California physicians to launch retail health clinic without the store

Two California internists are taking the in-store medical clinic concept outside the store.

Thomas W. Hopkins, MD, and Kenneth Redcross, MD, in January 2007 plan to open Medi-Stop, which, like an in-store clinic, will have nurse practitioners and physician assistants treating nonurgent conditions on a walk-in basis. But Medi-Stop will not operate inside a retail store with a pharmacy. Instead, its first location, in Natomas, Calif., will be in a strip mall.

The physicians say staying out of stores allows them to open facilities as big as 1,200 square feet, or up to six times larger than the usual in-store clinic. They also say that not having to ally with a retail chain will allow them more control.

That issue of control is one reason why Dr. Hopkins said he would rather run his own clinics than work with his affiliated hospital, Sutter Health, in overseeing six clinics the health system plans to open by year's end in Sacramento, Calif.-area Rite Aid drug stores.

"If I work for somebody else, they have their own agenda and I don't have any control," said Dr. Hopkins, a solo physician in Sacramento. "I'm in private practice because I can shape the care that I deliver for myself and I have always been an entrepreneur."

He does work with Sutter as a contributor to its local television program and he is also a health reporter for a Sacramento TV station.

Dr. Hopkins said he first thought about opening a retail clinic in 2003, after reading a newspaper story about the practice. He thought the concept was an "interesting" approach to improving access to care for the uninsured as well as for those who have insurance but can't get in to see their doctor.

(The AMA has policy stating retail clinics are consistent with its belief in multiple entry points for patients in the health care system, although it acknowledges the clinics are controversial among physicians.)

Dr. Hopkins said he also viewed the concept as a business opportunity.

He didn't act on the idea then, but told Dr. Redcross about it this spring, leading them to form Medi-Stop, Dr. Hopkins said. The two met three years ago when Dr. Redcross, an internist at Cedars Sinai Hospital in Los Angeles, visited Dr. Hopkins to learn about his bariatric and weight management practice.

Sutter Health said it does not have a problem with an affiliated physician competing against its Sutter Express Care clinics.

"There's lots of room in the marketplace for innovative solutions that respond to consumers' needs, and are convenient and affordable solutions for their immediate health care needs," said Karen Garner, a spokeswoman for the health system.

The California Medical Assn. did not have a comment about Medi-Stop, CMA spokesman Peter Warren said.

The medical association is developing policy on in-store clinics, but that effort is unrelated to Medi-Stop, Warren said.

In general, the society is concerned about the market forces that are fueling the growth of the clinics, and about quality and continuity-of-care issues related to them.

"The real problem is the fact that we have no programs for insuring 46 million [Americans], and so people without insurance are seeking care in the least expensive and most readily accessible way they can," Warren said.

"Because they don't have insurance, they have no ongoing relationship with a family physician, so that undermines their care," he said. "It's very important to have a family physician -- someone who knows you, your children, keeps records -- and the clinics are antithetical to that. So, we are concerned about that."

Clinic operators have said many of their patients have health insurance but come to them seeking treatment because of the convenience.