When Jim Norton, a managing consultant at A. Foster Higgins & Co. in Stamford, Conn., was at the corporate headquarters of the international benefits consulting business in New York recently, he made an "informal" visit to its on-site medical clinic. The physician on duty did some medical tests for him.
"Our corporate medical center has X-ray equipment and gives free exams, blood tests and prescriptions," said Mr. Norton, who belongs to a Stamford health maintenance organization. "Employees use it when they need to, and no one keeps track of whether or not it reduces the company's medical costs for employees."
There are thousands of such "informal" clinics in corporate America, but the trend is toward formal corporate medical centers -- some so sophisticated they compare to hospitals -- and toward keeping track of money saved in health-care costs.
"Over the past five years, a growing number of employers have either put such facilities in place or begun considering the option very seriously," reports Physicians Financial News.
A 1991 survey of 1,955 corporations by Foster Higgins shows that 17 percent have corporate clinics, most established to stem corporate health-care costs, which soared 12 percent in 1991. Some are run by medical groups such as the Mayo Clinic.
"It's the ultimate way to control costs, and it's going to spread considerably," said Mr. Norton, a consultant on six such facilities in the last year.
He says it would cost about $1.1 million for a company to open a 4,500-square-foot clinic for 4,000 employees that would "look like a small HMO satellite with two physicians, physical therapist, support staff and equipment for ophthalmology, mammograms, lab work and radiology."
Corporate clinics are growing because they meet the needs of employees, their dependents and retirees for high-quality health care, maintain wellness, build a healthier work force and, thus, curb corporate medical costs.
"Various forms of on-site medical care look like a major trend," said Elizabeth Hintch, managing editor of Human Resource Management News. "Companies have to save money somewhere, and this is a good way to do it. Costs are lower for actual health care, and productivity increases by not having employees out of the office for doctors' appointments. It also decreases turnover."
Company-managed clinics challenge the stereotypical image of a plant doctor doling out aspirin to injured employees sent back to work as quickly as possible.
"On-site medical care ranges from a nurse or physician on call for occupational hazards and injuries to actual working clinics," said Bill Custer, an economist and director of research for the Employee Benefit Research Institute in Washington. "For businesses, it's a fixed cost that you pay once and spread over a lot of employees. Though there is the same liability as a physician or hospital would have, as far as I know that hasn't been a problem."
Mr. Custer points out that a company-run clinic "may not be the right thing for all employers, even those with a concentrated work force, if it puts community hospitals and doctors out of business." But when it works, he says, it's a "bonus to employers and employees."
Among the companies offering their own medical care as one of several options to employees are Bristol-Myers Squibb, Deere|| TC Co., Gates Rubber, Gillette Co., Goodyear Tire & Rubber Co., Kelly-Springfield Tire and Nestle USA.
"Companies need to make an internal decision whether to manage health-care costs aggressively or to administer health-care benefits passively -- and employees must become knowledgeable medical consumers," said Dr. Jacques J. Sokolov, vice president and medical director of Southern California Edison Co., based in Rosemead, Calif.
The utility provides health care for 55,000 employees, dependents and retirees through its eight primary clinics. Participants pay 10 percent of the cost for services; the company, 90 percent.
"Employees can choose to go to our corporate clinics or use our self-funded HMO or preferred provider organization," said Dr. Sokolov, who supervises a staff of 250 professionals who see 100,000 patients a year.
Though Southern California Edison has had medical clinics since 1903, it reorganized its managed care program in 1989. Health-care costs at that time were $100 million annually and rising 23 percent a year. "We saved $66 million in health care costs our first year and at the end of 1992 will have saved over $100 million while improving the quality of health care to our people," said Dr. Sokolov.
Quad/Med Clinic, Pharmacy and Wellness Network in Pewaukee, Wis., opened in 1990, has nine physicians and offers full-service family medical care to the 5,000 employees of Quad/Graphics Inc., a private firm that did $500 million in sales last year.
"It's more than cost-cutting; we're devoted to our employees," said Dr. Robert A. Kessler, director of Quad's medical services.