Shortcut or short-change on your child’s health?

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By Elizabeth Michaels, D. O.

 

Parenting is an exercise in expecting the unexpected. Few things create immediate concern and derail a day more than the illness of a child. At a moment’s notice, parents need access to a health professional they can trust. They need quick, reliable answers about their child’s condition and a treatment plan that permits them to get their child on the road to recovery and their family back on track.

Retail-based clinics (RBCs), similar to those you would find in the larger drugstore chains, are a tempting option because they seem accessible, inexpensive and trustworthy. Not to mention the fact that sniffles can’t be that big of an issue, right?  The best answer is, it depends.

Earlier this year, the American Academy of Pediatrics (AAP) took a strong stand against RBCs. In its report to its members, it stated “AAP opposes retail-based clinics as an appropriate source of medical care for infants, children, and adolescents and strongly discourages their use.”  1

There are several reasons why RBCs are not an ideal method of providing medical care to children.

One Size Does Not Fit All

RBCs do not have a pediatric provider on site trained to evaluate conditions specifically in children.3 The same illnesses can affect a child differently than an adult presenting different risks and requiring different treatments.

Driving Blind

RBCs promote their electronic health record (EHR) systems as a benefit to patients, but when accessing these EHRs they do not include your child’s complete medical profile, such as immunizations, developmental history or ongoing health issues treated over time. This presents risk because the practitioners at these clinics make diagnoses based on incomplete information about your child.

In addition, if your child’s illness presents something more significant, they will be referred to your pediatrician for treatment anyway. Now you have just elongated the very process you were trying to shortcut. You also have likely increased the time your child is sick, not to mention placed additional demands on your time and increased costs.

Solution: Your Child’s "Medical Home”

In many areas of our lives we seek service professionals who provide us expertise, commitment and reliability. Once we find a hairdresser, auto mechanic or repairman who proves to fit the criteria, we develop a relationship that we rely upon year after year. We consider these people to be an extension of ourselves entrusted to handle the areas of our life we have neither the skillset nor the time to manage.

As parents, our children’s health and happiness are our top priority. Similar to other areas of our lives, we need an extension of ourselves. We need the service professional who knows our child’s specific health needs and history and provides the expertise to prescribe the right treatment when we need it.

Your child’s greatest opportunity for health requires continuity of care. That means the pediatrician/family relationship might be the most important service relationship you have. Your pediatrician needs to serve as your child’s medical home base or “medical home” as the AAP calls it. The AAP supports a “medical home” model of care, which provides accessible, family-centered, comprehensive, continuous, coordinated, compassionate and culturally effective care for which the pediatrician and family share responsibility.2

You might be saying to yourself, "That all sounds well and good, but the truth is that I cannot get my pediatrician in a moment’s notice. At least with an RBC, I can get someone to take a look at my child immediately." The good news is, that is changing!

My pediatric group recently decided that to be the best medical home we could be for the families we serve, we needed to become more accessible.  So we became the first pediatric group in the state of Illinois to offer pediatric-specific, after-hours care in the evenings, on weekends and on holidays for walk-ins 365 days a year.

Continuity of care for your child is achieved with continuity in your relationship with your pediatrician.  The shortcut of an RBC may be tempting in a moment of desperation, but know that there are risks in that approach.  Shortcuts can actually be short-changes in your time, money and, more importantly, your child’s health. That’s a risk none of us likely want to take.

1American Academy of Pediatrics, Retail-Based Clinic Policy Work Group. AAP principles concerning retail-based clinics. Pediatrics. 2006;118:2561–2562

2 http://www.aap.org/en-us/professional-resources/practice-support/pages/Talking-Points-Retail-based-Clinics.aspx

3 American Academy of Pediatrics, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. The medical home. Pediatrics. 2002;110:184–186

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