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

(Fixes typo in paragraph 19)

By Chelsea Emery

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

U.S. companies as diverse as chipmaker Intel Corpand printer Quad/Graphics Inc have opened in-househealth clinics with doctors, nurses and even dentists todiagnose suspicious symptoms, write prescriptions and more. Mostrecently, they are adding services to manage chronic conditionssuch as diabetes.

The clinics and their lengthening list of services reflectthe latest efforts to counter soaring healthcare costs. Whilecompanies have for years offered yearly flu shots or brought inyoga teachers, that hasn't been enough to offset expenses fromrising obesity rates and other conditions.

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

For every dollar spent on in-company programs, employers geta return on investment of $1.50 to $3, according to a 2009 studyby the American College of Occupational and EnvironmentalMedicine, a society of healthcare professionals.

Of course, in-house clinics can't do everything. Workersstill want and need outside specialists for complicated healthneeds like surgery or childbirth. And privacy concerns lingerdespite legal protections, with some employees worrying thatpersonal data could cause companies to fire less-than-healthyemployees.

Clinics are "potentially a very good idea," says LewisMaltby, president of the National Workrights Institute, a legaladvocacy organization. "Assuming, of course, that the medicalrecords are really confidential. That's a big assumption."Proponents claim the clinics do protect employee privacy.


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

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

After two days of feeling weak and exhausted , Liskowitzvisited the clinic in his West Allis, Wisconsin, building. Hewas dangerously dehydrated and suffering from highly contagiousmononucleosis. While being hooked up to intravenous fluids,Liskowitz, a diabetic, met the clinic's diabetes carecoordinator for the first time.

After getting mono "out of the way," Liskowitz began meetingregularly with the diabetes coordinator and found an insulintreatment 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 bodyweight, with the help of clinic staff.

Stories like these have prompted companies to either addmore clinic, or increase their focus on ongoing conditions likeobesity.

Employers "are seeing a tremendous increase in chronicconditions 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, operateson-site centers for companies. The centers can provide X-rays,physical therapy and emergency care.

The division, currently operating about 375 work-sitecenters, has seen demand grow by "low teens" over the past threeyears, says Hotz. Clients are clamoring for more anti-obesitymeasures, so they are stepping up nutritional counselingofferings, says Hotz.

Intel has four clinics at different locations and plans toadd three more in the "next year or so," says Graham. To meetgrowing demand for diabetes care, some have started providingcertified diabetes clinicians.

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


The growth in clinic demand comes as healthcare costs foremployers and employees, are "galloping ahead," says HelenDarling, president of the National Business Group on Health, anon-profit group that represents large employers' perspective onnational health policy issues.

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

Companies will pay an average $11,664 per employee forhealthcare costs this year, up 5.9 percent from last year,according to a Towers Watson/NBGH survey. Employees' share ofpremium 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 AmericanJournal of Preventive Medicine.

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

And there are other drawbacks. Not everyone is thrilledabout seeing a company doctor; worries abound that workers couldbe penalized or fired if their boss sees expensive medicalconditions in their personnel records. Clinic proponents,however, say on-site facilities are operated by third-partymanagers who never disclose data to employers.

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

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

"If the doctor says 'yes,' you can probably proceed withrelative 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 120hours by having regular diabetes checks at his office, ratherthan traveling. And the convenience and follow-up has improvedhis life in other ways.

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

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Editing by Jilian Mincer, Linda Stern and Steve Orlofsky)


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