Medical centers once scoffed at "mall medicine." But the trend has cut into their business, and even the Mayo Clinic is playing catch-up.
ALBERT LEA, MINN. - Far from its world-renowned Rochester campus, the Mayo Clinic is conducting an intriguing research project in a low-slung Albert Lea mall, right next to a nail salon.
The ALMC Express Care clinic in this southern Minnesota town is a Mayo-affiliated retail operation, where a lone nurse practitioner treats simple ailments without appointments.
The 262-square-foot kiosk marks a stunning turnaround in how the medical establishment is reacting to the proliferation of MinuteClinics and other such outlets.
Once derided by doctors as providing disjointed and possibly unsafe care, medical centers are starting to open their own retail clinics as a way to keep existing patients and reach new ones.
Now Mayo is hoping the year-old Albert Lea clinic will be a prototype for similar clinics across the sprawling Mayo Health System in southern Minnesota, western Wisconsin and northern Iowa.
On Friday, Mayo officials said they will open a Mayo Express Care clinic at a yet-to-be named strip mall in Rochester early next year.
"A couple of years ago, medical centers thought if they ignored [the trend], it would go away," said Tricia Dahl , associate clinic administrator at the Albert Lea Medical Center. "But patients tell us this is what they want."
Mayo is not alone. Minneapolis-based Fairview Health Services has opened Fairview Express Care clinics in Coborn's Superstores in Albertville and Elk River and is planning two more in Princeton and Hastings. In Rochester, Olmsted Medical Center opened OMC FastCare at a ShopKo last summer and plans a second late this year.
Retail clinics are "clearly not a flash-in-the-pan event," said Tom Holets , president of Allina Medical Clinic, which owns 45 primary care clinics in and around the Twin Cities. Allina has yet to open its own, but recently wrapped up a three-year study that concluded "we must be in this marketplace," Holets said.
The moves are defensive. The retail clinics have "skimmed off simple health conditions that are reimbursed well [and] left primary care clinics with their noses barely above the water," said Dr. Loie Lenarz , chief clinical officer of Fairview.
An explosion of clinics
The no-frills retail clinic, with its limited menu, low prices and walk-in access, is an example of what business consultants call disruptive technology.
Five years after the first MinuteClinic opened in the Twin Cities, 362 outlets have popped up in 24 states, with a goal of 400 by the end of 2007. MinuteClinic is now owned by CVS Caremark Corp, the country's biggest provider of prescription drugs. Target followed suit with its own brand of clinics, as did a host of other chains.
Patients like the fact that they can zip in and out quickly while shopping. Employers and insurers like the lower prices.
The explosion in retail care has shocked traditional providers out of complacency, forcing many hospitals, clinics and pediatric practices to start offering same-day appointments, extended urgent care hours and even patient care on weekends.
Now a small number of those providers are setting up their own retail clinics. By co-opting the idea, they say, they overcome a key worry raised by the American Medical Association -- fragmented care. At Mayo Express Care, for example, a nurse practitioner will have access to patient medical records already stored at Mayo.
"We're looking at this as part of a system of care," said Dr. David Herman, who leads the primary care effort at Mayo.
Many providers interested