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Delivering Health
Why Pediatricians Hate Health Clinics (and Why We Should Love Them)

American pediatricians have a health care clinic problem. Clinics are open 24/7. They charge insurance companies 30 to 40 percent less than traditional doctors’ offices. They are very convenient. They accept more kinds of insurance than many general practitioners. And pediatricians hate them. The WSJ reports on a statement on clinics released by the American Academy of Pediatrics (AAP):

While retail clinics may be more convenient and less costly, the AAP said they are detrimental to the concept of a “medical home,” where patients have a personal physician who knows them well and coordinates all their care.

“We want to do all we can to support the concept of ‘medical home’ for kids,” said James Laughlin, lead author of the statement, published in the journal Pediatrics Monday […]

Some of these concerns are legitimate. One tool that might address the need to ensure “continuity of care,” for instance, is an easily accessed online health record system. The clinic could see more of its patients’ background information, with their permission, of course.

The data show that there’s not much too the other concerns, however. One study quoted in the WSJ found that the people who typically use clinics are more affluent than the general public. In other words, these clinics don’t seem to be dumping grounds of second-best care for poor and uninsured clients.

We need more, not fewer, ways to deliver medical care. Clinics are among our best currently existing tools for achieving a cheaper and more efficient system overall. We should be doing everything we can encourage, improve, and learn from them.

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  • Agim Zabeli

    Hear, hear. This weekend Mrs. Zabeli had a very bad allergic reaction to something or other. It was Sunday morning. Clinic or ER; them’s the choices under such circumstances. Short wait, low cost, doctor seen, treatment started. We didn’t have to use a hospital or put her primary doctor in the position of having to decide whether to prescribe something based on symptoms described over the telephone.

    If health clinics didn’t exist someone would have to invent them.

  • free_agent

    You write, “the concept of a ‘medical home,’ where patients have a personal physician who knows them well and coordinates all their care”.

    Heh… In marketing, it’s called “bundling” (, that is, the commitment to get all of your goods/services of a particular general type from one and only one vendor. It’s well-known as a way to increase the total income of vendors.

    • free_agent

      A study came out a few days ago. It said that “having a medical home” doesn’t improve health status noticeably.

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