There's no waiting this morning at Meriter's walk-in FastCare Clinic on Madison's east side. Tucked into a corner at Shopko's Zeier Road location, the clinic looks like the miniaturized essence of a standard medical facility. There is a reception desk, a small waiting area with a couple empty chairs, a consultation room for seeing patients, and a lab for performing basic diagnostic tests. One man has just left, holding what appears to be a prescription note, perhaps bound for Shopko's convenient pharmacy.
If this is not the future of medicine, it's a significant niche that is seeing rapid growth. Green Bay's Bellin Health Systems has launched comparable FastCare Clinics at Shopkos in Green Bay and Manitowoc. The nation's largest pharmacy chains (Walgreens, CVS) have been opening similar low-cost, scaled-down clinics in hundreds of retail locations across the U.S., offering everything from basic physical exams and vaccinations to diagnosis and treatment of minor skin and respiratory ailments and injuries that are not serious enough to merit a visit to urgent care or a hospital.
Nicole Grossen, a physician assistant, serves as a one-person clinical staff this morning at the east-side Meriter FastCare. Today, she is the receptionist, medical professional and lab tech all rolled into one. Grossen is one of four full-time P.A.s serving this clinic and another FastCare at the west-side Shopko. The FastCare staff also includes several more part-time positions.
Traffic varies at the clinics. There were some slow days this summer, says Grossen, although "I did see a lot of poison ivy and bee stings."
Now that school is back in session and the flu season looms, more people are coming in with upper respiratory symptoms. "Yesterday I saw someone with a sinus infection and strep throat. We can do the rapid strep test here."
Among the other afflictions treated at the two FastCare clinics: athlete's foot, cold sores, ear infections, laryngitis, impetigo, sore throats, sties, minor burns and rashes (including mild sunburns) and mono. Patients must be at least 18 months old, with some higher age restrictions for conditions including poison ivy (3 years and up), sinus infections (5 and up) and bladder infections (females 12 and older). FastCare's on-site lab can also do urinalysis, pregnancy tests and other basic work.
FastCare's flat fee of $49 includes lab tests. At such a modest price point, Grossen says, "we get a lot of uninsured people."
No appointments are needed to visit a Meriter FastCare clinic. And they're open every day of the year except Christmas. Patients arriving at the clinic complete and sign a standardized registration form including basic patient and insurance information. They sign consents for evaluation and treatment, as well as release of medical information for insurance billing.
To have insurance billed, patients should bring their insurance card. They should also bring a complete list of their medications and dosages.
It's also important, Grossen cautions, to understand what the clinic and its staff are equipped to diagnose and treat: "We do get a lot of people who come in for things that are well beyond our scope." Walk-ins with more severe symptoms - including abdominal, chest or back pain, lacerations, dizziness, numbness, tingling or shortness of breath - are referred to their primary physician, urgent care or an emergency room.
Take Care Health Systems, a subsidiary of Walgreens, has likewise been opening low-cost walk-in clinics at a growing number of established Walgreens locations, including two in Madison and one in Fitchburg.
Staffed by nurse practitioners and physician assistants, the Walgreens Take Care Clinics offer a range of services for patients 18 months and older. Prices start at $65 for common ailments, with à la carte pricing for various vaccines, physical exams and other procedures.
The long and expanding menu of conditions that can be treated at Walgreens Take Care Clinics includes bronchitis and a host of other respiratory afflictions, diarrhea, nausea, vomiting, early Lyme disease, head lice, swimmer's ear, mono, chicken pox, shingles and other skin conditions, and minor burns and cuts. Diagnostic tests (including flu, tuberculosis and pregnancy) and a significant list of vaccinations are also part of the Take Care services.
Kids who need to pass a physical to participate in school sports can get that taken care of with a $60 physical. "We had a great patient response to our sport, camp and school physical services," says Take Care communications manager Gabriel Weissman.
Although the majority of patients at Take Care use insurance to pay for their visits, Weissman notes that nationally, "40% of our patients tell us that if it weren't for Take Care Clinics, they would go to the emergency room, urgent care clinic, or wouldn't seek treatment at all."
Patients in a hurry can check wait times at a specific clinic (or ask other questions) by calling 866-825-3227.
A recent study from the Annals of Internal Medicine comparing the costs and the quality of care at retail clinics (for three common ailments) with doctors' offices and ERs found standards of care to be equal or better at walk-in clinics and costs significantly lower.
Meriter FastCare Clinics
At ShopKo west, 7401 Mineral Point Rd.
At ShopKo east, 2201 Zeier Rd.
9 am-8:30 pm Mon.-Fri., 9 am-5:30 pm Sat., 10 am-5:30 pm Sun., and 10 am-2 pm on all holidays except Christmas
Walgreens Take Care Clinics
2931 S. Fish Hatchery Rd., Fitchburg
3710 E. Washington Ave.
3700 University Ave.
8 am-7:30 pm Mon.-Fri., 9:30 am-5 pm Sat.-Sun.