The Benefits of Workplace Clinics: An Interview with an Administrator

Dr. Faye Anderson has always believed that the power of healthcare lies in preventative care rather than acute treatment. While she ended up working in acute care for a long time, Faye—a retired nurse administrator based in Huntsville, Alabama—dedicated her career to innovative health initiatives to make people healthier.

“My favorite course in school was public health,” Faye told MHAOnline. “My core values were to prevent as opposed to treating after the fact. With that background, I continued to try to promote health in the setting I was in.”

One of the ways she did that was by building an onsite clinic at her place of work: the University of Alabama in Huntsville. Faye has been a chief nurse and system administrator for more than 15 years. She was also a faculty member at the University of Alabama in Huntsville, where she taught several courses in nurse administration graduate programs before retiring in 2013. Faye still consults with the school on accreditation and curriculum development

Workplace clinics were common in the late 20th century. Usually found in large manufacturing companies, these clinics primarily treated occupational injuries and illnesses. Early in her career, Faye worked in the health department in a paper mill in South Mississippi.

Registered nurses staffed the department, which was open 24 hours a day, seven days a week. The focus was diverse. First, to respond to accidents or injuries in the mill. Second, to focus on the overall health of employees, which included pre-employment screening, medical exams performed by local physicians, and routine checkups, such as checking blood pressure and treating headaches and colds.

As manufacturing and industrial jobs declined, onsite clinics went out of business. Now, only in the last decade has the country seen a resurgence in health departments within private and public organizations. Goldman Sachs, Capital One, and CustomInk are just a few examples of the companies that have invested in on-site clinics.

Amazon is a recent addition to this group. The company announced in August 2018 that it would build an Amazon clinic at its Seattle headquarters as part of a pilot project, with the intention of expanding in 2019. Amazon’s goal with this project is to make it easier for employees to get regular primary care treatment.

According to Mercer’s 2017 National Survey of Employer-Sponsored Plans, one-third of companies with 5,000 employees or more are now offering a general medical clinic to their employees—a notable jump from ten years ago, when only 15 percent of these employers offered a service of this kind. While worksite clinics used to focus on treating work-related injuries—i.e., acute care—they now center on preventative care.

“My perception is that we had moved so far away from preventative to acute care,” said Faye. “We’ve seen this renewed interest on prevention. With the reduction of what insurers will pay and an increase in premiums, companies are looking to save money. So many big companies are self-insured, so if they can keep their employees healthy—minimize visits to emergency rooms and hospital admissions—they’re going to save money.”

Faye suggests that a second big driver of the resurgence of onsite clinics is growing awareness that the U.S. population is not healthy. With higher rates of obesity and diabetes and the burgeoning trend of being too busy to focus on our health—eating fast food, not having time to cook, not exercising—Faye believes that there is an awakening happening within the U.S. population that we need to promote health rather than merely treat it.

Workplace clinics promote health in multiple ways. Thanks to the added convenience of clinics, employees are more likely to get routine checkups, which increases early detection of illnesses, minimizing events that have to be hospitalized, and save money. With the increasing shortage of physicians, patients end up having to wait a long time to see doctors.

“Unfortunately, our healthcare system has been built around convenience for the providers. In large areas, folks have to travel a good distance to find a provider,” Faye told MHAOnline. “Our archaic healthcare model sometimes does not fit in with that whole focus on convenience and looking at the needs of your customer. But ultimately, the patient is the customer.” Workplace clinics are a positive move in that direction.

Faye says that all companies can benefit from workplace clinics, regardless of type (private or not-for-profit), size, or industry. The clinic she helped establish at the University of Alabama in Huntsville in 2007 has been thriving. It first opened in the school’s athletic department with a front office assistant and a nurse practitioner to provide quality care to university employees. Today, the clinic offers primary care services to hundreds of employees every year.

According to an article that Faye and her colleague wrote for The Online Journal of Issues in Nursing, the school spends less on outpatient services for its employees and saves $50,000 to $62,500 per year on healthcare expenditures thanks to the clinic. What’s more, sick leave usage and health insurance claims have been consistently decreasing since the clinic’s opening. And finally, the university has also seen savings through added productivity. The report calculated lost productivity as the time away from work while still getting paid by the employer and found that savings totaled more than $1 million. Due to the clinic’s success, the facility moved to a more central location with additional exam rooms, longer opening hours, and innovative equipment and software in 2015.

Companies of all kinds can begin offering onsite health benefits either with the creation of a workplace clinic or by outsourcing clinics by hiring consultants like Crossover Health and One Medical to provide healthcare, depending on their needs and budget. Faye explains that these projects can start out small, like the one she piloted, and then grow into full-fledged departments once proven beneficial. However, Faye strongly encourages workplace clinic advocates to look at the financial element first.

“Sometimes nurses promote prevention and having a health focus for employees, but to sell it, we have to look at the cost factor,” she explained. “More and more nurses are looking at that. It has been a weakness in our argument for years. We have to speak the language of finance to the decision makers.”