Mayo Clinic’s second, and Rochester’s fifth, convenience medical clinic opens today.

The new Mayo Express Care is inside the Hy-Vee south grocery store, 500 Crossroads Drive S.W. Mayo announced plans a year ago to open several such clinics.

“This additional location will help meet a continued high demand for this cost-effective model of care, which provides convenient access for patients with minor medical issues requiring prompt treatment, such as allergies, colds, ear infections, sore throats, pinkeye, respiratory illness, sinus infections (and) skin conditions,” says a Mayo Clinic announcement.

The quick clinics offer limited services in retail settings. The first one in Rochester was opened at Shopko in October 2007 by Olmsted Medical Center. Soon after, Target Clinic opened in the Target in Shoppes on Maine in south Rochester. Another FastCare and the first Mayo Express care followed.

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The CVS pharmacy chain is hoping that an ambitious flu vaccination program will provide a shot in the arm in another way — by drawing first-time customers to its stores and clinics.

With a goal of delivering 1 million flu shots this year, the company recently launched a high-profile advertising campaign that, for the first time, puts its MinuteClinic outlets front and center.

National TV ads promoting the flu vaccinations began airing in October and showed up during such marquee broadcasts as the Major League Baseball playoffs. The company declined to say how much it had spent on the campaign, which centers on prime-time television with some radio and print.

“We’re trying to build awareness of MinuteClinic,” said Bari Harlam, vice president of pharmacy marketing for CVS Caremark Corp.

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As in-store health clinics continue to expand in the Pittsburgh market, research is raising concerns about their long-term viability.

Featuring upfront, no-frills menus limited to routine needs, retail clinics embrace a 15-minute, fast-food approach to health care that has gained in popularity.

Since the first such clinics opened here two years ago, the number has grown. The Pittsburgh area is expected to have 24 retail clinics by the end of the year, almost evenly divided between Take Care centers at Walgreens and MinuteClinics at CVS.

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Walk-in retail clinics, launched in Minnesota eight years ago, continue to carve a niche as providers of basic, uncomplicated health care. Despite recent missteps, slower than anticipated growth and opposition from physician groups, the clinics are becoming an established member of the nation’s health care delivery system, and health plans increasingly are contracting with them.

The reasons: cost, convenience, growing consumer and employer acceptance, generally high-quality care, and a recognition that these clinics can help relieve pressure on overburdened (and expensive) hospital emergency rooms (ERs). Large and small insurers (as well as Medicare) cover their services, typically with modest copayments. Blue Cross and Blue Shield of Minnesota recently dropped its required copays to encourage member use of local retail clinics.

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When people look at the US healthcare system, they imagine that private healthcare has to be hugely expensive. But the reason it’s expensive is because it’s hugely over-regulated. Tax and regulatory rules promote insurance through employers – reducing individual choice and meaning you lose your insurance when you change jobs. You can’t buy insurance across state lines – live in New York and you have to have a Rolls-Royce insurance plan of the kind New York specifies: you can’t buy a SmartCar plan, even if that suits you better.

And of course a rising part of the US healthcare system is the federal Medicare and Medicaid plans - bigger than the UK National Health Service, and growing fast:, according to the CBO, Medicaid and Medicare alone will absorb 20% of GDP in 70 years’ time.

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Despite all the hype, the rise of mini-clinics on every street corner that once seemed so inevitable appears to have stalled, or at least has lost some of its initial steam, in parts of the Metroplex.

For instance, in February, when the world’s largest retailer, Wal-Mart, announced plans to build 400 health clinics at its supercenters nationwide by 2010, it seemed that the “doc-in-a-box” phenomenon was destined to take off. Wal-Mart identified Dallas, Atlanta and Little Rock as among the first markets to open clinics by April. Target was another big-box retailer that had thrown its hat into the ring in select locations nationwide.

Wal-Mart leased space in dozens of stores to outside companies to operate the medical clinics. And the company initially stated that it expected to open the clinics with RediClinic and an unnamed local hospital system in Dallas by the summer of 2008.

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