US20060143997A1

US20060143997A1 - Hospital medical care and referral system with clinics at off-site locations

Info

Publication number: US20060143997A1
Application number: US11/025,306
Authority: US
Inventors: David Libenson
Original assignee: INTERNATIONAL HOSPITAL Corp
Current assignee: INTERNATIONAL HOSPITAL Corp
Priority date: 2004-12-29
Filing date: 2004-12-29
Publication date: 2006-07-06
Also published as: WO2006071870A2; BRPI0519665A2; WO2006071870A3; MX2007007809A; CA2592386A1

Abstract

A hospital system and method for providing medical care and patient referral in which a clinic is located off-site from a hospital at a facility which is open to the public for non-medical activity. The clinic is affiliated with the hospital such that the clinic provides medical care of a type and quality required by the hospital and is obligated to refer patients to said hospital. Patrons at the facility can seek and receive medical care at the clinic and can be referred by the clinic to the hospital.

Description

BACKGROUND OF THE INVENTION

This invention relates to a system for providing medical care. More particularly, this invention relates to a system of providing medical care and patient referrals to hospitals through hospital affiliated clinics located at off-site facilities or stores which are accessible to the public for non-medical activities. The clinics are staffed by medical personnel, including licensed physicians. According to the invention, people who enter the off-site facility for a non-medical activity also now have access to the clinic and are able to utilize the clinic to receive medical care from the medical personnel at the clinic. When the medical care required is beyond that which can be provided by the clinic, the clinic personnel refer the person to the affiliated hospital.
In the United States, patients usually obtain medical care and are referred to hospitals in a variety of ways. In a typical situation, a patient will obtain primary medical care from his or her doctor and will be referred to a hospital for medical care that the doctor cannot provide at the doctor's office. The doctor may know of a number of hospitals within the area and the doctor can refer the patient to the hospital best suited to the patient's particular medical needs. In emergency situations, a patient may be taken to the closest hospital with an emergency room capable of handling the emergency medical condition.
Also, hospitals with emergency rooms may receive patients with various medical needs. These patients may select a hospital themselves because of their knowledge of the hospital or may be referred to a hospital emergency room by their doctors who cannot for one reason or another handle the medical need at the time required by the patient. Many people refer themselves to emergency rooms because they do not have medical insurance or a private doctor. In any case, emergency rooms usually require a long wait especially for less critical medical problems, and thus are often not an efficient way for a hospital or the patient to attend to routine medical problems.
While these traditional ways of gaining access to patients have worked in the past for hospitals in the United States, the competition to attract patients has become intense. This has led hospitals to advertise their services and the credentials of their medical personnel, particularly the licensed doctors on their staff, as a way of promoting the hospitals and reaching out to the communities they serve. However, in the United States, hospitals are still looking for other ways of attracting patients, especially for the more severe types of medical problems for which are they are better suited.
Additionally, in many foreign countries, such as, for example, Mexico, there is not an infrastructure of licensed physicians with private practices to act as a patient referral source for hospitals. Private hospitals in these countries thus have a greater difficulty in reaching the population they serve. These hospitals therefore are likewise in need of ways to attract more patients.
Also, in the United States, as an alternative to seeking care in a hospital emergency room or a doctor's office, medical kiosks or booths have been placed in convenience and retail store chains to provide relatively inexpensive health care and treatment without requiring the supervision of a licensed physician. For example, medical kiosk operations such as FastCare (in Kroger stores), MEDspot (in Scott's) and MinuteClinic (in selected Target and Cub Foods stores) offer child vaccinations, flu shots, basic health screenings and sports physicals, diagnosis of minor health problems such as ear, sinus or bladder infections and cold or flu, and treatment of minor injuries or allergies. By providing these medical services in a setting such as a grocery or convenience store, such kiosks enable shoppers to obtain basic medical services more efficiently and without having to travel separately to an emergency room or a doctor's office. They also reduce the normally long wait periods for examination and also the amount of paperwork involved.
However, in spite of the convenience offered, medical kiosks are limited in the medical procedures they can provide (e.g., physical exams and medical screenings and prescribing some medications) and the medical diagnoses they can make, since they are staffed only by nurse practitioners. Also, these kiosks are privately owned by independent companies that are not readily recognizable to the public they are trying to attract.
As a result, while these operations offer an alternative for obtaining medical treatment, they fall far short of the care that can be provided by a doctor or in a hospital emergency room. Also, the lack of recognition that might otherwise attract a person to a doctor or hospital makes the kiosks less attractive to the public they are trying to serve.
Another system in which medical kiosks are proposed is described in U.S. Pat. No. 6,046,761. In this patent, medical stations arranged at the kiosks are provided to alleviate the need for a person to visit a doctor at a doctor's office. These medical kiosks, which can be staffed by a nurse, permit the user or patient to communicate through the kiosk with a doctor at a remote location such as at a doctor's office or a hospital to obtain medical advice. In particular, the kiosks have video and audio capabilities which enable an exchange of information between the patient and doctor so that the doctor can make a medical diagnosis of the patient's condition. The '761 patent also mentions that a doctors' group can set up kiosks in rural towns at a distance from the doctors' group so as to permit the residents in the rural towns to communicate with the doctors for medical diagnosis and treatment.
While the system of the '761 patent permits a more accurate diagnosis because of doctor participation, the limited contact over the telephone and by video between the doctor and patient is undesirable. Additionally, people may not be motivated to use these kiosks because of not knowing who will be providing their medical treatment.
It is therefore an object of the present invention to provide a hospital medical care and referral system which can provide efficient and convenient medical care to a patient, while at the same time providing a source of patient referral to a hospital.

SUMMARY OF THE INVENTION

In accordance with the principles of the present invention, the above and other objectives are realized in a hospital medical care and referral system and method wherein a clinic affiliated with a hospital is provided at a facility which is open to the public for non-medical activities and which is off-site from the hospital. The affiliation of the clinic with the hospital is such that the quality of medical care at the clinic is at least the same as required by the hospital and the clinic is obligated to refer patients to the hospital.
The clinic is staffed by one or more medical personnel, including at least one licensed doctor. Each licensed physician on the clinic staff is credentialed by the affiliated hospital and has to meet the criteria of the hospital, meaning the physician must abide by the rules and regulations of the affiliated hospital and must provide medical care that is of the type and quality required to be provided by the affiliated hospital.
The clinic is accessible to the pedestrian traffic at the facility. A person at the facility, either coming there for a non-medical activity or specifically to seek medical advice, has access to the clinic for any medical problem the person may have. The person can be treated by the medical personnel at the clinic, if the medical problem is treatable by such personnel, or the person will be referred by the medical personnel to the affiliated hospital for the appropriate treatment.
The system thus provides an affiliated hospital with access to pedestrian traffic that it would not otherwise have, i.e., those people engaging in non-medical activities at the facility. Because of the presence and convenience of the clinic, certain of these people may choose to seek medical care at the clinic. This care will result in referrals to the affiliated hospital in the event a medical condition is found that requires hospital treatment. Accordingly, the system provides more convenient care for patients, while at the same time increasing the patient base and referrals to the affiliated hospital.
In the preferred embodiment of the invention discussed hereinbelow, the clinic is at and within the facility and is staffed by medical personnel who may be employed by the hospital, including at least one licensed physician credentialed by the hospital. The facility is of the type in which the non-medical activities include at least the sale of food products and may include the sale of other types of products and/or services. Particularly, the facility is preferably a store such as a grocery store, supermarket, emporium, wholesale-club store, “mega supermarket” or similar retail market in which food and other household items and products are sold. Moreover, the clinic is situated along the flow path of the pedestrian traffic in the facility and, preferably, near an exit or entrance of the facility. If the facility has an area with one or more cashiers, the clinic is preferably arranged in this area and more preferably between the cashier area and the exit or entrance of the facility.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other features and aspects of the present invention will become more apparent upon reading the following detailed description in conjunction with the accompanying drawings in which:
FIG. 1 is a schematic view of a hospital medical care and referral system according to the principles of the present invention;
FIG. 2 is a schematic view of parts of the system of FIG. 1 showing in greater detail the hospital and off-site facility;
FIG. 3A is a detailed schematic showing the features of a first embodiment of a clinic of an off-site facility of the present invention;
FIG. 3B is a detailed schematic showing the features of a second embodiment of a clinic of an off-site facility of the present invention;
FIG. 3C is a detailed schematic showing the features of a third embodiment of a clinic of an off-site facility of the present invention; and
FIG. 4 is a flow chart illustrating the steps in a method for providing hospital medical care and referral according to the present invention.

DETAILED DESCRIPTION

FIG. 1 illustrates a hospital care and referral system 10 according to the principles of the present invention. The system 10 provides medical care and referral of patients to a hospital 20 which has a licensed medical staff. The system 10 includes one or more facilities 30 which are remote or off-site from the hospital 20. Although FIG. 1 shows a plurality of facilities 30, systems which include only one facility 30 are within the contemplation of the invention.
The facilities 30 are open to the public for any type of activity including at least a non-medical activity and are designed to support pedestrian traffic, as will be described in further detail below. The facilities 30 may be open or enclosed structures or buildings. In the illustrative embodiment of the invention discussed herein, the facilities 30 are stores that sell at least food products and may also sell household goods or other types of products or offer services to the pedestrians that frequent the facility. Examples of the types of facilities contemplated are supermarkets, grocery stores and “mega supermarkets” or warehouse-club stores that sell food items, clothing products, household products and various other types of products as exemplified by the following stores: HEB, Stop & Shop, Kroger, Tom Thumb, Food Emporium, Costco and Sam's Club. As above-indicated, each facility 30 is open to the public for an activity other than a medical activity, such as grocery shopping, so that it draws a regular flow of pedestrians to the facility. The facility may be independently located or may be enclosed within a larger structure such as a mall in which other facilities which provide non-medical activities are also located. The location of a clinic at a grocery store or supermarket that is in turn located at a mall or similar larger structure would serve to further increase the flow of pedestrians to the clinic.
In accord with the invention, a clinic 40 is disposed at and within each facility 30. Each clinic 40 is adapted to provide medical care and is staffed by medical personnel including at least one government-licensed physician. In further accord with the invention, each clinic 40 is affiliated with the hospital 20 such that the clinic is required to provide medical care of a type and quality required by the hospital and is obligated or has agreed to refer patients to the hospital. This referral obligation is indicated by a line 50 between the hospital and the each clinic.
In the preferred form of the invention, the affiliation with the hospital extends to the medical personnel, including the one or more licensed doctors at each clinic, in that these physicians are members of the hospital staff and are credentialed by the hospital 20, meaning they must meet the criteria of the hospital and provide medical care that is of the type and quality required to be provided by the affiliated hospital. Also, in the preferred form of the invention, the clinic 40 has additional features or attributes which indicate to the pedestrian flow in the facility 30 that the clinic is affiliated with the hospital 20. These will be described in more detail below.
As can be appreciated, therefore, in the system 10 of the invention, the hospital affiliated clinics 40 in the off-site facilities 30 extend the presence of the hospital 20 to convenient and publicly accessible locations which support pedestrian traffic for non-medical activities. The system 10 thus provides the hospital 20 with an outreach to a large number of people who might not have otherwise have been exposed to the hospital and for whom it can provide medical care through the clinic and receive referrals for medical care through the clinic.
FIG. 2 is a schematic view of a part of the system 10, including the hospital 20 and a detailed schematic of one of the off-site facilities 30 and its clinic 40. As shown in FIG. 2, the facility 30 has a main entrance and exit 131 for entering and leaving the facility. This leads to an exit/entrance area 132 having separate entrance and exit doorways 132 a, 132 b. Beyond the exit/entrance area 132, the facility 30 has a main shopping area 133 and may include separate stands, kiosks or displays along the interior periphery of the facility 30. In the embodiment shown in FIG. 2, the shops 134, 135 may be accessible from within the facility, or from outside the facility, or both.
As described above, the facility 30 is open to the public for grocery shopping or any other non-medical activity that draws a regular flow of pedestrians to the facility. The facility 30 also includes parking areas 136 external and adjacent to the facility, so that outside entrances to peripheral shops 134, 135 and the main entrance 131 of the facility 30 are easily accessible. Within the main shopping area 133 of the facility, aisles 137 are formed by lines of product displays. Such aisles 137 may be in rows, as shown, or may take various other forms depending on the configuration of product displays and layout of the facility 30. A checkout area 138 is located at one end of the main shopping area 133, preferably between the aisles 137 and the entrance and exit doorways of the facility.
Located within the facility 30, near both the checkout area 138 and the entrance and exit doorways 132 a, 132 b, is a clinic 40. The clinic 40 has an entrance 142 which is accessible to the flow of pedestrian traffic in the facility. The clinic may also have a second entrance 144 which is accessible to pedestrian traffic from the parking lot 136. This entrance also may be used by ambulances or other emergency medical vehicles. The clinic 40 is staffed by at least one licensed physician and possibly by other medical personnel, e.g. a nurse or nurse practitioner, and non-medical personnel, who assist the physician in rendering medical services. The scope and nature of the medical services provided in the clinic 40 will be described in further detail below with respect to the particular design and features of the clinic 40. The clinic 40 also includes a plurality of rooms 146, which will also be described in further detail with respect to three embodiments of the clinics 40 shown in FIGS. 3A, 3B and 3C.
As previously noted with regard to FIG. 1, the clinic 40 is affiliated with the hospital 20 such that the medical care is of a type and quality required by the hospital and such that patients are referred to the hospital for medical services not able to be performed at the clinic. This affiliation is represented by line 50 and, in the case of FIG. 2, is realized, in part, by the medical and non-medical personnel at the clinic being on the staff of and employed by the hospital 20. This affiliation is further realized by there being information flow between the clinic 40 and hospital 20. This can be realized via telephone, facsimile, the Internet or other modes of communication and enables the clinic to access information from the hospital 20 such as patient medical records or diagnostic tools and to supply patient information to the hospital, all of which enhance the medical treatment that can be provided to a patient.
In the case illustrated, the affiliation 50 also comprises incorporating features or attributes in the clinic which identify the clinic with the hospital. Thus, the clinic 40 uses similar signage and a similar motif as are used in the hospital. In particular, the clinic 40 uses the same colors, marks and logos, as used by the hospital 20, and these may be also incorporated in a sign 155 located adjacent the entrance 142 to the clinic.
The layout and design of the facility 30 dictate the pattern of flow of pedestrians through the facility. In the illustrative embodiment, a path 160 of pedestrian traffic is shown. This path has the entrance and exit doorways 132 a and 132 b of the facility 30 as end points and encircles the main shopping area 133, around most of the aisles 137. Obviously, many variations of the path of pedestrian traffic exist, based on the specific layout of the facility 30, the configuration of the main shopping area 133 and aisles 137, any additional product displays that may exist, and the location of checkout area 138. It is therefore understood that the substantially circular path 160 of pedestrian traffic shown in FIG. 2 is used herein as an example and that the invention is not limited to this specific traffic flow.
As can be seen, however, in the FIG. 2 embodiment, the clinic 40 is located so as to be accessible from the various pedestrian paths through the facility 30, and is particularly accessible by travel along the path 160. More particularly, in FIG. 2, the clinic 40 is located closer to the part of the path 160 at the entrance door 132 a of the facility 30. However, the clinic 40 is also in the area of and visible from the checkout area 138 and the exit door 132 b. The clinic 40 is thus visible from all pedestrians' paths, since they all have these areas, i.e., the entrance door 132 a, the checkout area 138 and the exit door 132 b in common.
As can be appreciated, the location of clinic 40 near the entrance and/or exit doorways 132 a and 132 b of the clinic, and preferably between the checkout area 138 and an entrance and/or exit doorway, exposes the patrons who visit the facility 30 to the clinic 40. A person entering and walking through the facility for purchasing a product or receiving a service, i.e., for a non-medical activity, is thus stimulated to consider also using the clinic 40 for a medical problem. This, in turn, may lead to the person to seek medical care at the clinic and, in some cases, to be referred to the hospital 20. The clinic 40 thus offers a way to provide both convenient patient care and increased patient referrals to the affiliated hospital.
If the size of the facility 30 permits, a pharmacy 170 may also be located therein, which may or may not be affiliated with the clinic 40 and the hospital 20. As shown in FIG. 2, the pharmacy 170 is also preferably located near the path of pedestrian traffic. The inclusion of a pharmacy 170 in the facility 30 further enhances the convenience and efficiency of the medical care to a person receiving care at the clinic 40. For example, a patron of the facility 30 who enters the clinic 40 and receives a prescription may then have the prescription filled at the pharmacy 170, so that a separate trip to a drug store or remote pharmacy is not required. In another possible scenario, a prescription may be called in to the pharmacy 170 by the physician in the clinic 140 so that the prescribed medicine is waiting for the patient when he arrives at the pharmacy. If the prescription cannot be filled expeditiously, the patient can either begin or continue shopping in the facility 30 and pick up the filled prescription later, on his way out of the facility 30, or he may pick up the filled prescription on his next trip to the facility 30. In this way, the combination of a clinic 40 in a facility 30 that also includes a pharmacy 170 provides a convenient and efficient system for patrons of a grocery store, for example, to receive medical attention and to obtain prescribed medicine promptly and easily.
Three different embodiments of the clinic 40 in the system of the present invention will now be described with reference to FIGS. 3A-3C.
In a first embodiment, shown in FIG. 3A, clinic 40 has a basic square layout. The clinic 40 includes an entrance 205 and reception area 210. A receptionist may be seated at reception desk 215 and may take identification information from a patient so that the patient's medical file, if already created, can be retrieved, or so that a new file can be created for the new patient. The entire clinic 40 in general, and the reception area 210 in particular, have privacy features 218 including, but not limited to, sound proof tiles in the walls and frosted glass. These privacy features 218 add to the comfort of a patient waiting to be seen by a physician in the clinic.
When a patient is to be seen by the physician or by his assistant, who can be a nurse or other trained medical assistant, the patient enters either a first examination room 220 or a second examination room 230. Each of the examination rooms are approximately the same size and include medical equipment necessary for basic medical evaluations and physical examinations, such as height, weight, and blood pressure. One or both of the examination rooms 220, 230 may also be suitably equipped with materials necessary to provide vaccinations and to collect laboratory samples from the patient. A bathroom 240 is also provided.
In the second embodiment shown in FIG. 3B, clinic 40 has a rectangular layout. The clinic 40 includes an entrance 305 and reception area 310 with a reception desk 315 where a receptionist may be seated. The receptionist may take identification information from a patient when the patient enters the clinic and is seated in the reception area 310 so that the patient's medical file, if already created, can be retrieved, or so that a new file can be created for the new patient. As in the first embodiment, the entire clinic 40 in general, and the reception area 310 in particular, have privacy features 318 including, but not limited to, sound proof tiles in the walls and frosted glass. These privacy features 318 add to the comfort of a patient waiting to be seen by a physician in the clinic.
When a patient is to be seen by the physician or by his assistant, who again can be a nurse or other trained medical assistant, the patient enters either a first examination room 320 or a second examination room 330. Again, each of the examination rooms are approximately the same size and include medical equipment necessary for basic medical evaluations and physical examinations, such as measuring height, weight, and blood pressure, and one or both of the examination rooms 320, 330 may also be suitably equipped with materials necessary to provide vaccinations and to collect laboratory samples from the patient. A bathroom 340 is also provided.
In the second embodiment of FIG. 3B, there is also included a stairway 350 that leads to a second floor area (not shown) that may be used for storage of supplies, or as additional patient examination space, or for observation beds or the like. By providing a second floor area, the use of the space within the facility in which the clinic 40 is located is maximized.
A third embodiment of a clinic 40 according to the present invention is shown in FIG. 3C. The dimensions of the clinic 40 are greater than those of the first and second embodiments shown in FIGS. 3A and 3B. The clinic 40 includes an entrance 405 and reception area 410 including a desk 415 at which a receptionist may be seated. The receptionist may take identification information from a patient so that the patient's medical file, if already created, can be retrieved, or so that a new file can be created if the patient is new. As in the other embodiments described above, the entire clinic 40 and the reception area 410 in particular have privacy features 418 including, but not limited to, sound proof tiles in the walls and frosted glass, which add to the comfort of a patient waiting to be seen by a physician in the clinic.
When a patient is to be seen by the physician or by his assistant, who can be a nurse or other trained medical assistant, the patient enters either a first examination room 420 or a second examination room 430. Each of the examination rooms are approximately the same size and include medical equipment necessary for basic medical evaluations and physical examinations, such as height, weight, and blood pressure. One or both of the examination rooms 420, 430 may also be suitably equipped with materials necessary to provide vaccinations and to collect laboratory samples from the patient. A bathroom 440 is also provided. In addition, in the third embodiment of the clinic shown in FIG. 3C, there is also included a third examination room 450 that is slightly larger than the first and second examination rooms 420, 430 to accommodate equipment for use in taking patient X-rays.
The clinic 40 in the system 10 of the present invention is not limited to the three embodiments shown herein. Additional rooms may be included so that further services may be provided, such as, for example, blood drawing rooms; emergency rooms including direct access to the parking area for ambulances or other emergency medical vehicles, so that emergency patients may be seen in the clinic or transported directly from the clinic to the hospital; observation beds, if space permits; radiology rooms; and the like. All furniture, equipment and medical materials in each clinic, regardless of its configuration, comply with the requirements of government health standards.
FIG. 4 is a flow chart illustrating the steps involved in providing medical care in the clinic 40 of the present invention. At step S100, a person enters the and offers identification to the receptionist. The receptionist identifies the person as either a new patient for whom a new patient record must be created, or a returning patient whose medical file may be retrieved, either physically, if kept at the clinic, or electronically, via secure Internet connection with the hospital 20. Once the patient is identified and a patient file has been created or retrieved in step S110, the patient is interviewed in step S120.
As in a normal visit to a doctor's office, in the clinic 40, basic medical information including the patient's medical history, allergies (if any), and description of current symptoms is gathered from the patient during the interview step S120. The information is entered at step S130 into the patient's file. Based on the information obtained in step S120 and in the patient's file, the patient is examined at step S140 by a licensed physician who is on the medical staff of the hospital 20. As described above with respect to the features of various embodiments of the clinic shown in FIGS. 3A-3C, equipment is provided in the examination rooms of the clinic for the physician to perform an adequate and thorough examination of the patient.
Once the examination is concluded, the physician or the other medical personnel at the clinic may render additional medical services in step S150. Such additional medical services may include, but are not limited to, first level outpatient care; vaccinations; minor medical procedures; medical education for high risk patients; medical counseling for referral to specialists; chronic and degenerative disease screening and educational programs; well-baby programs; prenatal programs; radiology; and issuing certificates of good health for, e.g., students, athletic programs, etc. These services also depend on the demand at the clinic 40, as well as the equipment and materials available at the clinic location.
After examining the patient and providing medical services, the physician may decide whether to prescribe medication or other treatment to the patient in step S160. If a prescription is written, the patient can easily have it filled after his or her visit in the clinic if the facility 30 also includes a pharmacy, as described above with regard to FIG. 2. In any case, if a prescription is written by the physician in step S160, the patient's file is further updated with the prescription information in step S165.
If no prescription or other treatment is warranted, or if the physician has not yet formulated a diagnosis, the physician may decide in step S170 whether to collect samples of biological materials (blood, urine, etc.) from the patient to aid in the diagnosis. If such samples are taken, they are independently controlled and stored and then analyzed off-site, at step S180. Once the off-site analysis of the patient's lab samples is concluded and results are available, the patient's file is again updated (S165). In step S185, the patient can access the lab results, or any other component of his medical file, remotely via a secure Internet connection with the hospital 20. The patient may alternatively visit the clinic to access his lab results and medical file via secure Internet connection between the clinic and the hospital, in situations where, for example, the patient does not have Internet access at home.
If no lab samples are taken and the physician's treatment of the patient is concluded, the patient ends his visit to the clinic. Depending on the physician's treatment and diagnosis of the patient, in step S190 the patient may be directly referred to a specialist in the affiliated hospital for further evaluation and treatment.
In all cases it is understood that the above-described arrangements are merely illustrative of the many possible specific embodiments which represent applications of the present invention. Numerous and varied other arrangements can be readily devised in accordance with the principles of the present invention without departing from the spirit and scope of the invention.

Claims

1. A hospital system for providing medical care and patient referral, comprising:

a clinic located at a facility that is off-site from a hospital, said facility being open to the public for non-medical activity; and

said clinic being affiliated with said hospital such that said clinic provides medical care of a type and quality required by said hospital and is obligated to refer patients to said hospital;

whereby patrons at said facility can seek and receive medical care at said clinic and can be referred by said clinic to said hospital.

2. The hospital system according to claim 1, wherein said facility is adapted to support pedestrian traffic for said non-medical activity and said clinic is accessible to said pedestrian traffic.

3. The hospital system according to claim 2, wherein said clinic is accessible from one or more of inside said facility and outside said facility.

4. The hospital system according to claim 3, wherein said facility has a parking area.

5. The hospital system according to claim 3, wherein said facility includes an entrance, an exit and one or more pedestrian flow paths between said entrance and exit, and said clinic is situated in said facility along a pedestrian flow path.

6. The hospital system according to claim 5, wherein said clinic is situated in said facility to be viewable from one or more of said entrance and said exit.

7. The hospital system according to claim 6, wherein said facility includes a checkout area and said clinic is situated in said facility to be viewable from said checkout area.

8. The hospital system according to claim 7, wherein one or more of said entrance and exit are viewable from said checkout area.

9. The hospital system according to claim 8, wherein said entrance, exit and checkout area are disposed in adjacent regions of said facility.

10. The hospital system according to claim 8, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

11. The hospital system according to claim 10, wherein said affiliation of said clinic with said hospital includes one or more of: the staff of said clinic includes at least one licensed physician who is on the staff and employed by said hospital; all of the staff of said clinic are employed by said hospital; the clinic and hospital have access to each other for communication of information; the clinic has attributes indicative of the affiliation with said hospital.

12. The hospital system according to claim 11, wherein said attributes include one or more of features of the motif of said hospital, logos of said hospital and signage indicative of said hospital.

13. The hospital system according to claim 10, wherein the staff of said clinic includes at leased one licensed physician.

14. The hospital system according to claim 1, wherein the staff of said clinic includes at least one licensed physician.

15. The hospital system according to claim 14, wherein said affiliation of said clinic with said hospital includes one or more of: the staff of said clinic includes at least one licensed physician who is on the staff and employed by said hospital; all of the staff of said clinic are employed by said hospital; the clinic and hospital have access to each other for communication of information; the clinic has attributes indicative of the affiliation with said hospital.

16. The hospital system according to claim 15, wherein said attributes include one or more of features of the motif of said hospital, logos of said hospital and signage indicative of said hospital.

17. The hospital system according to claim 15, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

18. The hospital system according to claim 1, wherein said clinic is located within said facility.

19. The hospital system according to claim 1 wherein said facility offers services to said public.

20. The hospital system according to claim 1, further comprising:

one or more further clinics each disposed at a different further facility off-site from said hospital, each said further facility being open to the public;

each said further clinic being affiliated with said hospital such that said further clinic provides medical care of a type and quality required by said hospital and is obligated to refer patients to said hospital;

whereby patrons at each said further facility can seek and receive medical care at said further clinic at said further facility and can be referred by said further clinic to said hospital.

21. The hospital system according to claim 20, wherein: the staff of said clinic includes at least one a licensed physician and the staff of each said further clinics includes at least one licensed physician.

22. The hospital system according to claim 21, wherein said affiliation of said clinic and each said further clinic with said hospital includes one or more of: the staff of said clinic and each further clinic includes at least one licensed physician who is on the staff and employed by said hospital; all of the staff of said clinic and further clinic are employed by said hospital; the clinic and further clinics and hospital have access to each other for communication of information; the clinic and further clinics each has attributes indicative of the affiliation with said hospital.

23. The hospital system according to claim 22, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

24. The hospital system according to claim 20, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

25. The hospital system according to claim 1, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

26. The hospital system according to claim 25, wherein the staff of said clinic includes at least one licensed physician.

27. The hospital system according to claim 1, wherein said affiliation of said clinic with said hospital includes one or more of: the staff of said clinic includes at least one licensed physician who is on the staff and employed by said hospital; all of the staff of said clinic are employed by said hospital; the clinic and hospital have access to each other for communication of information; the clinic has attributes indicative of the affiliation with said hospital.

28. The system in accordance with claim 27, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

29. The system according to claim 1 wherein said clinic includes one or more of;

at least one examination room;

a waiting area adjacent to one of said at least one examination room;

a bathroom;

a blood drawing room; and

a room for taking X-rays.

30. The system according to claim 29, wherein said waiting area provides visual and audible privacy.

31. The system of according to claim 29, wherein said clinic is at least 300 square feet in size.

32. The system according to claim 1, wherein said medical care provided at said clinic includes at least one of:

vaccinations;

minor medical procedures;

collection of laboratory samples for further analysis;

screening for diseases;

providing well baby programs;

prenatal care;

medical education; and

medical counseling.

33. The hospital system according to claim 32, wherein further analysis of said laboratory samples is performed at said hospital.

34. The hospital system according to claim 1, wherein said clinic is staffed by at least one licensed physician and by at least one assistant to said physician.

35. The hospital system according to claim 34, wherein said at least one assistant is either a lab technician or a nurse practitioner.

36. The hospital system according to claim 20, further comprising one or more of: said facility, said hospital and each said further facility.

37. A method for providing medical care and patient referral, comprising:

locating a clinic at a facility that is off-site from a hospital, said facility being open to the public for non-medical activity; and

affiliating said clinic with said hospital such that said clinic provides medical care of a type and quality required by said hospital and is obligated to refer patients to said hospital;

38. The method of claim 37, further comprising staffing said facility with at least one licensed physician.

39. The method of claim 38, wherein said step of affiliating said clinic with said hospital comprises: staffing said clinic with at least one licensed physician who is on the staff and employed by said hospital; staffing said clinic with all employees of said hospital; enabling the clinic and hospital to have access to each other for communication of information; providing the clinic with attributes indicative of the affiliation with said hospital.

40. The method of claim 39, wherein said attributes include one or more of the features of the motif of said hospital, logos of said hospital and signage indicative of said hospital.

41. The method of claim 39, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

42. The method of claim 37, wherein said clinic is located within said facility.

43. The method of claim 37, wherein said step of affiliating said clinic with said hospital comprises: staffing said clinic with at least one licensed physician who is on the staff and employed by said hospital; staffing said clinic with all employees of said hospital; enabling the clinic and hospital to have access to each other for communication of information; providing the clinic with attributes indicative of the affiliation with said hospital.

44. The method of claim 43, wherein said attributes include one or more of the features of the motif of said hospital, logos of said hospital and signage indicative of said hospital.

45. The method of claim 43, wherein said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

46. The method of claim 37, wherein, said facility is one of a grocery store, a supermarket which sells food and household items, and a warehouse-club store or mega supermarket which sells food, household items and other products.

47. The method of claim 46, further comprising staffing said facility with at least one licensed physician.