Photos by Jason Redmond / Star staff Medical assistant Chris Spieth works on a laptop with WellnessMart founder Dr. Richard McCauley nearby. The doctor's new retail store in a Thousand Oaks strip mall, also seen at bottom, offers preventive healthcare services at fixed prices.

As an internal medicine doctor who works in an emergency room, Richard McCauley takes care of the sick. As owner of the WellnessMart in a Thousand Oaks strip mall, he's all about the healthy.

"If you cough, you're in the wrong place," he said inside a business billed as the antidote to traditional healthcare.

Because his preventive healthcare business is different, it's almost easier to explain what it isn't. It's not a doctor's office. It's a retail store designed to operate more like a Kinko's, where people walk in and get what they need.

There's no waiting rooms, no receptionists and few if any appointments. People walk in to find a doctor and a medical assistant standing behind a long counter, poking at life-sized anatomy mannequins or using computers to demonstrate how plaque builds up in arteries.

The store doesn't sell vitamins or medication but markets preventive health services like screenings that may tell a 33-year-old man he has a 17 percent chance of a heart attack over 30 years. It sells annual checkups, weight management, vaccinations and travel immunizations. Customers can buy programs that give them 24-hour, seven-day-a-week access to a doctor and help in compiling electronic medical records.

Free seminars, posted prices

Free seminars are held three times daily on topics like the sexually transmitted disease HPV and how to deal with insurance companies to navigate a broken healthcare system.

The store doesn't stop at old-school boundaries that keep doctors from operating like other businesses. Prices are listed on a banner-like menu behind a long counter. The heart screening costs $100. Nutrition counseling for a month costs $40. Vaccination for hepatitis A costs $89.

People who want to bill a WellnessMart service to an insurance company are on their own. But McCauley does sell insurance policies at the store from providers like Blue Cross and Aetna. He says the best way to save is buying catastrophic coverage and paying for everything else out of pocket.

An MRI scan that an insurance company might price at $3,870 may cost $755 if people pay in cash, McCauley said. More bargains for various medical services offered at doctor's offices, labs, imaging centers and pharmacies throughout the area are listed in directories at the shop.

"The problem with shopping for healthcare is no one knows the prices," McCauley said. "If you don't know the prices, how can you shop?"

And if the business sounds different and strange, that's by design.

"There's a small revolution that's going on in this store," he said. "There's no place in the country that's doing anything like we're doing."

He's 46, lives in Malibu and works five ER shifts a month at a veterans hospital in West Los Angeles. His business was born from the convergence of several firmly held contentions.

"Why is it that sick people and healthy people go to the same places for care?" he asked, arguing the setup makes healthcare inconvenient for people who aren't sick and means they don't get screenings and checkups. People want to know about health risks and wellness but they don't know where to go.

He blisters the insurance system, too, saying the industry marks up price so high that people think all healthcare is out of their price range.

"People can afford this stuff," he said. "Healthcare is affordable."

A time for experiments

The business started in the hallway of a fitness club in Thousand Oaks where McCauley offered screenings and preventive medicine. Several weeks ago, he opened up shop in a new Thousand Oaks shopping center, next door to a store that sells Bundt cakes. To attract attention, he placed an anatomy mannequin outside the front door.

Present the business concept to others and they cite the mixture of medicine and retail in-store-based clinics at Wal-Mart. They refer to doctors who build their practices around wellness screenings or using the Internet to increase their accessibility to patients.

"It sounds kind of different but there are a lot of different ways of enhancing people's health," said Dr. Richard Frankenstein, president of the California Medical Association. "We should be open to all kinds of healthcare systems."

Others say healthcare is going through a transition in which doctors are trying to figure how to best serve patients and operate a successful business.

"There is a lot of experimentation going on right now," said Margaret Laws of the California Healthcare Foundation. "Who's going to come up with the right combination of what consumers want and what they'll pay for?"

McCauley, who hopes to open more stores, is convinced he's found the right combination.

"America's ready for this because the healthcare system is broken," he said.