Shoppers stroll through Wal-Mart on Lake Mead Parkway in Henderson filling their carts with food, alcohol, toilet paper, kitchenware and clothing.
You can buy almost anything at the superstore — including health care.
Just steps from the cash registers, patients can get treated for bronchitis, high blood pressure or depression.
Retail health clinics have spread around the Las Vegas Valley in recent years in chain stores and strip malls. They include both drop-in clinics at pharmacies and big box retailers, as well as urgent care offices.
The clinics make medical care more convenient, if not more fragmented, and lure people away from more traditional primary care offices. And the clinics continue to expand in the valley for a key reason: Las Vegas has a shortage of primary care physicians. Patients might wait a few weeks to get an appointment in a traditional doctor’s office. Or, they can walk into a retail clinic unannounced and be seen in an hour or two.
Clinics in chain stores typically offer vaccinations and treat sore throats, earaches and other minor ailments. Urgent care centers in strip malls do the same but also treat more serious problems, such as lacerations and fractures.
Urgent care clinics shouldn’t be confused with emergency rooms. The centers aren’t equipped to treat life-threatening conditions, so staffers send those patients to the hospital.
Both chain store clinics and urgent care centers take appointments but rely heavily on walk-ins.
It’s a booming business. CVS has five MinuteClinics in the valley and will open two more this year as part of a national expansion. Clark County’s University Medical Center operates 10 Quick Care clinics and, after not opening a new location for a decade, now wants two more. Walgreens is expanding services at its Take Care Clinics around the country, including its 13 offices in Las Vegas.
Southwest Medical Associates runs Wal-Mart’s three local clinics, which last year had almost 23,000 patient visits. The store on Lake Mead Parkway sees an average of four patients an hour. Staff members treat infections, write prescriptions, conduct physicals and help people with chronic back pain and anxiety.
Near the waiting area, Wal-Mart shoppers stock up on cheap wine and frozen pizzas. Patients waiting to see a provider can take a restaurant-style pager with them and shop while they wait for it to buzz.
The clinic looks like any other medical office. It has four exam rooms and a small lab.
“Once you’re in here, do you feel like you’re in Wal-Mart?” Southwest Medical President Linda Johnson asked.
Retail clinics market their long hours and convenient locations. In general, Las Vegas’ retail clinics are open for up to 12 hours a day on weekdays and six to eight hours a day on weekends, if not more.
Chain store clinics typically are staffed by nurse practitioners and physician assistants, not doctors. Urgent care clinics normally have doctors on staff.
Emergency rooms are notoriously expensive and can bill thousands of dollars for relatively minor problems. However, at an urgent care center, a patient with, say, a broken ankle might pay only $240 to be treated and outfitted with a walker boot and crutches.
Summar Giorgione visits Advanced Urgent Care on Eastern Avenue at St. Rose Parkway for all her medical needs. The 28-year-old Henderson woman hasn’t seen a primary care doctor in two years because it takes weeks to get an appointment, she said.
“It may be a couple hours’ wait,” she said of Advanced Urgent Care. “But it’s not a whole month.”
Las Vegas is in dire need of family doctors, pediatricians and internists. There aren’t nearly enough here, partly because the valley grew too quickly for primary care doctors to keep pace. What’s more, doctors leave medical school with staggering debt and often shun primary care work, which pays far less than surgery or other specialty practices.
The median compensation for a primary care doctor was $212,840 in 2011. Specialists earned $384,467. Meanwhile, last year’s medical school graduates had a median debt of $170,000.
Nationally, there is expected to be a shortage of 45,000 primary care doctors by 2020, said Reid Blackwelder, president-elect of the American Academy of Family Physicians.
“This is a very important issue right now,” he said.
Blackwelder said many family doctors, like retail clinics, offer same-day scheduling, extended hours and weekend appointments, but he acknowledged that medical school graduates often prefer higher-paying specialist jobs. That limits the number of new primary care doctors.
At the same time, President Barack Obama’s Affordable Care Act will force almost everyone in the country to have health insurance next year. Many of the newly insured are expected to stop visiting emergency rooms — where federal law enables them to get treated for free for any ailment — and instead see regular doctors.
Additionally, chronic obesity and diseases such as diabetes continue to worsen, and aging baby boomers are expected to have more health care needs in the coming years.
The factors combine to create a strong business potential for retail clinics.
CVS has 640 drop-in clinics nationwide and wants 1,500 by 2017. About half of its patients do not have a primary care doctor.
“We think we can be part of the solution,” said Andrew Sussman, president of CVS’ MinuteClinic network.
Sussman isn’t the only one.
Retail chains and pharmacies have been opening health clinics in the valley since at least 2007. Walgreens has the most locally.
Urgent care centers also are spreading. Nationwide, for the past several years, more than 300 clinics have opened annually. There now are 8,700, which see an average of 342 patients a week, according to the Urgent Care Association of America.
The clinics often are in strip malls or stand-alone buildings near shopping centers, giving them good visibility and easy access. All of UMC’s Quick Care clinics are “pretty much right on (a main) road or very close to it,” UMC Associate Administrator John Eddy said.
There even is a medical clinic franchise, Doctors Express, which was founded in 2005 in Maryland by a former emergency room doctor and his business partners.
Doctors Express franchisees don’t need a medical background to operate a clinic. There were 49 locations nationwide last year.
The first (and so far only) Doctors Express in Nevada opened in July on Green Valley Parkway in Henderson. The clinic is in a retail center with a Petco, Staples, Layers bakery and New York Chinese Restaurant.
Clinic owners Robert and Nonna Russell, neither of whom is a physician, have statewide franchising rights. They plan to open three to five more Doctors Express clinics in the valley over the next few years, marketing director Stephanie Glankler said.
Advanced Urgent Care, which opened on Eastern Avenue in 2004, is just steps from an Extreme Mattress Outlet, a beauty salon and a GameStop video game store. The clinic sees about 50 patients each weekday and 30 to 40 a day on weekends.
At least four other urgent care clinics have opened within five miles of the Advanced clinic, said co-owner Govind Koka, a family medicine physician. The term “urgent care” has become so popular that some doctors use it even when they don’t run that kind of office, he said.
“Some clinics, I think, just use it as a moniker just to get patients to come in,” Koka said.