The Doctor Is In

A push for more efficient healthcare challenges designers to bring medical services to retail
Posted June 10, 2013

Any Lab Test Now is probably your doctor’s worst nightmare. The service, which allows patients to request their own lab tests without a physician’s order, has even trademarked the phrase “No insurance? No problem.” It’s like Googling your own symptoms on steroids: Instead of a rumpled printout (apology expected), you can hand your physician a crisp set of lab results to back up your self-diagnosis.

Whether it’s the beginning of a new age of medicine and hyper-informed patients or a symptom of rising national hypochondria, retailers launching healthcare clinics and services expect robust growth. From pharmacy-side clinics to natural health stores staffed with medical professionals, the move to harness consumers’ impatience and curiosity about their health is adding new opportunities and challenges for designers across the U.S. Oh, and Any Lab Test Now is currently franchising, if you’re interested.

While these clinics offer a way to address health concerns free of scheduling hassles, they may also reflect the sobering fact that there are fewer and fewer primary care physicians. The passage of the Affordable Care Act in 2010, with all of its questions about curbing healthcare costs, hasn’t curtailed the flood of practitioners leaving primary care as insurer reimbursements dwindle and workloads swell. Appointment waiting lists in cities like Boston, where healthcare is already universal, are regularly longer than 60 days, according to Andrew Sussman, a physician and president of CVS Caremark’s MinuteClinic (Woonsocket, R.I.).

“Not surprisingly, Massachusetts is one of our fastest-growing markets,” Sussman says. “This demonstrates what the national experience could be in 2014.”

Currently, more than 1400 retail-based clinics – MinuteClinic claims 650 of these – have popped up in “high-traffic retailer outlets with pharmacies,” according to the Convenient Care Association. A 2009 study found that retail clinics cost 30-80 percent less than comparable visits to emergency departments, urgent care clinics or physicians.

These clinics reflect not only changing legislation in the U.S., but shifting American mindsets about health. And they are indicative of the move from provider-centric, symptom-based medical care to a model many hope will broaden access to preventive care without creating an unmanageable financial burden. The premise is simple: prevent costly illnesses, and you can treat more people for less.

Crosby Renwick, executive director of strategy, CBX (New York), says these retail clinics are positioning themselves as self-care service providers: “People are saying, ‘You know what? I’m going to take care of this.’ They aren’t waiting for the doctor to get back to them with results.”

In some cases, they aren’t visiting the doctor at all, as companies like Any Lab Test Now grow in popularity. The company has 150 stores and even offers AmeriDoc telemedicine services, which allow for physician-patient phone conferences.

Blue Cross Blue Shield and UnitedHealthcare are among the insurance companies offering retail locations where members can sign up for coverage or question claims. It’s a nod to the expected growth in individual insurance buyers in 2014, and a new frontier for insurance companies accustomed to working business-to-business.

Yet retailers themselves may be best positioned to take advantage of the growing demand for high quality, walk-in medical care. “As consumers, we know we’re in a CVS or in a Walgreens,” says Andres Nicholls, a partner at Prophet’s New York office. “Trust comes from the brands that are offering the services. Design is a tool, but when you go to a MinuteClinic, you go to a CVS. If we insert a lookalike healthcare facility, it’s not going to fly.”

The challenge to designers, then, is to balance the brand aesthetic, comfort and the white-coat sterility that consumers associate with trustworthy medical environments. “It’s a delicate balance between cozy and warm and clinical and professional,” Renwick says. An environment that’s too informal undermines trust, yet a clinic in a retail setting is too unpleasant to encourage browsing. For balance, Renwick advises keeping white coats for instant credibility, but balancing them with calming, natural materials that suggest wellness for a spa-like feel.

If a spa-like aesthetic doesn’t quite fit, a domestic tone might. Mike Wittenstein, managing principal and lead experience designer for the brand strategy consultancy Storyminers (Marietta, Ga.) says environments one notch nicer than a patient’s living room “make people feel comfortable, well-treated and respected.” That means interplay of wood and fabric materials and varied lighting rather than simple spotlights.

Wittenstein also urges designers to consider the psychological implications of rows of chairs – and anxiously waiting patients – facing each other. Seating arrangements that encourage indirect lines of sight, he says, add a sense of privacy and lower stress. And calmer, more relaxed patients can have a ripple effect: “The staff gets a warmer, friendlier patient to talk to, which reduces their stress. When they go in the back, they don’t share those negative vibes. It perks the whole place up – things flow more smoothly, and special requests are handled with more grace.”

Visible, approachable signage – the antithesis of dog-eared Xeroxes that warn patients of impending fees and penalties – sets a friendly tone, increases patient satisfaction and can prevent interruptions that typically lengthen wait times.

Color, of course, plays a part in aesthetic, too. The typical greens, blues, oranges and yellows we associate with health and medical companies may still work if given a thoughtful refresh. Prophet’s Nicholls suggests adding more energetic hues that represent health and credibility, with minimal use of red: “Red connects with the notion of healthcare, but it’s scary, too. Red is life, but red is also blood.”

After accounting for lighting conditions – are there nearby windows or is the clinic in a corner? – Nicholls suggests using vibrant hues sparingly and pairing them with a bright white tone that matches available light. “We can select the most beautiful blue, but if it’s overused across the environment, people will feel overwhelmed and sick,” he says. He points to CVS’ MinuteClinic as a design that works, with red pulled from the company logo and a vibrant sky blue that evokes health and energy.

Working with larger, more established brands may also force designers to pay close attention to what the brand conveys emotionally to its advocates, and why that tone works. According to Wittenstein, designers used to a blank slate from clients – ever had a client shrug when asked about their brand’s personality? – should expect a bit more information from these larger players: “Most often, these companies are extremely aware and have deeply developed brand guidelines. Merchandisers who see themselves as brand strategists, too, will create first impressions and lock-in moments that are vital to the brand.”

Retailers like Pharmaca (Boulder, Colo.), which offers a pharmacy, along with supplements, cosmetics, healthy edibles, facial care products and eco-friendly gifts, exemplify this strong branding. The integrative pharmacy knows its target shopper: someone who is proactive; open-minded; interested in community, sustainability and natural living; and who values organic products, recyclable packaging and sustainably sourced ingredients.

Pharmaca has taken the retail clinic/convenient care concept, tweaked it for a sustainably minded audience, and integrated clinicians with the store environment, bringing Ayurvedic practitioners, herbalists, estheticians, naturopaths and other experts not to an isolated clinic, but to the store floor itself.

Materials reflect the core values of these niche shoppers and include recycled carpeting, bamboo flooring and low-VOC paints. Each store has a tea room with complimentary beverages for the domestic touch Wittenstein advocates. “It’s almost like sitting in the home of a close friend,” says Mark Panzer, Pharmaca’s ceo.

This sense of a clean, natural environment with the comfort of home is bolstered by pharmacists in white coats and practitioners on the floor in light green lab coats for added expertise. Store signage lists practitioners on the floor that day so shoppers can seek out their preferred expert.

Still, the most valuable service retail clinics provide isn’t merely a physician replacement. In fact, nearly every interviewee for this article said that clinics should supplement, not overshadow, a primary care physician, providing a level of time-saving and convenience doctors’ offices rarely match.

Convenience in these clinics may mean incorporating smarter technology, not merely electronic medical records and iPad scheduling devices. “Make it intriguing to be in the environment,” says Wittenstein. “Could you get an app that reminds you to take your pills or reminds you not to get junk food at 4 p.m.?” When visual merchandisers take ownership of saving patients time and energy, he says, their skills will be most valuable.

That means easy, private scheduling with the swipe of a loyalty card, suggested shopping lists, the ability to browse the store and be notified when your provider is ready and leveraging available medical technology to bring patients into the experience. For example, what if a doctor could not only look in your child’s ear, but project that image onto a screen to show you exactly what she’s doing?

While designers create spaces that are as comforting as home yet trustworthy enough to visit for an ear infection or a sore throat, it pays to keep an eye on potential players in this sector. Nicholls says Walmart and Target are companies to watch: “They don’t have the immediate association with healthcare like CVS and Walgreens, but they have strong pharmacy programs.” 

As retailers learn to be healthcare providers, health agencies turn an eye to walk-in clinics and a nation waits to see how the ACA will trickle down in 2014, perhaps the only certainty is that physicians and patients alike are ready for a less stressful interaction.

“Traditional healthcare environments scream, ‘It’s not about you, it’s about us,’ ” says Aaron Spiess, president and co-ceo of Big Red Rooster (Columbus, Ohio). “Uncomfortable chairs, sick people, strange smells and someone behind a glass partition yelling your name: No retailer would run an environment like that.” The challenge for designers, then, is to create a new environment for this new world of healthcare – whatever it looks like, come 2014.