By JOYZELLE DAVIS
Scripps Howard News Service
Saturday, June 16, 2007
Jennifer Bridge woke up with a fever, throbbing sore throat and no doctor to call.
Bridge's employer recently switched insurance carriers, and her longtime physician was no longer covered. The Littleton, Colo. mother of two knew she'd have to wait days to see a new doctor, and she didn't want to shell out $125 for an emergency room visit.
So she went to a SmartCare in-store clinic at her local Wal-Mart, where she was out the door 30 minutes later with prescription in hand for the cost of her $25 insurance co-pay.
"If I had gone to the emergency room, it takes forever and it's expensive, and you're exposed to God knows what while you're waiting," she said. At SmartCare, "I showed up when it opened at 9 and was right in and out."
Greenwood Village-based SmartCare is one of nearly a dozen in-store clinic operators that are trying to revolutionize health care by making basic services as easy to get as a gallon of milk. In the past five years, such clinics have popped up at retailers including Wal-Mart, Target and Walgreens.
Mainly staffed by nurse practitioners, who can work independently of physicians and are authorized to write prescriptions, the clinics treat a range of minor ailments like pink eye, sinus infections and mono for an average cost of $65. Customers can walk in without an appointment six days a week until 9 p.m. and on Sundays until 6 p.m.
SmartCare opened its first clinic in September and within six months expanded to some 15 Wal-Marts in Colorado. The closely held company, which recently signed an agreement with Kroger for its Atlanta-area grocery stores, has ambitious plans to open 1,050 centers within five years.
"We want to be everywhere people live, work and shop," said SmartCare CEO Lawrence Hay.
In-store clinics were initially expected to serve uninsured patients who make too much money to qualify for discounted care at a community clinic. That hasn't been the case at SmartCare, where about 80 percent of its customers have insurance, Hay said. The company accepts most insurers (more than 30 health insurance carriers have preferred provider agreements with SmartCare), recently began accepting Medicare and soon will take Medicaid.
A typical customer is June Williams, a regular Wal-Mart shopper who stopped in after her 9-year-old daughter showed early signs of strep. Williams, of Littleton, has insurance and paid the same $15 co-pay she spends for a doctor's visit.
"It was just so convenient," Williams said.
SmartCare saw a surge in cold and sinus infection cases this winter, although customers come in with ailments "across the board," said nurse practitioner Kellie Monahan. A surprising number of patients pop in with general questions about their health -- like the 40-something woman who hadn't seen a doctor in years and wondered whether she needed her cholesterol checked.
"It's medicine meeting the community. A lot of our job is education," said Monahan, who spent more than a decade in ER care before joining SmartCare.
A physician is always on call in case the nurse practitioners have questions. Patients who come in with ailments beyond the scope of the clinic's care -- such as an ongoing condition like diabetes or an acute problem like a broken bone -- are either referred to a physician's office that's accepting new patients or transported to a hospital in an ambulance.
Physicians have viewed the emergence of in-store clinics as everything from a competitive threat to a chance to bolster business through referrals. The Medical Group Management Association, which tracks salaries and costs for medical groups nationwide, hasn't taken a position on the clinics, in part because it's too early to tell what impact they will have.
"It could turn out to be the greatest thing since sliced bread or a great business idea that failed because people don't want to get their health care at a Wal-Mart or Target," said Dr. William Jessee, CEO of the medical group.
The American Medical Association last year announced guidelines to ensure the clinics provide quality medical care and don't prevent a patient from forming a relationship with a primary care doctor. SmartCare's Hays emphasizes the company isn't out to replace anyone's general practitioner and has measures in place such as asking customers for permission to notify their regular doctor of what treatment they received.
SmartCare's centers, which typically are about 500 square feet, don't look much like a doctor's office. Designed by the same firm that crafted the look of Starbucks and Barnes & Noble stores, SmartCare centers feature blond wood floors, slate blue and wasabi green countertops and soothing music piped into the waiting area.
"It's so welcoming," said Mary Tjerandsen, a Colorado Springs resident who stopped in for a blood pressure screening on her way to Black Hawk.
Not everyone is sold. Littleton resident Lindsay Abbink has gone to her doctor for the past 20 years and never has had a problem getting an appointment, even in a pinch.
"I have a really good relationship with him," said Abbink as she headed out of the Littleton Wal-Mart. "I don't need to go anywhere else."
Post new comment