Galveston County Daily News, Jan. 27, 2008
Dr. Brian Zachariah, UTMB emergency services director, is quoted in this article about the growing popularity of in-store health care clinics.
Clinics a fast fix when you're sick
By Sara McDonald
The Daily News
Published January 27, 2008
Aniccia Quinonez was aching, feverish and tired. Sitting in a stiff chair for hours at the doctor's office was the last thing she felt like doing after work Thursday, especially when Quinonez is one of the 5 million Texans without health insurance.
Instead, she went to the grocery store. Less than an hour later, she left with a diagnosis - the flu - and a filled prescription to help her get well.
"It was really easy," she said. "This is the first time I've been here, but it's fast."
The health clinic Quinonez visited, the RediClinic inside the H-E-B grocery store at 2955 Gulf Freeway S. in League City, was the first in the area to offer a quick-stop primary care visit for a fraction of what most doctor's offices charge.
But industry experts say it won't be the last.
Growing Presence
There are 800 in-store clinics nationwide, a number that's expected to grow to 5,000 by 2012, according to the Convenient Care Association, an organization of national in-store clinics.
The clinics are showing up in grocery stores, pharmacies and supermarkets such as Wal-Mart and Target. Recently, both Walgreens and CVS pharmacies' in-store clinics announced plans to break into the Houston-area market.
The reason for the popularity is simple, RediClinic spokesman Brad Petak said.
"What consumers want is eventually going to happen," he said.
And judging by accounts from customers, the clinics are a dream come true compared to crowded doctor's offices.
Patient's visits at RediClinic last about 15 minutes, cost $69 without insurance and don't require an appointment. Other in-store clinics that haven't yet spread here, such as Dallas-based MedBasic clinics, cost $49.
In Texas, the clinics are required to have a doctor on site 20 percent of the time and review a portion of patient charts. Most clinics also partner with a major hospital that oversees the medical care. RediClinic's Houston-area locations partner with Memorial Hermann hospitals.
Most visits are handled by a nurse practitioner, which is one reason some in the medical field are wary.
Health Care Concerns
The clinics only treat routine illnesses such as strep throat, the flu and bronchitis, said Ann Maag, the clinic manager of the League City RediClinic.
That kind of limitation can lead to patients being expected to diagnose themselves, said Dr. Brian Zachariah, emergency services director at the University of Texas Medical Branch in Galveston.
"It depends on the circumstances," he said. "If you have pneumonia and you're young, healthy and have a bad cough, it's probably OK. If you're elderly and have underlying medical issues, you don't want to go to a clinic.
"One of the downsides is you ask the patient to sort of triage themself."
Zachariah said patients with severe pain, chest pains or injuries should still go to an emergency room.
"These places are really better for minor illnesses than minor injuries," he said.
It also can be difficult for clinic staff to make diagnoses without a complete medical history, said Dr. Nate Rickels, a professor at Northeastern University in Boston.
"It's really best for physicians to take care of them because they know the patient the most," he said.
"A patient who is a good historian and is able to articulate their concerns, that's the best kind of patient, the ones that this will work for. If they're a really poor historian and don't know their allergies, this is going to be a real challenge."
Maag said she never hesitates to refer patients elsewhere if she thinks she can't handle their condition.
"If a fever is out of my comfort zone, I have no problem directing them to the hospital," she said. "If we test someone and they're pregnant, I say ‘Congratulations. Now go see your regular doctor."'
Critics also question whether the in-store clinics are a push to sell more prescriptions.
Rickels dismissed those claims, saying the clinics were actually about service.
"For many years, pharmacists have been trying to increase the opportunity to do more counseling," he said. "Corporate will talk about the bottom line being the number of prescriptions you fill. We see that changing. There's a demand for service."
The Convenience Concept
The clinics started out of customers' needs, said Brian Jones, the CEO of MedBasics.
"There is a significant gap for a large percentage of the population between their ability to get timely access to medical care and when they can actually go," he said. "We're open nights and weekends, which are perfect for filling that gap."
Before these clinics existed, there was little choice but to go to an emergency room if a medical issue needed to be addressed by Monday morning.
RediClinic also performs physicals, conducts pregnancy tests, gives vaccinations and conducts cholesterol tests.
Those services help people who either don't want to bother to make an appointment or who can't fit it into a doctor's office schedule, Maag said.
If there is a wait to see Maag at the clinic, patients are given a pager like ones used at restaurants so they can do their grocery shopping while waiting for their turn.
That's the major selling point of the clinics over hospital visits, Zachariah said.
"Affordability and access are the two main things that our health industry lacks at times," he said. "Anytime you can improve access, you're going to see everyone pleased."