Right size engineering: MinuteClinic CEO Michael Howe puts retail service suite in context

As far as Michael Howe is concerned, the healthcare community should no longer question whether retail clinics are here for the long haul. The way he sees it, the criticisms about quality and continuity remain theoretical and spoken by a vocal minority. But even more so, the millions of consumers who are driving demand for retail-clinic services seem to have answered the question already.

This in-store model with its prepriced services, evening and weekend hours, and technology infrastructure is an interesting phenomenon in a healthcare system that's reached a tipping point for making fundamental changes. As the CEO of MinuteClinic, the largest brand among more than 20 retail-clinic organizations, Howe can't find any reason to slow the pace.

MinuteClinic, with more than 180 locations, was acquired by retail pharmacy giant CVS last year, so it has a richness of capital that most other CCCs do not. Nearly all of the clinic brands are independent, but appear to be ripe acquisition targets. Most recently, Walgreen Co. announced its acquisition of the Take Care brand, which currently operates 50 clinics.

Some of the bullish attitudes among developers are based on the fact that consumers like the product and will keep coming back. A recent Wall Street Journal Online/Harris Interactive survey found that more than 90% of CCC users nationwide were satisfied with the clinics' quality of care. Howe says the satisfaction ratings from MinuteClinic patients are above 90% and that 99.3% said they'd come back again. "Any consumer goods company would kill for half those numbers," he says.

Service Suite

Opponents say the clinics lack true medical oversight and are skimming the "one and done" conditions from primary care physicians, leaving the PCPs with sicker patients, longer exam times and reduced revenue. Supporters say CCCs stratify the primary care market into more complex and less complex-a distinction that has never been made previously-while serving the needs of the less sick, freeing up physicians for complex cases, for which they would actually be reimbursed more.

How much CCCs will affect primary care remains to be seen, however, the LA Times reported last month that HealthCare Partners, a major medical group in Torrance, Calif., began posting prices for 58 of its routine services, partly motivated by area competition from convenient-care clinics.

According to Howe, local physicians don't have to view MinuteClinics as rivals.