Need to see a doctor? Try Target or Wal-Mart

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On a hectic Saturday, a busy mom can not only get her toddler suffering from pink eye a walk-in appointment with a nurse practitioner, but also load up on shampoo and toothpaste at her local CVS.

CVS, Target, Wal-Mart and Albertsons, in a hyper-competitive under-one-roof race, have quietly begun testing small-scale health clinics in partnership with for-profit health providers inside their stores. These clinics offer not just flu shots, but strep-throat tests, ear infections and even sports physicals.

"This is a wonderful branding opportunity, to take the emotional currency of the nurse practitioner/patient relationship and provide a service for consumers in a place and time they really need," said Michael Howe, who until January of 2004 was CEO of fast-food chain Arby's but now serves as CEO of MinuteClinic, whose tagline is: "You're Sick. We're Quick."


MinuteClinic operates 59 locations in seven states through nonexclusive licensing agreements with Target, CVS and the Seattle-based drugstore chain Bartel Drug. Growth plans call for 90 locations by the first quarter of 2006 and an additional 150 by the end of next year. By 2007, Mr. Howe said he expects that number to rise to almost 500.

The Minneapolis-based company is backed by private investors and Bain Capital, a Boston venture-capital group. Mr. Howe would not disclose revenue.

With so-called consumer-driven health care sweeping the insurance industry-a trend that includes higher deductibles and tailored coverage aimed at making patients pickier-on-site retail clinics will no doubt only push this idea further. After all, a typical visit at a doctor can run upward of $100, while costs at on-site retail clinics run about $60. Even so, only about 3 million of 186 million insured Americans are enrolled in consumer-driven plans.

Statistics indicate demand will explode if current trends continue. According to the U.S. Bureau of Labor Statistics, only 66% of full-time workers at private firms have health insurance, a steep decline since 1989 when more than 80% did.

But the clinics aren't just for the uninsured. In fact, some 85% of MinuteClinic patients have health care insurance. And more insurance providers are covering the service, including UnitedHealthCare and Blue Cross Blue Shield of Minnesota and Tennessee.

MinuteClinic isn't the only player racing to win retailer favor and access to the heavy foot traffic a big-box retailer affords. As for the retailer, the advantage for is clear: Some 90% of prescriptions written by MinuteClinic nurse practitioners are filled immediately on site.

Wal-Mart already operates 3,600 pharmacies nationwide, including Sam's Clubs locations. For now, though, it's moving cautiously, carefully testing concepts with four different providers, including Interfit, Solantic, MedExpress and QuickQuality Care. Only five Wal-Mart locations, mostly in Bentonville, offer the service.

All about convenience

"This isn't Wal-Mart getting into the health-care business," said Wal-Mart spokeswoman Sharon Weber. "This is very convenient and affordable health care and could enhance the entire community by having this available in such an affordable and convenient manner."

Dr. Michael Barr VP-practice advocacy and improvement at the American College of Physicians, said the growth of specialized, niche players leads to more fragmentation and hinders the development of long-term patient/physician relationships. "We believe in a true patient/physician relationships as the best way to get care," Dr. Barr said. "Physicians ideally should be there when patients have these acute, emergency needs, but the system of reimbursement we are under doesn't promote that."

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