The Problems With Walk-Clinics and Medical Care

(Promoted by Stuart O’Neill from the article by County Doc and his subsequent answer in the comment section. Hope you don’t mind, Country Doc. This is a worthy subject.)

Since Stuart has goated me on, studies show that walk-in clinics are less expensive that an ER visit, but more expensive than a primary care office for the same diagnoses.  Cost, however, is only a small part of my bias against this form of care.

The real issue with walk-in clinics, urgent care centers, retail clinics, or any other no appointment necessary model is that the care is by definition episodic and discontinuous.  This is the antithesis of what health care should look like.

Walk-in clinics can treat asthma exacerbations, but not prevent the flare up from starting.  Urgent care can treat a child’s cold, but the discussion with the parents about their need to quit smoking for the child’s sake looks much different coming from a stranger than it does from trusted primary care provider.  But isn’t a cold just a cold?

In ideal primary care settings, every appointment, no matter how insignificant, can be an opportunity to check in with a patient and see how someone’s weight loss is going, or how is their depression doing.  It is an opportunity to update immunizations, order mammograms, and check cholesterol.

Every visit to an urgent care center robs primary care and patients of these opportunities.Walk in clinics are a symptom of our health care problems and not a sign of a cure.  It is this unappreciation of the value and the power of the continuity of care for the patient and the health care system as a whole that frustrates me so.  When there are more primary care offices opening and urgent care centers are no longer necessary, then I’ll know that we are on the right path.

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2 Responses to The Problems With Walk-Clinics and Medical Care

  1. I really can’t agree with you. For example it’s 10 o’clock at night and you’ve just sprained an ankle. It’s on a weekend and trying to get your doctor is going to be impossible. Do you go to the emergency room and pay $2000 min for x-rays, or a quick care clinic that can take x-rays and not bill the horrendous emergency room price tag. I think you’re confusing the needs of primary care with the needs of a non-emergency 24 hour care option.

  2. Limited access to primary care is an important point to address. If people could call their doctor and get in to be seen in a reasonable amount of time, studies show that patients would rather see their physician than one at an urgent care center. One of the important issues is that there are not enough primary care docs to make this ideal happen. In this model of a healthy primary care system, if someone sprains their ankle at 10 o’clock at night, but is confident that they could be seen by their doctor the next morning, most would put a bag of ice on the ankle, take a couple of ibuprofen, and wait until their doctor can see them.