A few months ago I was out of town for work over a weekend, and called home at the end of the day. My husband reported that my 8-year-old had said her ear was hurting, so he brought her to the local "Care Station" health clinic.
"Wait--why didn't you bring her to Urgicare?" I asked, referring to the hospital-based after-hours service our pediatric practice offers.
"I didn't even know about it," he said. "Anyway, she has an ear infection so I got the antibiotics and she's feeling better."
I felt a few emotions. Dismay that I wasn't home when my child was sick. Gratitude that my husband handled it without even needing to call me. Relief that my daughter was feeling better. And slight frustration that we used an urgent-care clinic when we have a great backup system available to us, one that would have not only come with a lower co-pay, but would have logged the visit in her official records. Now it would be up to us to contact her pediatrician's office and let them know about her ear infection so that they'd have a complete picture of her health history. (Which reminds me... I never did.)
All of this illustrates why the American Academy of Pediatrics has just updated its policy statement on what it calls "retail-based health clinics." The AAP declares these services "an inappropriate source of primary care for children because they fragment children's health care and do not support the medical home."
This is not to say that such clinics should never be used. We all know how convenient they can be, especially when it's late at night, your doctor isn't open--or you're out of town--and you want to avoid an ER visit. What the AAP worries about are families who rely on clinics as the primary--or worse, only--source of their child's healthcare. The main concerns:
* A pediatric office is better suited to care for a child's long-term or chronic health problems. So if your child has, say, asthma, and you only use urgent-care facilities to handle her attacks, then no one is paying attention to the big picture of her illness and thinking about ways to better manage it.
* Doctors and nurses at urgent-care centers typically do not necessarily have a lot of experience in treating children. In fact, pediatricians make up only about 1.5 percent of the urgent-care workforce, according to the Urgent Care Association of America. In some cases, nurse practitioners and physician assistants provide care and doctors are available only by phone.
* Not all urgent-care centers can perform blood or urine tests or X-rays. Clinics in drugstores don't offer X-rays, and generally offer only a few screening tests, such as rapid strep or flu tests.
We covered all of this in an in-depth story about urgent care in our December issue. Written by pediatrician and Parents advisor Ari Brown, M.D., the story outlined the best way to utilize urgent-care clinics, what you should do afterward, and which conditions always require immediate care or a trip to the hospital. You can read it here.