Patient Care and Retail Based Clinics

patient_careThe American Academy of Pediatrics (AAP) recently released a strongly worded policy declaration re-enforcing its place that retail-based treatment centers (RBCs) are unsuitable locations for pediatric patient care. Many workers in pediatrics are also up-in-arms over the increase of RBCs as many practices feel they are taking valuable sufferers. The fact is that RBCs are an excellent supplement to the micro practice design that our practice is depending on. For us, the advantage of RBCs is that they do what we do not want to do. Namely, they open on evenings, Saturdays, Sundays and vacations. But one major adverse is that they cannot staff as many hours as the bigger, multi-provider practice.

A recent cover story at The Harvard Business Review said to forget about work-life balance and it described that life is about hard choices; this is a fact. Employees want to be home for supper with their family and invest their time in their children’s days off from school having fun. We like knowing that the RBCs are there to fill in for the bigger practices when they are closed. It should be said that RBCs offer a convenience; medically, there is usually no reason why someone with symptoms cannot get some over-the-phone patient care from the health professional or physician on call and then wait for their office to open at 9 a.m. the next morning. But for those who choose not to wait and in some situations are willing to pay a premium for the comfort, why should not they go see an experienced and certified health professional specialist at an RBC? Whether the strep test is run by bigger practices or RBCs, provided that there is interaction, there shouldn’t be an issue with RBCs offering mid-level triage for us.

They key is, as with most issues affecting personal and community health, has to do with RBC rules. How much can a patient really value the guidance of a company who works for an organization that makes money when you buy over-priced over-the-counter snake oil? Government departments have a responsibility to make sure that RBCs are not favoring client care over quality clinical judgment. Think about it: Patients looking for needless medications are more likely to buy over-priced products when they have gladly obtained the medication they desired but probably did not need. As a primary patient care provider, one of the greatest values of RBCs is the ability to diagnose illness as early as possible in order to treat the patient for the best possible outcome.

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