By Garren Shipley — Daily Staff Writer

STEPHENS CITY — From the outside, Valley Health's Quick Care clinic near Stephens City could be any other strip mall health clinic.

But the facility, which opened late last year, is the first wave of a sea of change to hit the Northern Shenandoah Valley in how health care is delivered.

Staffed by nurse practitioners, wait times at the clinic are minimal, and costs are known upfront. Visits start at $50 or an insurance co-pay, and the clinic will treat a wide variety of minor maladies from skin rashes to sinus and bladder infections.

For Valley Health, the clinic is all about bringing a basic level of health care to an area short of physicians, according to Wes Williams, a spokesman for the nonprofit chain.

"We're trying to expand our primary care base in the area," Williams said. "Research shows that there aren't enough primary care providers in the area."

That sent people with minor ailments to the emergency room at Winchester Medical Center or Urgent Care centers — places where minor care is very expensive.

"At the same time, consumers are growing restless with the typical way that health care is provided, especially younger health care consumers," Williams said.

"They're not happy with the long waits," he said. And "a lot of people are looking for a less expensive way to take care of some of their simpler health care needs."

The end result is the region's first experiment in "retail health care," he said. "That's what people are asking for and demanding. They want convenience, they want accessibility and they want things quick."

Since it opened in September, the clinic has been a resounding success, and the nonprofit is considering adding other locations.

The idea of "retail health care" is a relatively new one. The first such clinic opened in Minnesota in 2000 and took only cash.

In 2006, there were more than a dozen companies across the country running clinics.

As of November 2007, there were 700 clinics up and running, with that number expected to more than double by the end of 2008.

While Quick Care is the leading edge of the wave for such establishments in the Northern Shenandoah Valley, for-profit operations have established a significant beachhead in the commonwealth — with a decided emphasis on "retail."

Minute Clinic, co-located in CVS pharmacies, has 21 locations in Northern Virginia and Richmond, while Redi-Clinc, another national company, has nine operations located inside Wal-Marts in and around Richmond.

Retail clinics are expanding and will likely become commonplace, so Valley Health wanted to set up the first one in this area so as to "set the bar" for the level of care provided by such facilities, Williams said.

Some 300 miles to the south, the retail clinic model has already taken wing.

Mountain States Health Alliance, a nonprofit chain of hospitals in Southwest Virginia and Northeast Tennessee, partnered with regional grocery chain Food City to open a number of cash-only clinics just across the state line.

For a $40 fee, nurse practitioners and physician assistants will take care of routine illnesses like sinus infections, skin rashes as well as provide immunizations and other services.

Prices are made clear upfront before any tests or other services are done.

The initial idea was simple — unclog the emergency rooms at the chain's hospitals, according to Ed Herbert, a spokesman for the Johnson City, Tenn.- based company.

"It started with the fact that our emergency department was being misused by people who had minor aches and illnesses," Herbert said.

Having seen the retail clinic idea work in other places, Mountain States decided to give it a try in their region.

It worked, maybe a little too well.

Not only did the minor injuries and illnesses trend away from the emergency rooms, but people who might not otherwise have sought treatment for illness — such as those without health insurance — flocked to the clinic.

Not everyone is a fan of retail medicine, though.

The American Academy of Pediatrics opposes the concept on several grounds, most notably on the grounds that children need to be seen at a single practice.

By going to a retail clinic rather than a pediatric practice, children with chronic diseases that present as periodic illness might not get the treatment they need, the group says in a policy statement.

"Many pediatricians use the opportunity of seeing the child for something minor to address issues in the family, discuss any problems with obesity or mental health issues, catch up on immunizations, identify undetected illness, and continue strengthening the relationship with the child and family," the group says.

No one is trying to replace the primary care physician, according to Herbert.

"The strength of ValuCare was that these people didn't have physicians," giving Mountain States the opportunity to steer patients toward traditional doctors once their immediate needs were met, he said.

Valley Health also is trying hard to compliment, not compete with, primary care doctors, said Williams. And some practices have shown interest in setting up their own retail clinics as a way to see patients in a more efficient manner.

Even with referrals, the clinics remain busy. It's not hard to see why.

"This is something that is quick and easy. When you leave the ValuCare you can step right over to the pharmacy. It's one stop shopping," Herbert said.

"Right now what we're finding is that if we just tap the Food City [shopping] population, we'll probably be overwhelmed," Herbert said.

* Contact Garren Shipley at gshipley@nvdaily.com