Bruce Beadle used a multifaceted approach to lose 90 pounds and get his blood pressure, cholesterol and diabetes under control.
He did aerobic and weight training every day at 5 a.m. He swapped greasy breakfasts for steel-cut oats. He wrote down the contents of six meticulously balanced meals daily.
His success makes Beadle a 55-year-old poster child for a program that put a medical clinic at the Massillon company ARE Accessories, where he serves as director of information services.
The growth of such on-site medical care is expected to continue a several-year trend as more companies look for ways to control their health-care-related costs.
Beadle doubts he could have achieved his positive health outcome without the help of the in-house medical staff at ARE Accessories, which monitored him weekly after finding his conditions during an annual health assessment in November 2010.
“Everything was off the chart,” he said. “They said I should be in the hospital, but I convinced them I was feeling all right.”
The clinic staff kept him accountable for maintaining the lifestyle changes that might have saved his life.
“It was a constant reminder,” he said. “It was easier for me.”
Periodic blood tests done to monitor his condition required a night’s fasting before each one. Had Beadle gone to a doctor elsewhere, he would have risked getting light-headed while driving. Using the in-house clinic allowed him to take his normal drive from Canal Fulton to work, give his blood sample, eat breakfast and go to his desk.
During the steepest part of his climb to good health, there were times Beadle didn’t feel right. He was able to drop into the clinic on Tuesdays and Fridays without an appointment. He could do the same thing before or after a long weekend.
“It’s access,” said Shelly Rentsch, chief operating officer of Employer HCS, a Jackson Township company that provides workplace medical clinics. “It’s ease of getting into the clinic. I think access is critical to compliance.”
The clinic Beadle used was opened after William Schweizer was brought in to turn around ARE Accessories, a maker of truck caps, in 2007. He identified medical care as a significant cost. Even though the company was self-insured, expenses were rising more than 12 percent a year.
“And when you analyze what drives the cost of that health care, you typically find that on the order of 15 percent of the plan members push 85 or more percent of the cost, typically in the form of catastrophic costs,” said Schweizer, who believed so strongly in the merits of putting a doctor in the shop that he left ARE to start Employer HCS.
Immediately prior to his hiring at ARE, two employees needed kidney transplants, a procedure that can cost more than $250,000 each.
“A diabetic patient who is noncompliant with their medication [regimen] can blow out a kidney and need a kidney transplant in the future,” said Schweizer, president and chief executive officer of Employer HCS. “If you can avoid that kidney [transplant], you’ve avoided a significant cost.
“For example, high blood pressure and high cholesterol can often lead to coronary artery disease. If you can catch that early and manage it medically, then you avoid things like stents, bypasses, heart attacks.”
Those conditions, which can be silent killers, go undetected in people who don’t bother to get examined because they don’t feel sick.
The purpose of the workplace clinic is to eliminate as many barriers as possible to ensure employees get an annual health evaluation and act on significant findings.
“At ARE, the employees actually go to the clinic on the clock,” Schweizer said. “We schedule the appointments at 15-minute intervals.
“There is no insurance paperwork or anything to deal with. We expect the doctor to be dealing with the patient, addressing their lifestyle issues, their genetic issues, their medication issues for 15 minutes.”
Dollars make sense
Dr. Nashat Gabrail, one of Schweizer’s partners in Employer HCS, boiled down the benefit to the employee.
“If you come and see us in this clinic, you don’t pay a single dime. Prescriptions are all free for you,” he said.
“Essentially we want to avoid emergency room visits, avoid hospitalization. And how do you do that? Through early detection and prevention of complications and management of chronic diseases.”
It has worked at ARE, where medical costs dropped 25 percent, from $6,000 per employee per year to $4,500 in the five years after the clinic opened, according to Schweizer.
In addition to improving health by encouraging prevention, the company saved money by hiring a medical staff for nine hours a week.
“This is like time-sharing a doctor,” Schweizer said. “It’s buying wholesale versus buying retail.”
He said the up-front savings were twice the cost of the clinic’s operations.
The average visit to a private doctor’s office is $190, said Schweizer, whereas the clinic’s average is $120.
Gabrail pointed to a typical blood test that might be administered as part of an annual physical. The cost billed to the insurance company is around $200. The clinic does it for $10 or $15.
It’s a matter of dollars and sense to Gabrail, whose main practice is in cancer treatment.
“Traditionally, the way health care works in America is the employer ... basically pays the bill,” he said. “So here you are, the person who pays the money is completely out of it. There is no other business model in the world just like that one.
“With our plan, which really works best with people who are self-insured, the employer is in charge because they actually own the clinic.”
About 59 percent of private-sector workers with health coverage were in self-insured plans in 2011, according to Jay Senter, public relations strategist for the American Academy of Family Physicians, based in Leawood, Kan.
A growing idea
Having a doctor in the shop seems to be a growing trend.
In 2011, 23 percent of companies in a national survey said they had an on-site medical clinic, Senter wrote in an email. The number rose to 28 percent in 2012 and 32 percent in 2013. Some 39 percent planned to provide on-site clinics in 2014.
Stark County Commissioner Richard Regula believes a workplace medical clinic could trim the $16.9 million the county is expected to spend this year on employee insurance claims. He points to the success at ARE and at snack food maker Shearer’s Foods of Massillon, which opened a similar clinic.
Regula estimates that about half the county’s employees and covered dependents don’t get annual checkups.
“If you don’t think taking half a day off work and a $25 co-pay isn’t a deterrent to going to see the doctor, it is,” he said.
Regula said workplace clinics cut costs “because you find these train wrecks before they become train wrecks.”
Commissioner Janet Weir Creighton, however, says the county has too many pressing concerns to start a clinic.
“I think it’s extremely difficult for a government to go start down that path given that we are a 24/7 operation, No. 1,” she said. “No. 2, I think we give our employees great health-care benefits, and I’m not really here to dictate to them that they use the doc on site.
“We give them the benefits; they need to make the decision. I cannot force you to go to a doctor.”
Communication is key
ARE’s experience with costs that rose and fell sharply might have been due to the relatively small size of its population.
“It’s sometimes [good or] bad luck,” said Dr. Robert L. Wergin, who is president-elect of the American Academy of American Physicians. “It doesn’t take too many people to skew your data.”
Wergin sees a role for job-site clinics in reducing costs and improving accessibility in the same way as those that have emerged in such retail locations as drugstores.
“I would say in the case of retail clinics, we feel that scope should be defined, and then if you have some chronic or complex illness, that you ought to have a primary-care doctor help coordinate and take care of that,” Wergin said in a telephone interview. “The key point there is to communicate with that physician in some way.
“I still feel, and I think the academy feels, that fragmentation of care is not good,” said Wergin, a family practitioner in Milford, Neb.
His philosophy is that medical services should be delivered by “the right provider at the right time and the right care.”
Dr. Yousif Alhallaq, 34, tries to be an important part of that mix at ARE Accessories.
He became the clinic’s doctor Nov. 19, when Employer HCS took over from the original contractor.
A native of Kuwait who spent his early childhood near Dayton, Alhallaq has worked in hospitals where he saw patients who suffered heart attacks and strokes from uncontrolled chronic conditions.
“Then if they have permanent paralysis or partial paralysis, or if the heart muscle is weak, the damage could be life-long,” he said.
Schweizer said the Employer HCS clinic at ARE has exceeded expectations.
“We’ve seen over 400 patients already,” he said last month. “They’re doing their annual blood draws. We’ve already found several significant cases.”
Among them are a woman whose blood pressure was high enough to cause a stroke, and another, only 37, who was believed to have already suffered a mini-stroke or transient ischemic attack.
Alhallaq said the clinic gives him the chance to put into practice the principle he learned as a medical student at the University of Jordan.
“If you can prevent an illness, it’s better than 100 treatments.”
Nancy Molnar can be contacted at email@example.com.