Company doctors make a comeback

June 5, 2011 at 12:00a.m.

Star Tribune (Minneapolis)

MINNEAPOLIS

April Sedgwick was thrilled when the employee health clinic opened at the Anoka County Courthouse last month. A case aide in the Family Services Department, Sedgwick couldn’t help but think of the work time she lost recently, shuttling her kids to their sports physicals.

“I was gone an hour and a half,” she said. “I could have had them over here in 15 minutes, instead of going down to the clinic, checking in, waiting with them and then getting them back to school.”

At Anoka County and workplaces across Minnesota and beyond, the company doctor is making a comeback. Businesses and, increasingly, government entities are sinking thousands of dollars into on-site clinics to try to curb medical costs, boost productivity and retain workers.

“Employers are taking this tack — which for most businesses is pretty extreme — that they need to get more directly involved in providing health care for their workers,” said Dr. Bruce Hochstadt, who specializes in on-site clinics for Mercer, a benefits consulting firm.

Demand for workplace health clinics has been rising for the past five years, according to the Center for Studying Health System Change in Washington, D.C.

About 42 percent of workplaces with 500 or more employees now have clinics that provide basic immunizations, throat cultures and other care typically gotten at the doctor’s office, Mercer surveys show.

While many businesses scaled back or delayed plans during the recession, 27 percent of large employers say they’re considering adding a clinic this year or next.

HealthPartners, which is staffing and doing the lab work for Anoka County and its 3,600 enrollees, has built five worksite clinics since 2005.

John Hansen, HealthPartners’ director of worksite health, said he made 25 or 30 presentations to employers last year, twice as many as the year before.

“Some have high emergency-room costs; some have high workman’s comp costs; some do it because they want to attract and retain employees,” he said.

“Generally speaking, money talks. They want to find a way to help reduce medical costs. Productivity is key, too. They want to keep people at work.”

The workplace doctor dates back to the 1800s but fell out of favor in the 1930s and ’40s. Companies took heat for using them to put productivity over patient care. In the 1950s, workplace-safety issues led to more clinics at factories, mines and logging companies.

In recent years, people have grown accustomed to seeing physician assistants and nurse practitioners at retailers and grocery stores, helping to spur interest in workplace clinics.

Employers, which lose $1.3 billion in earnings each year when workers are ill, focus on prevention and on helping workers deal with such chronic conditions as diabetes and heart disease, which account for as much as 60 percent of costs.

Many have nutritionists and pharmacists on site and can do blood tests and other basic lab work. Some offer chiropractic care and ob/gyn services.

“We have people who come in almost daily for blood pressure checks,” said Brent Sabin, vice president of benefits at Ameriprise. About two years ago, the clinic expanded its mission to become a “health coach,” as Sabin put it, giving the 5,000 employees more opportunities to work one-on-one with clinical staff.

At General Mills, a pioneer in establishing a headquarters clinic more than 25 years ago, employees can get their teeth cleaned and eyes examined and receive basic dermatology care. Staff includes two physicians, three physician assistants, four nurses and lab technicians.

Some critics have voiced privacy concerns when employers are so closely aligned with health-care providers. Many companies try to allay such fears by using third-party providers.