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AAP advises against using retail clinics for primary care

Wednesday February 26, 2014
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Families may decide to use a retail-based health clinic because they believe it is convenient and less expensive, but according to the American Academy of Pediatrics, these clinics do not provide children with the requisite level of high-quality, regular preventive healthcare.

In an updated policy statement, published Feb. 24 on the website of the journal Pediatrics, the AAP emphasizes that retail-based clinics are an inappropriate source of primary care for children because they fragment children’s healthcare and do not support the medical home.

The American Association of Nurse Practitioners expressed disappointment with the AAP’s stance. Most retail clinics are staffed by nurse practitioners or physician’s assistants.

“It is unfortunate that the American Academy of Pediatrics continues to oppose patient access to safe, convenient and affordable care,” the AANP wrote in a statement. “At a time when our nation is searching for ways to meet growing healthcare needs and bring down healthcare costs, our patients need all providers working together to improve healthcare.”

The AAP acknowledged that the number of retail-based clinics has grown to more than 6,000 as of 2012. Surveys indicate 15% of children are likely to use a retail-based clinic in the future, although the majority of patients are adults.

“The AAP recognizes that convenience and access to care will continue to be important drivers of how healthcare is delivered,” James Laughlin, MD, FAAP, lead author of the policy statement, said in a news release. “However, the expertise of the pediatrician and the medical home should continue to be recognized as the standard for care of children, and we encourage all AAP members to provide accessible hours and locations as part of a medical home.”

Pediatricians are specifically trained in child health issues, according to the statement. They know each child’s health history and are best equipped to take care of both simple and complicated problems comprehensively within the medical home. As young patients and their health issues become more complex, the possibility arises that even a simple complaint may be related to a more serious, underlying condition that could be overlooked by someone not as familiar with the patient, according to the AAP.

Although the AAP believes the medical home is the optimal standard of care for pediatric patients, and does not recommend that parents use retail-based health clinics, it is understood that the services of these clinics may be used for acute care outside of the medical home.

If parents choose to use a retail-based clinic for their child’s illness, they should ask whether the clinic has a formal relationship with their pediatrician, whether the clinic will communicate with the pediatrician about the visit and what the protocol is for following up if the illness does not resolve or the clinic is closed. Parents should consider only using retail-based clinics that have a formal relationship with their child’s pediatrician, according to the statement.

In its response, the AANP noted that most retail clinics “already have policies that require communication with a patient’s primary care provider.

“Investing efforts toward creating mechanisms that improve community-wide health record integration, expanding state immunization registry programs, advancing affordable options and increasing appointment availability are endeavors that have the promise of real improvements for patients and can further coordinated care across multiple settings,” the AANP stated.

The AANP has been engaged in “proactive dialog with the Convenient Care Association on issues that matter to patients, primary care providers and the retail-based clinic community.” The Convenient Care Association is the national trade association of companies and healthcare systems that provide healthcare in retail-based locations.


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