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hen renewed interest in onsite clinics started to take off, questions arose in the medical field as to how they would affect established local health care providers — and their revenues, Boress said. But rather than cut-throat competition, longtime medical groups appear to be collaborating with companies and their workplace clinics, at least in the Bay Area. “In the beginning, there was this impression that we might be stepping on each other’s toes,� said Dr. Ronesh Sinha, lead physician for
Palo Alto Medical Foundation’s corporate outreach efforts. “But now we find that health care is so complex, and for a busy employer, we have to figure out ways to partner and make it simple and convenient for the employee. “Our hope is that it will probably offload our burden, and we’ll have more availability and take on more patients,� he said. The medical foundation’s involvement with on-site centers has evolved from customized lectures to mobile clinics and other services, he added. Some hospitals do compete with private vendors to establish their own on-site clinics, but large em-
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ployers like Cisco or Apple prefer to hire health companies that can easily scale up to provide services nationally, or even worldwide, according to Sinha. Hospitals and on-site centers, however, work together at times to organize seminars and refer employees to specialists. A dermatology telehealth program launched by Stanford Hospital & Clinics in collaboration with Cisco, for instance, allows employees to consult with a Stanford dermatologist while in Cisco’s Health Center via videoconference. Stanford Hospitals also recently conducted lectures and blood-pressure screenings in May at Qualcomm for more than 200 employees, according to Stanford’s Dr. Sumbul Ahmad Desai, associate chief medical officer for strategy and Innovation. “We have seen no impact on primary care providers. ... Our goal is to facilitate increased collaboration across the health care continuum,� she wrote in an email. Stanford Hospitals also run its own on-site clinic at the Redwood City campus of DreamWorks Animation, operating since September 2012, where about 500 employees get access to a primary care doctor three times a week. Palo Alto Medical Foundation doctors also provide monthly lunchtime lectures, biometric screenings, health risk assessments and consultations for Marvell Semiconductors employees. By partnering with on-site clinics, doctors at local hospitals can access health information gathered during a patient’s on-site visit or refer the patient to an on-site clinic for follow-up visits, according to Sinha. “If a PAMF patient has a chronic condition like diabetes, for instance, and we know ... they have to follow up for an exam or a vaccination, we can refer them to the on-site clinic,� he said. rivacy concerns have surfaced as one area of concern to potential patients of on-site clinics. So employers are trying to address privacy by establishing clear boundaries between the clinic and themselves. “We have some employers who don’t even want their names or logos anywhere near the health center; they just have the vendors’ logo — like
Receptionist Sarah Schofield staffs the desk where Facebook employees check in for the health center using an iPad.
having a McDonalds in your cafeteria — to make sure that people know that this is a third party and they don’t have anything to do with it,� Boress said. “Employers still get aggregate reports, so they know what’s going on, but they never get individual reports.� HP’s clinic, for instance, uses separate Internet and phone lines to maintain appropriate boundaries. When looking to the future of onsite centers, workplace health professionals predict that the service will add to a company’s lure in attracting more employees. Conveniences such as letting employees access their own health information in real-time and
make appointments on smartphones could add to the allure. “When people start looking for jobs, they are going to be asking, ‘Is there a health center available on site?’� Boress said. Some employers, like HP, have already extended their services to employees’ families, while others plan to. “It’s certainly our hope to do that,� Facebook’s McQueen said. “Since it is such a tremendously successful program, we would love to offer it to our (employees’) families in future.� N Ranjini Raghunath is a Palo Alto area freelance writer.
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