Calling in sick, while at work

Some employees are finding it much easier to see a doctor these days.

In the last year, large companies such as Capital One Financial Corp., Discovery Communications Inc., Sprint Nextel Corp. and mortgage guarantor Freddie Mac have opened on-site medical clinics with physicians and nurse practitioners. The clinics offer medical treatment for free or, compared with the company’s health plan, at reduced prices.

The seeming throwback to the more paternalistic corporations of yesterday is of course convenient for employees. They can have a sore throat examined, for example, without a lengthy wait.

But the companies have a more pressing goal: They are trying to save money after years of runaway increases in health expenditures. In some cases, the clinics allow them to more tightly control who is referred for additional, expensive treatment; keep a watchful eye on potentially costly employees with diabetes, high blood pressure or a high-risk pregnancy; and push budget-conscious treatments such as generic medications that are often filled in the company doctor’s office or on-site pharmacy.

“It has the potential to help lower both short-term and long-term health costs,” said Helen Darling, president of the National Business Group on Health, a nonprofit employer coalition representing 240 employers.

Although use of the centers is usually optional, a small number of employers are requiring workers who have been deemed health risks -- such as those who are obese or have diabetes or high blood pressure -- to regularly see a company doctor.

By directly overseeing medical care, Darling said, companies might be able to save more money than they could by entrusting care of employees to outside physicians.

Having employers provide their own medical care “is an idea whose time has come,” said Joe Marlowe, senior vice president at Aon Consulting, a human resources firm. “It’s something that just makes sense from a lot of angles.”

Many of the clinics, which can be as sizable and well staffed as a traditional doctor’s office, offer basic care for sick employees as well as annual physicals, immunizations, physical therapy and low-cost prescriptions.

The new corporate medical centers are usually open only to current employees, but some companies are treating spouses, dependents and retirees. Employees who have opted out of the company’s health plan or who are not eligible for insurance typically can’t use the clinics.

Although some employers have had on-site medical staffs for years, benefits experts say they’ve been limited mostly to manufacturing companies with high rates of worker injuries or to companies in rural areas with limited access to medical care. In contrast, many of the employers who are beginning to offer medical services are large or mid-sized national companies in a variety of industries, such as telecommunications and finance.

Kerry Floyd, a marketing manager at Sprint Nextel’s corporate campus in Overland Park, Kan., began using the company’s new 2,600-square-foot medical center in April to treat a minor condition.

Since then, Floyd, who lives 45 minutes from work, has used the clinic several times and estimates he’s saved about a day of work in travel time. “I love the fact that I can see a doctor, fill a prescription and be back at my desk in an hour,” said Floyd, who is on a new nutritional plan that his company’s doctor recommended.

Employers say they’re willing to try anything to slow the rising cost of providing employee healthcare. Other cost-savings efforts in recent years -- such as requiring workers to pay a higher share of medical bills -- don’t seem to be working. Health premiums are expected to jump an additional 10% this year, according to a national survey released last month. For the first time, health premiums in the U.S. have risen above the annual salary for a minimum-wage worker.

Moreover, by preventively treating employees on site, companies are putting faith in the adage that an ounce of prevention is worth a pound of cure.

Although there’s little research so far about the cost-effectiveness of corporate clinics, benefits experts say some employers who have had medical centers for several years have cut employee health costs by as much as 25%. Roughly a quarter of the companies in the U.S. are self-insured, meaning they pay their own medical bills, using insurance companies only to process claims.

Benefits experts estimate that a few dozen large employers have recently started providing medical care to their employees, but a recent survey by Watson Wyatt Worldwide, a benefits consulting firm, found that as many as a third of companies are exploring the idea.

Critics worry that employers who hire doctors may be able to access employees’ medical records. Although federal privacy laws forbid doctors to reveal medical information to anyone other than the patient, there have been several cases nationally in which employers have improperly received access to a worker’s medical information, experts said. In recent years, more employers have been collecting health information on employees by asking them to fill out questionnaires known as health-risk assessments.

“It’s not rocket science,” said Lewis Maltby, president of the National Workrights Institute, an employee advocacy group based in Princeton, N.J. “If the doctor is an employee of the company, there are serious questions about the confidentiality of employees’ medical data.”

Some companies are offering care for minor conditions such as upper respiratory infections or gastrointestinal problems but are shying away from treating more complicated problems. They don’t want to take on the responsibility of treating all of their employees’ medical needs.

For that reason, doctors at Pitney Bowes Inc., based in Stamford, Conn., will write prescriptions for minor ailments but not for chronic conditions like diabetes. They do, however, see patients with such conditions regularly to monitor their health and occasionally contact an employee’s physician to consult them about their case.

“We want to serve as an extension of people’s primary care provider, not supplant them,” said Dr. Brent Pawlecki, Pitney Bowes’ associate medical director.

Others say they hope employees can get as much of their medical care at work as possible. Denise Stump, executive vice president at Ohio-based Scotts Miracle-Gro Co., which is opening a spacious clinic with three on-site doctors and nurse practitioners and a pharmacy in December, said it is advantageous for employers to treat their own workers and that a high percentage of the company’s employees use its doctors.

“Because we’re paying the claims, we know what we’re dealing with -- poor diet, obesity, smoking, sedentary lifestyle,” she said. By getting more involved, “we can help our employees confront their own demons.”