For some companies, the doctor is truly in the house Jose Pelaez / Image Source A growing number of companies are offering employees in-house health clinics staffed by doctors in an effort to rein in soaring health care costs. By Chelsea Emery, Reuters So much for the "I have a doctor's appointment" excuse when seeking a three-hour lunch break from work. U.S. companies as diverse as chipmaker Intel Corp and printer Quad/Graphics Inc have opened in-house health clinics with doctors, nurses and even dentists to diagnose suspicious symptoms, write prescriptions and more. Most recently, they are adding services to manage chronic conditions such as diabetes. The clinics and their lengthening list of services reflect the latest efforts to counter soaring health care costs. While companies have for years offered yearly flu shots or brought in yoga teachers, that hasn't been enough to offset expenses from rising obesity rates and other conditions. "We were beginning to see ... growing chronic conditions in our population," said Tami Graham, director of global benefits for Intel. All the stuff that ails America, ails Intel. For every dollar spent on in-company programs, employers get a return on investment of $1.50 to $3, according to a 2009 study by the American College of Occupational and Environmental Medicine, a society of health care professionals. Of course, in-house clinics can't do everything. Workers still want and need outside specialists for complicated health needs like surgery or childbirth. And privacy concerns linger despite legal protections, with some employees worrying that personal data could cause companies to fire less-than-healthy employees. Clinics are "potentially a very good idea," said Lewis Maltby, president of the National Workrights Institute, a legal advocacy organization. Assuming, of course, that the medical records are really confidential. That's a big assumption. Proponents claim the clinics do protect employee privacy. Employers and employees hail the services, saying they save money and time. Workers can walk to nearby clinics, rather than spending work hours commuting to doctors' offices. And the convenience prompts many to get symptoms checked quickly. Urgent - and contagious - conditions are then caught earlier. 'A whole new world' Such was the case with Quad/Graphics customer service representative Tim Liskowitz. After two days of feeling weak and exhausted, Liskowitz visited the clinic in his West Allis, Wis., building. He was dangerously dehydrated and suffering from highly contagious mononucleosis. While being hooked up to intravenous fluids, Liskowitz, a diabetic, met the clinic's diabetes care coordinator for the first time. After getting mono "out of the way," Liskowitz began meeting regularly with the diabetes coordinator and found an insulin treatment that worked better than his previous regime. "It was a whole new world from there," said the 33-year-old Liskowitz, who recently lost 30 pounds, more than 10 percent of his body weight, with the help of clinic staff. Stories like these have prompted companies to either add more clinics, or increase their focus on ongoing conditions like obesity. Employers "are seeing a tremendous increase in chronic conditions which is mirroring what we're seeing in the country," said Peter Hotz, a group vice president at Walgreen Co. A Walgreen subsidiary, Take Care Health Systems, operates on-site centers for companies. The centers can provide X-rays, physical therapy and emergency care. The division, currently operating about 375 work-site centers, has seen demand grow by "low teens" over the past three years, said Hotz. Clients are clamoring for more anti-obesity measures, so they are stepping up nutritional counseling offerings, added Hotz. Intel operates four clinics at different locations and plans to add three more in the "next year or so," said Graham. To meet growing demand for diabetes care, some have started providing certified diabetes clinicians. Financial firm American Express Co , which has 15 "wellness centers," has added to its obesity and stop-smoking programs and said it has seen employee weight and tobacco use drop. Cost 'gallop' The growth in clinic demand comes as health care costs for employers and employees, are "galloping ahead," said Helen Darling, president of the National Business Group on Health, a nonprofit group that represents large employers' perspectives on national health policy issues. "Unhealthy people cost a lot more," Darling said, adding that the rising rate of obesity is one of the biggest culprits. Companies will pay an average $11,664 per employee for health care costs this year, up 5.9 percent from last year, according to a survey by Towers Watson/NBGH. Employees' share of premium costs rose 9.3 percent, to $2,764 per employee. An estimated 42 percent of U.S. adults could be obese by 2030, adding $550 billion to health care costs over that period, according to a study published earlier this year in the American Journal of Preventive Medicine. That leaves room for a lot of spending on obesity prevention programs, but the clinics are costly for employers to sponsor. An average Intel clinic, for example, can cost $1 million to build and another $1 million to run, said Graham. And there are other drawbacks. Not everyone is thrilled about seeing a company doctor; worries abound that workers could be penalized or fired if their boss sees expensive medical conditions in their personnel records. However, clinic proponents say on-site facilities are operated by third-party managers who never disclose data to employers. "There are very strict laws against that," said Take Care's Hotz. Maltby of the National Workrights Institute recommends that all patients ask how medical records are kept and who has access to them. In addition, employees should always ask their doctor if there is a "doctor-patient relationship," in which medical conditions are kept private, said Maltby. "If the doctor says 'yes,' you can probably proceed with relative confidence," he said. Many employees find any potential risk worth the reward. American Express counted more than 35,000 visits to its six U.S. wellness centers in the past year. Quad/Graphics's Liskowitz estimates he's saved about 120 hours by having regular diabetes checkups at his office, rather than traveling to see a doctor. And the convenience and follow-up have improved his life in other ways. "My wife loves it because I'm going to live now," said Liskowitz.