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Published: Sunday, 10/18/2009

Retailers' clinics aim to boost health of clients, bottom lines

INSIDE THE Kroger store on Navarre Avenue in Oregon, patients have been making their way in a steady stream to the Little Clinic retail health outlet with one thing on their minds: flu shots.

“It is very seasonable as to what our scope and services are,” said Matt Rauch, Little Clinic's regional manager of operations, which include the two metro Toledo clinics. “Right now everybody wants flu shots.”

The Little Clinic inside the grocery store has since 2007 provided a variety of low-cost, walk-in health services.

A number of stores are offering flu shots this year, but that service is just the tip of an expanding array as retailers try to enhance brand loyalty and their sales of related items such as prescriptions, health-care products, and foods.

Those sales are important. Retail prescription sales nationally topped $253 billion last year, with $104 billion at chain drugstores and $26 billion at grocery stores, according to the National Association of Chain Drug Stores. Sales of cosmetics, cough and cold remedies, tissues, deodorant, hair care, and other health and beauty aids topped $62 billion last year, according to AC Nielsen Co.

Customers of the Little Clinic aren't obligated to shop at Kroger, but because they are in the supermarket, it is easy to do so, said Little Clinic spokesman Jennifer Martin. “The convenience is there, and if you like, we can electronically send your prescription to the pharmacy,” she said. “So while you're waiting for your prescription to be filled, you can also get your tissues and your chicken soup in Kroger.”

Technician Jamielah Mottley, left, consults with Gloria Wright of Toledo on the results of tests Ms. Wright underwent when the Walgreen health-screening bus was at the Monroe Street store.
Technician Jamielah Mottley, left, consults with Gloria Wright of Toledo on the results of tests Ms. Wright underwent when the Walgreen health-screening bus was at the Monroe Street store.
JETTA FRASER Enlarge

Walgreen Co., the drugstore chain based in Deerfield, Ill., plans for 400 Take Care clinics in its stores this year — none so far in the Toledo area — and it also uses 10 tour buses to provide free health screening at its stores.

One of those buses, co-sponsored by AARP, is in Toledo, making stops at seven area stores.

Jamielah Mottley, of Chicago, a medical technician who has been with the bus since April, said the response to the free services has been great. “People are pinching pennies right now and it's just easier to go get this done for free and not worry about co-pay or that sort of thing,” she said.

Another service offered by many chains this fall is flu shots. “We have locations that are convenient to many area residents that want this service,” said John Hoover, an executive at The Andersons, explaining his firm's decision to offer flu shots.

Others providing the shots in the Toledo area include Walgreen, Rite Aid, Kroger, Meijer, Giant Eagle, Target, and Wal-Mart.

The in-store clinics can draw people into the store who then might buy food or other products. No solid numbers are available on how much such services boost sales.

From a handful of in-store clinics nationwide in 2000, the number now is 1,147, affiliated with 39 retailers and 47 hospital systems, in 38 states. CVS Pharmacy has the most, with 445 Minute Clinics. Walgreen has 345 Take Care clinics, including 13 in Ohio, and Kroger operates 69 Little Clinics, including 10 in Ohio. In the Toledo area, Little Clinics, partly owned by Kroger, are in stores in Oregon and in the Spring Meadows Shopping Center in Holland.

The clinics, which operate alongside banks and video rental areas, are about 200 to 500 square feet. Experts say they provide quality health care, but are costly.

Consultant Tom Charland, whose Minneapolis company Merchant Medicine tracks the retail clinic industry, said, “From a business perspective, these clinics take quite some time, about two years, to get to break even.”

Two hundred clinics closed last year — even Wal-Mart shut 70 — because they were unprofitable.

Mr. Charland said opening a clinic costs $50,000 to $100,000 are pay for a nurse practitioner is about $45 an hour. The top two clinic operators, CVS and Walgreen, average about 11 patients daily, and each patient spends about $55, generating annual revenues of about $221,000 a clinic.

He said smaller, privately backed operators tend not to survive because their investors usually can't wait long for an investment return. Such was the case at Meijer stores, which had 70 privately run clinics in its stores a few years ago. Only two are left.

Mr. Charland attributed Walgreen's, Kroger's, and CVS' success to backing from a large retail corporation and to clinic customers' purchases in the stores.

Gabe Weissman, a spokesman for Walgreen's Take Care clinics, said in-store clinics offer affordable services. An examination for a respiratory illness might cost $350 at an emergency room but is $65 at a Take Care clinic, he said.

Most retail clinics have a published list of services so that a patient generally knows the cost up front. For example, Little Clinic charges $59 to treat allergies, bronchitis, common cold, ear infections, flu, sunburn, pink eye, urinary tract infections, and sinus infections. School and sports physicals are $29, vaccinations are $25 to $155 depending on serum, and health testing is $16 to $84.

Most clinics are staffed by certified nurse practitioners or physician's assistants who are trained to treat common illnesses and minor injuries.

“There's a lot of misconception that we're just a practicing nurse and just not capable of handling a lot of things,” said Mr. Rauch, a nurse practitioner. “But in fact nurse practitioners can treat, diagnose, and prescribe medications. We can manage acute and chronic illnesses.”

The American Medical Association and physician groups have criticized quality of care at retail clinics, but a two-year study by Dr. Ateev Mehrotra, a policy researcher for the Rand Corp. and a professor of medicine at the University of Pittsburgh, found that in-store-clinic care is good.

It questioned 2,100 patients treated at retail clinics for ear infections, sore throats, and urinary tract infections and compared them to similar patients treated by physicians, urgent care centers, or emergency rooms. It found the quality of care at retail clinics was equal to or higher than at those other settings.

“Further … the costs were much lower,” Dr. Mehrotra said.

In-store clinics are not going to replace doctors' offices, he said, but they serve a role for the uninsured and others with limited insurance coverage.

Contact Jon Chavez at:jchavez@theblade.comor 419-724-6128.



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