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Health system reacts to retail clinics

March 29, 2009|By HEATHER KEELS

HAGERSTOWN -- You already can go to Wal-Mart for your groceries, your photos, your oil change and your eye exam.

What if you could get your sore throat examined or your child's earache diagnosed, too?

That's the concept behind a new health-care trend that has spread across the country in recent years at retailers like Wal-Mart, Target and CVS, and it has local health-care experts sitting up and taking note.

At a recent community forum, Washington County Health System Vice President Michael Zampelli warned that while retail health clinics might be convenient, they have drawbacks, too.

That's why Washington County Health System is trying to head off the trend by adapting its existing walk-in urgent-care facilities to mimic the ultraconvenient retail clinic model, Zampelli said.

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"We're not a Wal-Mart and we're not a Target, but we are a comprehensive health system, so we actually have a leg up, and we can do this better than someone else could," he said.

The trend has not reached Washington County yet, but two of the leading brands, CVS' Minute Clinic and Target's Target Clinic, are already thriving in Maryland communities as close as Howard and Montgomery counties.

The clinics are typically open for extended hours, seven days a week, and staffed by nurse practitioners, who see patients on a first-come, first-served basis for common ailments such as bladder infections, pink eye and strep throat. The nurse practitioners can write prescriptions that can then be filled at a pharmacy in the same store.

The drawback, Zampelli said, is that the clinics are not integrated into the rest of the health system, so the results don't automatically end up at a patient's doctor's office, or in his or her prescription records, and the clinic might not get the patient's full medical history.

Brent Burkhardt, a spokesman for Minute Clinic, said the clinic does take an extensive medical history from every patient on the first visit, and offers at the end of each visit to send the record to the patient's doctor's office. In addition, Minute Clinic keeps an electronic patient history that can be accessed from any Minute Clinic location nationwide, he said.

"I don't think many other health-care providers could do that," Burkhardt said.

Studies have shown that the retail flavor, with prices posted upfront (Flu, $94; Mono, $69) is comforting to people who conduct most of their daily transactions in a retail environment, Zampelli said.

In contrast, many people associate traditional health care with appointments, long waits and an illness-related atmosphere, he said.

A survey of users of Washington County's urgent-care clinics revealed many of them choose urgent care for the same reasons that consumers are attracted to retail clinics elsewhere, Zampelli said.

Urgent care was set up several years ago to take pressure off Washington County Hospital's emergency room, but the survey revealed many people are using it instead of a primary-care physician because they prefer walk-in care to scheduling appointments.

To better accommodate that trend, the health system recently doubled its staffing, adding more nurse practitioners, Zampelli said.

The goal is to meet the region's demand for convenient walk-in care before the retail clinic trend arrives, Zampelli said.

However, spokespeople for Minute Clinic, Target and Wal-Mart all said their brands have no immediate plans to expand into the Washington County area.

Minute Clinic is currently focusing its clinics in major metropolitan markets, Burkhardt said. It has about 500 locations in 25 states across the country.

Target has clinics in Minnesota and Maryland, and Wal-Mart has about a half-dozen independent clinics at stores in eight states.

Minute Clinic projects it will have 2,500 locations nationwide over the next several years, while Wal-Mart is projecting 2,000 clinics by 2014, Zampelli said.

Zampelli noted that as the retail market shrinks, health care is a natural evolution for retail chains, because the health care market is growing.

"So it could be that someday, we may be going to Wal-Mart for our MRIs, our CTs and our cataract surgeries, our nurse practitioners," he said. "I don't know about you, but to me, that's a scary thought."

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