what you’re going to receive’” Smith said. “That is something I think consumers are very interested in.”

Good health, good business
Agnesian HealthCare of Fond du Lac made its debut into the retail clinic market this past July. Already, the grand opening of Agnesian’s EZ Care – located at 1107 E. Johnson St. near Festival Foods – has generated an outpouring of interest, especially within the business community.

“This is an option for (businesses) to encourage employees to seek appropriate and cost-effective health care,” said Barb Knutzen, Agnesian’s vice president of ambulatory services.

Low-cost, limited-scope retail clinics are increasing in popularity as high-deductible health care plans are becoming more commonplace, Knutzen said. Companies are promoting it to their employees as a way to access high-quality health care outside of conventional business hours and control insurance premiums by capping medical costs. In the months prior to the clinic’s debut, Agnesian received many inquires from local companies.

After two years of needs assessments and careful planning, Agnesian launched EZ Care on Fond du Lac’s east side on July 28. Since Agnesian didn’t have a presence on that side of the community, it saw the retail clinic as an opportunity to fill a unique niche in the community both in terms of geographic location and services provided.

“We’re trying to remove some of (patients’) frustrations and make certain that it is truly convenient,” Knutzen said, noting that the clinic is located “in an area where it’s easy to park; it’s easy to get in and out.” 

Retail clinics such as Agnesian EZ Care prove that convenience does not have to come at the expense of quality.

“People are seeing that this is a successful model,” Knutzen said. “When done well – when you have a type of service that is clearly defined, you can give high quality care in this setting.”

EZ Care specializes in diagnoses that are “quickly assessed and treated,” she said. Patients have the option of paying a discounted cash rate of $45 for the services or billing their insurance providers.

“When people pay cash and we don’t have to submit to insurance, that reduces overhead cost,” Knutzen said.

The big picture
More than saving time and money, greater accessibility to health care can also saves lives.

Nurse practitioner Jennifer Kainer – regional supervisor for Walgreen’s Green Bay area and Neenah Take Care clinics – has worked in convenience care settings since early 2007.

Kainer staffed one of the state’s first Take Care clinics in Milwaukee. She recalls one patient who showed up at the Milwaukee clinic with a suspicious-looking rash. The Take Care nurse practitioner referred the patient to a dermatologist for a same-day appointment. The skin lesion turned out to be melanoma, a highly aggressive form of skin cancer that is terminal in the advanced stage but curable if caught early.

By making the health care system easier to access, retail clinics play a leading role in detecting more serious conditions and connecting patients with primary care providers and specialists.

For patients without insurance or a primary care physician, “We can serve as a portal into the health system,” Kainer said. Some patients “come in for a relatively simple thing and are referred immediately for a high-risk problem. We have a very collaborative arrangement and relationship with the providers in the community.”

Retail clinics also provide health education services and limited screening. During skin cancer awareness month, nurse practitioners educated Walgreens shoppers and pharmacy customers about the ABCs of melanoma and skin cancer. School and athletic physicals, immunizations, and tuberculosis skin tests are also provided at a low cost.

“We’re ambassadors for the whole store,” Kainer said.  While people are waiting in line at the Walgreen’s pharmacy, “We’ll do general health promotion. We have a huge customer service approach to all the people that we hire.”

Although retail clinics can treat some of the most common ailments, the lack of X-ray machines and a full-scale laboratory means there are many conditions that fall outside of retail clinics’ jurisdiction. The clinics cannot diagnose and treat patients younger than 18 months old.

Many retail clinics have turned that seeming constraint into an opportunity to provide superior customer service. Through the use of electronic medical records, diligent follow-up and relationship-building with other providers, retail clinics can serve as a gateway to the entire medical system, connecting patients with an integrated provider network that puts high-quality health care within everyone’s reach.

“We take pride in being there for the patient and doing the right thing for the patient and being approachable to the community,” Kainer said.

Jessica La Plante-Wikgren is a freelance writer based out of Green Bay. She previously worked as a feature writer and staff reporter for The Door County Advocate and the Green Bay News-Chronicle. La Plante-Wikgren can be reached by email at jlaplante@centurytel.net.