- The Washington Times - Sunday, August 29, 2004

Nurse practitioner Shavon Legette waits to administer medical care in a gleaming new examination room.

Tucked behind rows of pet supplies in the corner of a sprawling retail store, it is one of a new breed of medical clinics sprouting up in Target stores in suburban Baltimore.

MinuteClinic Inc., based in Minneapolis, promotes itself as a low-cost, quick alternative to family physicians. The clinic’s nurse practitioners diagnose and treat common health problems from bronchitis to pink eye to poison ivy for as little as $25.

They assure patients that visits take no more than 15 minutes, even without an appointment.

“This is for people who are busy. It’s for people who can’t get in to see their doctor. If you can’t see your doctor, your options aren’t real pretty,” said Tom Charland, senior vice president of MinuteClinic.

The company branched out beyond Minnesota when it opened clinics in Towson, Cockeysville and Pikesville two weeks ago. It plans to open five more clinics in Maryland by the end of September, including one in Laurel.

About five patients a day trickle into MinuteClinic in Towson for medical care that costs from $25 to $62. A quick test for strep throat or treatment for female bladder infection costs $48. The clinics will offer vaccines for tetanus/diphtheria, flu, pneumonia and hepatitis B.

MinuteClinic’s nurse practitioners diagnose and treat a limited number of illnesses. Offering limited medical care ensures that patients are seen quickly and eliminates the potential for misdiagnosis, Mr. Charland said.

The clinics refuse to see children younger than 18 months.

“These are very black-and-white cases,” he said.

The exam room has a container with tongue depressors and a box with rubber exam gloves. The cabinets are full of medical and office equipment. A device to process credit card payments sits on the counter next to a photocopier.

Miss Legette wears a knee-length white physician’s coat.

But there is no doctor. Each clinic has at least two nurse practitioners who work without direct supervision from a physician.

“We try very hard to tell people that this is not a replacement for a primary-care physician,” Mr. Charland said.

If nurse practitioners can’t treat a condition, they tell patients to see a doctor, said Donna Westphal, MinuteClinic’s director of Maryland operations.

MinuteClinic must have a doctor on call at all times, and the same doctor also reviews the work of nurse practitioners twice a year.

A nurse practitioner typically has a two-year master’s degree in nursing and two years of training.

Baltimore physician Dr. Joseph Zedley said the clinics shouldn’t replace visits to family doctors, but he predicted their convenience will appeal to people seeking quick treatment for mild illnesses.

“If you’re sick at 3 p.m. and you want to see me right away, it’s very hard for me to accommodate that,” said Dr. Zedley, a member of the American Academy of Family Physicians.

Difficulty seeing family doctors persuaded Steven Pontius and Rick Krieger to start MinuteClinic in 1999. Mr. Pontius wanted a quicker treatment for easily diagnosed conditions. MinuteClinic’s health care facilities are open seven days a week.

Venture capitalists have invested $10 million in the firm, which has 68 employees.

MinuteClinic has 14 clinics in Minnesota and has had 150,000 patient visits since opening its first office in May 2000. The company estimates revenue will reach $4 million this year.

MinuteClinic isn’t alone in the field. Milwaukee-based Aurora Quick Care has clinics throughout Wisconsin, and FastCare Family Health Center has opened clinics in two grocery stores in Louisville, Ky.

MinuteClinic sees insured and uninsured patients, though about 85 percent of people seeking care are covered.

In Minnesota, MinuteClinic has agreements with health insurer Blue Cross Blue Shield, Health Partners and others so that most health plans cover visits to the company’s health care facilities.

In the Baltimore area, CareFirst Blue Cross Blue Shield has included MinuteClinic in its network and covers visits by its members. Cigna Health Care is covering visits of Black & Decker employees, but not visits of clients from other firms.

MinuteClinic’s alliance with Target has been a boon for the retailer. Once patients are diagnosed, most walk to the store’s pharmacy to have prescriptions filled.

“I think it will definitely drive business in the pharmacy. I mean, why would you go anywhere else?” said Steve Mittler, manager of the Target store in Towson.

MinuteClinic has had another benefit for the Towson store. Days after MinuteClinic opened Aug. 17, an elderly customer fell in the store. The impact of the fall left her with a gash in her forehead, Mr. Mittler said.

Target employees called for paramedics, but MinuteClinic nurse practitioner Marietta King tended to the woman before the ambulance arrived.

“Having someone in the store was a nice feeling for us and the [customer],” Mr. Mittler said. “We’re not medical experts.”

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