Walk-ins welcome, but only if they're healthy

As an internist and emergency physician, Richard McCauley, MD, spends five shifts a month treating the sick and injured at a California VA hospital. But on just about every other day, he can be found at a local strip mall, catering to the healthy.

Dr. McCauley owns WellnessMart, which he describes as a health store for the healthy. Two different groups of patients, two different locations. That's the way Dr. McCauley believes it should be.

"Why is it that sick people and well people go to the same place for care?" he asks. "What well people want is convenience and a place they can go to on their terms.

"If someone sneezes, we don't take care of them. I tell them they're in the wrong spot," Dr. McCauley said.

Started in the hallway of a health club a few years ago, the health store moved to a storefront in a strip mall in Thousand Oaks, Calif., last month.

Walk-in visitors can find free informational materials on various diseases and free workshops on how to prevent them. There also are mannequins available that visitors can take apart to see where the organs are in the body.

The store also offers immunizations, annual checkups, vaccinations and travel immunizations. Borrowing from McDonald's, Dr. McCauley said, WellnessMart lists all prices on a large menu board so patients know what they will be charged.

And while he doesn't accept insurance, his center does sell it. But he sells only plans with a high deductible, which he believes makes more financial sense for families and eventually will bring down the cost of health care.

Candis Cohen, a spokeswoman for the Medical Board of California, said her organization has no problem with a physician selling health insurance, or with one who cares only for the healthy. She said there is a list of categories for which a physician can't discriminate, but there is no rule against discriminating on the basis of sickness or wellness.

Dr. McCauley said the bulk of his clients are walk-ins, but church, school and employer groups use his wellness screenings and informational programs as well.

The physician said he conceived of the idea of the WellnessMart while serving as medical director for Fullerton, Calif.-based Beckman Coulter, which sells diagnostics to physicians' offices. "I was very much involved with point-of-care diagnostics. From there, I had the idea that wouldn't it be nice if the community had access to some of this information. It evolved from there," he said.

Dr. McCauley believes that a lot of people don't take advantage of preventive medicine because it is inconvenient and difficult to navigate. The purpose of his WellnessMart, he said, is to break those barriers.

The physician and two medical assistants staff WellnessMart from 10 a.m. to 7 p.m. six days a week, with Sundays off.

Richard Frankenstein, MD, president of the California Medical Assn., said that although he doesn't know that much about WellnessMart, his concern is that Dr. McCauley has a plan for continuation of care for his patients, if needed. Dr. McCauley says he does.

"There are a lot of various ways in which health care is delivered. Some work better than others for some patients. As long as there are plans to ensure continuity and hand off important information to another doctor, physicians can have a wide variety of models," Dr. Frankenstein said.

Only in business for a couple years, and at the strip center for about a month, Dr. McCauley said it's too early to tell if his concept will work, or if any other physicians will follow his example.

"I don't expect it to make a profit in the next couple years. I didn't go into it to make a profit. I've been happy with the move," he said.