Pediatrics Group Advises Against Retail-Based Clinics

Parents must weigh convenience against doctors who know their child's full medical history

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Just as CVS is promoting itself as a one-stop-shop for health with both a pharmacy and medical services, the American Academy of Pediatrics (AAP) is telling parents they should not take their kids to a retail-based clinics.

On Monday, the AAP released an updated statement criticizing retail clinics as poor places for medical care because they fragment a child’s care and do not provide what the AAP calls a medical home, where doctors know the patients and their history. The AAP has long taken a strong stance against the clinics because the physicians at the clinics do not have a child’s medical record and there is no patient follow-up.

However, the AAP does acknowledge that retail clinics are not going away anytime soon, citing the fact that surveys show that 15% of kids are likely to use a retail-based clinic in the future. A 2013 study of parents who took their kids to retail clinics found that the majority did consider taking their child to their pediatrician, but that they changed their minds because the retail clinic hours worked better for their schedules.

(MORE: Pediatricians v Retail Clinics: Is It Time to Think Beyond the Office Visit?)

The convenience of retail clinics appeals to consumers who want more access on their own watch. Some argue the backlash from pediatricians is simply a turf battle, while others believe it’s dangerous to see someone who doesn’t know your child’s full medical history.

The AAP encourages pediatricians to provide accessible hours, and patients to at least ask the retail clinics if they have a formal relationship with a pediatrician.

7 comments
Gettingstarted
Gettingstarted

Instead of lamenting the symptom, let's address the problem.  The problem is NOT that these clinics have no access to patient history, that is a symptom. The problem is that we STILL do not have universal electronic health records, a fact which causes so many misdiagnoses and complications that it is baffling that we do not mandate its implementation.

IceToes
IceToes

Of course having a doctor you see regularly is best, but the problem is actually being able to see them! By the time you can get an appointment, you may not need it. Most doctors have a bigger than ideal patient load for many reasons, and you'd think it would be a relief to manage fewer upset stomachs in favor of focusing on larger-scale care for a patient. People work 9-5 less than ever, and very few can lose the work hours taking a kid (or themselves) to a doctor's office during the day. Clinics fill a definite need, and it's certainly not their fault if they provide more convenient and personable care.

MaryPaddock
MaryPaddock

One of the boys was suffering from mild depression and we'd  visited a local doctor who was just terrible. I didn't have an issue with the extra tests he ran or that he wanted him to refer him to someone better suited to determining whether the boy was suffering from something chronic or something that would pass. Those were sensible responses.

What annoyed me beyond measure was his complete lack of empathy or compassion. The entire time the boy sat in the room with him, the doctor stared at a computer screen, never once really looking at his patient, asking questions in a disinterested tone of voice. The only time the man moved was to enter the room and to leave it. 


I had to take him to the walk-in clinic some months later for an unrelated reason (flu or something) and was struck by how personable the doctor was--how quickly he established a relationship with my son and how much my son immediately liked him.  I've been back to this clinic three times with different boys and my husband. They know us when we walk in the door now. They have their medical history.  As far as I'm concerned--they've become our family doctor's office. 

civisisus
civisisus

The community of medical professionals is deficient in many things, and this variant of bedside manner - or lack of it  - is representative.


Walk-in clinics are better suited to handle an assortment of routine, non-emergency health conditions, and clinicians - in this case pediatricians - have no defense other than this kind of harumphing humbug. 


Walk-in clinics - particularly the larger chains - are BETTER prepared to coordinate care, particularly inter-clinician communication, than the typical pediatrician's office. They provide a summary of treatment visits for sharing with a patient's regular physician AS A MATTER OF PROTOCOL. Please, AAP, provide a list of your members who does this as standard operating procedure - it will fit on one sheet of paper.


AAP wishes its members' practice habits were aligned with the treatment needs of so many of its patients (and parents of patients). Unfortunately, merely wishing does not make it so.

murse88
murse88

What a joke. Sure, if you take your kid to the clinic because he has a fulminate disease, the clinic isn't going to do much in terms of continuity of care. However, the clinic is a great place to take those kids that are experiencing coughs, runny noses, upset stomachs, etc... The alternative? Let them sit in the ER, accrue higher fees, and increase all our premiums. There is NOTHING wrong saving a lot of money taking your kid to a clinic for mild ailments. Sure, it may not be the BEST solution, but it is does serve an alternative to the traditionally expensive care exposed in hospitals. In addition, it can serve as a conduit of cheaper care for those individuals that do not carry insurance.

matwija
matwija

My husband and I go to a doctor's office located in a supermarket in Ottawa, Ontario.  This office has 7 physicians.  We find it convenient because they have evening as well as weekend hours.  The patients each have their own physician but if your doctor is not working that day or evening and you have an emergency, you get an appointment with one of the other physicians.  The medical records are computerized and can be accessed by all the physicians within that group.

skyarizonadreamer
skyarizonadreamer

So, if the medical establishment shares patient medical histories, then this issue will be resolved, right?