RETAIL MEDICINE: AAP Advises Parents Against Using Retail-Based Clinics —

For Release:  February 24, 2014

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The AAP Advises Parents Against Using Retail-Based Clinics …

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 high-quality, regular preventive health care children need.

In an updated policy statement published in the March 2014 Pediatrics, the AAP emphasizes that retail-based clinics are an inappropriate source of primary care for children because they fragment children’s health care and do not support the medical home.

The policy statement, “AAP Principles Concerning Retail-Based Clinics” released online Feb. 24, updates the Academy’s 2006 policy statement, which expressed strong opposition to the use of retail-based clinics. The AAP acknowledges that the number of retail-based clinics has grown to more than 6,000 as of 2012. Surveys indicate 15 percent 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 health care is delivered,” said James Laughlin, MD, FAAP, lead author of the policy statement. “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.”

6 secrets concierge medicinPediatricians are specifically trained in child health issues. 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 who is less familiar with the patient, according to the AAP.

While 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 if the clinic has a formal relationship with their pediatrician, if 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.

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The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

Source: http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/The-AAP-Advises-Parents-Against-Using-Retail-Based-Clinics.aspx#sthash.2Q3d7oEJ.dpuf

One thought on “RETAIL MEDICINE: AAP Advises Parents Against Using Retail-Based Clinics —

  1. AAP uses the terms “Primary Care” and “Medical Home” as if they own the concept – but stop short of defining them – probably because they don’t want to look in the mirror about this issue.

    Reading APP statement about the inadequacies of Retail Clinics smells of insecurity and protectionism. Yes, they encourage members to increase access and be available, but this is mostly lip service unfortunately. One thing is clear; the AAP believes that their member physicians are the embodiment of children’s “primary care” and nothing short of their version of a “medical home” will do.

    If they (Pediatric practices) were providing true primary care without boundaries, which doesn’t stop when the visit is over, then Retail clinics would not be an issue. Instead of the defensive accusatory language, maybe the APP should ask why a market for Retail Clinics exists in the first place. If Pediatricians or FP’s don’t want their patients going to Retail Clinics, then they should provide the lifestyle friendly convenient care that these clinics provide. Problem solved!

    I can suggest this because I asked this of myself and colleagues in adult primary care. We fell short in the same ways and ceded an unmet need of our patients to the Retail Clinics. Falling short of these goals is also what led me to start a DPC practice, enhanced with telemedicine services to enhance after-hours access. This simply can’t be done in a practical way given the constraints of the Revenue Cycle of traditional practices.

    Does the AAP really think that an experienced clinician, be they a PA, RCNP, or urgent care doctor, who sees high numbers of sick children an adults will render less than optimal care for common childhood illnesses? Truth is that a good seasoned ER or UC doc, PA or RNP might be better equipped to identify and accurately manage childhood illness than an office-based “primary care” pediatrician. I am not saying the non-pediatrician is better; just that often they are just as good in certain situations. It is the total experience combined with the practice environment in which the practitioner is working in that really matters here.

    News flash: The whole idea of a true medical home is nearly impossible to implement successfully within third-party network constrained practices. Why? Because most of the time & effort of providers and staff is focused on tasks that have little to do with longitudinal continuity, which is mostly about communication with patients/families in between visits.

    It isn’t fair to implicated the AAP or pediatricians specifically here; this is a shortcoming of all managed care-reimbursed practices. Whether they/we believe it or admit it, they/we are at the mercy of the Revenue Cycle. Despite all the rhetoric to the contrary, the realization of Continuity of Care and all the holistic benefits of Medical Homes are largely lost in the third-party model.

    So, are the AAP and AAFP/ABFM really serious about the benefits of Primary Care Medical Homes and their uniqueness to deliver the care? If so, they need to face the music and realize they will never reach these lofty goals within the framework of third-pary dominated network care. Only by working directly for the patient in an unencumbered manner will The AAP and the AAFP/ABFM succeed in reclaiming this hallowed ground.

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