Quick clinics and health kiosks are taking off at airports

A growing number of businesses are banking on treating busy travelers by setting up shop at the place that people tend to have time on their hands -- the airport.

Clinic operators across the country are moving into airport terminals, past the security checkpoint, hoping that instead of reading or grabbing a cup of coffee, passengers will get their blood pressure checked or have that achy head examined.

Until recently, the on-site clinics have been content to be located off the beaten path, with most of the clients being airport or airline employees, or passengers who were sent there by someone in the know.

But when some of these clinics recently set up flu shot kiosks in the passenger terminals on the other side of security, they started to realize the benefits of a location with heavy foot traffic. And taking a clue from the retail-based clinic model, they also saw the value in convenience.

The University of Illinois at Chicago Medical Center, for example, has had a clinic at Chicago's O'Hare International Airport since 1995. Even though it's located inside the secured area, it's still off the beaten path, says John Zautcke, MD, medical director of the clinic.

The clinic decided to expand its flu shot program last year by setting up kiosks adorned with the clinic logo throughout four terminals at the airport. The feedback was so great that the clinic is in the process of starting a year-round program at the kiosks.

Passengers will be able to receive several diagnostic blood tests for which results can be checked online via a secure Web site once the passengers arrive at their destinations. In addition, patients can receive a health identification card detailing pertinent medical history. While passengers can't be examined for illnesses at the kiosks, Dr. Zautcke said their presence acts as an advertisement for the actual clinic.

Dr. Zautcke expects that business travelers, who made up a large percentage of his flu-shot clientele, will be most likely to use the kiosk services. He said that's because they generally are too busy to squeeze in appointments with their primary care doctors between business trips.

Last year, Harmony Pharmacy, a Purchase, N.Y.-based company, won a competitive bid to secure a location in the C Terminal at Newark (N.J.) Liberty International Airport that houses not only a small medical clinic but also a full-service pharmacy.

Howard Hertz, MD, an internist and chair of Harmony Pharmacy, said he got the idea of an airport clinic and pharmacy from his own patients, many of whom are business travelers who routinely needed a quick exam or a prescription refill before a trip.

Dr. Hertz said the clinics, staffed with nurse practitioners, see non-emergency cases ranging from patients wanting to check their Coumadin levels before boarding a flight to patients wanting treatment for a cold. Physicians also can call in prescriptions for patients who may have left their pills at home.

"If someone is having a heart attack, that is not someone we will be treating; the airports already have the mechanism built in to take care of those folks," Dr. Hertz said. "But what we do is not built in." He said these types of services have been nonexistent in airports, but the demand for them is high.

Harmony plans to open six more locations at airports across the country this year.

Trouble finding space

But it's a lot harder to open up shop at an airport than at other locations. Before the clinics worry about the employee background check and FBI clearance required to work on the secure side of an airport terminal, the first hurdle is finding space.

AeroClinic, an Atlanta-based airport clinic company, opened its first clinic at the Hartsfield-Jackson International Airport in Atlanta in May 2007.

According to Dominic Mack, MD, chief medical officer for AeroClinic, the company hoped to get a location in one of the passenger concourses, but the space was simply not available. It took what it could get and opened up in a space outside the security checkpoint.

While airline and airport employees provide a great deal of business for the clinic, it wants a larger part of the passenger market.

Like the clinic at O'Hare, AeroClinic set up flu-shot kiosks that not only attracted passersby but also acted as an advertisement for the actual clinic. It is considering expanding its kiosk program to include year-round activities focused on preventive medicine. More than 60% of travelers who come to Atlanta connect to another flight and never leave the secured area. So Dr. Mack said the kiosks can help gain business from passengers who otherwise wouldn't know the clinic is there or take the time to leave security to visit it.

The company was able to secure a location inside a terminal at the Philadelphia airport, where it plans to open a clinic in April. Dr. Mack anticipates that it will become increasingly competitive to secure space inside terminals as the idea gains momentum. Harmony already has faced fierce competition and was forced to bid on all six of the locations it plans to open this year.

It's too soon to say if the airport clinics will be scrutinized to the level retail clinics have been. At its 2007 Annual Meeting, the AMA House of Delegates adopted policy calling for an investigation into possible conflicts of interest between the clinics and the retail pharmacies that house them.

The AMA and the American Academy of Family Physicians each created a list of desired attributes that retail clinics must follow.

AAFP President Jim King, MD, a family physician from Selmer, Tenn., said the airport clinics could be a good way to improve access to care as long as they follow the same attributes as retail clinics. He also stressed the importance of continuity of care, especially for those clinics doing diagnostic tests.

"What if you have abnormal lab values that need immediate attention and they have no way to get in touch with that person?" he asked.