REFILE-The doctor (in the next cubicle) will see you now

Tue Oct 9, 2012 5:34pm EDT

By Chelsea Emery

NEW YORK Oct 9 (Reuters) - So much for the "I have a doctor's appointment" excuse when seeking a three-hour lunch break from work.

U.S. companies as diverse as chipmaker Intel Corp and printer Quad/Graphics Inc have opened in-house health clinics with doctors, nurses and even dentists to diagnose suspicious symptoms, write prescriptions and more. Most recently, they are adding services to manage chronic conditions such as diabetes.

The clinics and their lengthening list of services reflect the latest efforts to counter soaring healthcare costs. While companies have for years offered yearly flu shots or brought in yoga teachers, that hasn't been enough to offset expenses from rising obesity rates and other conditions.

"We were beginning to see ... growing chronic conditions in our population," says Tami Graham, director of global benefits for Intel. "All the stuff that ails America, ails Intel."

For every dollar spent on in-company programs, employers get a return on investment of $1.50 to $3, according to a 2009 study by the American College of Occupational and Environmental Medicine, a society of healthcare professionals.

Of course, in-house clinics can't do everything. Workers still want and need outside specialists for complicated health needs like surgery or childbirth. And privacy concerns linger despite legal protections, with some employees worrying that personal data could cause companies to fire less-than-healthy employees. Clinics are "potentially a very good idea," says Lewis Maltby, president of the National Workrights Institute, a legal advocacy organization. "Assuming, of course, that the medical records are really confidential. That's a big assumption." Proponents claim the clinics do protect employee privacy.

WORKERS CHECK SYMPTOMS ON THE FLY

Employers and employees hail the services, saying they save money and time. Workers can walk to nearby clinics, rather than spending work hours commuting to doctors' offices. And the convenience prompts many to get symptoms checked quickly. Urgent - and contagious - conditions are then caught earlier.

Such was the case with Quad/Graphics customer service representative Tim Liskowitz.

After two days of feeling weak and exhausted , Liskowitz visited the clinic in his West Allis, Wisconsin, building. He was dangerously dehydrated and suffering from highly contagious mononucleosis. While being hooked up to intravenous fluids, Liskowitz, a diabetic, met the clinic's diabetes care coordinator for the first time.

After getting mono "out of the way," Liskowitz began meeting regularly with the diabetes coordinator and found an insulin treatment that worked better than his previous regime.

"It was a whole new world from there," says the 33 year old, who recently lost 30 pounds, more than 10 percent of his body weight, with the help of clinic staff.

Stories like these have prompted companies to either add more clinic, or increase their focus on ongoing conditions like obesity.

Employers "are seeing a tremendous increase in chronic conditions which is mirroring what we're seeing in the country," says Peter Hotz, a group vice president at Walgreen Co. A Walgreen subsidiary, Take Care Health Systems, operates on-site centers for companies. The centers can provide X-rays, physical therapy and emergency care.

The division, currently operating about 375 work-site centers, has seen demand grow by "low teens" over the past three years, says Hotz. Clients are clamoring for more anti-obesity measures, so they are stepping up nutritional counseling offerings, says Hotz.

Intel has four clinics at different locations and plans to add three more in the "next year or so," says Graham. To meet growing demand for diabetes care, some have started providing certified diabetes clinicians.

Financial firm American Express Co, which has 15 "wellness centers," has added to its obesity and stop-smoking programs and said it has seen employee weight and tobacco use drop.

COSTS "GALLOP"

The growth in clinic demand comes as healthcare costs for employers and employees, are "galloping ahead," says Helen Darling, president of the National Business Group on Health, a non-profit group that represents large employers' perspective on national health policy issues.

"Unhealthy people cost a lot more," Darline says, adding that rising obesity rates is one of the biggest culprits.

Companies will pay an average $11,664 per employee for healthcare costs this year, up 5.9 percent from last year, according to a Towers Watson/NBGH survey. Employees' share of premium costs rose 9.3 percent, to $2,764.

Some 42 percent of U.S. adults could be obese by 2030, adding $550 billion to healthcare costs over that period, according to a study published earlier this year in the American Journal of Preventive Medicine.

That leaves room for a lot of spending on obesity prevention programs, but the clinics are costly for employers to sponsor. An average Intel clinic, for example, can cost $1 million to build and another $1 million to run, says Graham.

And there are other drawbacks. Not everyone is thrilled about seeing a company doctor; worries abound that workers could be penalized or fired if their boss sees expensive medical conditions in their personnel records. Clinic proponents, however, say on-site facilities are operated by third-party managers who never disclose data to employers.

"There are very strict laws against that," says Take Care's Hotz.

Maltby recommends all patients ask how medical records are kept and who has access. In addition, employees should always ask their doctor if there is a "doctor-patient relationship," in which medical conditions are kept private, says Maltby.

"If the doctor says 'yes,' you can probably proceed with relative confidence," he says.

Many employees find any potential risk worth the reward. American Express counted more than 35,000 visits to its six U.S. wellness centers in the past year.

Quad/Graphics's Liskowitz estimates he's saved about 120 hours by having regular diabetes checks at his office, rather than traveling. And the convenience and follow-up has improved his life in other ways.

"My wife loves it because I'm going to live now," says Liskowitz.

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