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Ask Dr. K: Walk-in clinics are not a good substitute

DEAR DOCTOR K: What do you think of the walk-in health clinics that are popping up? Can I use them instead of going to my regular doctor?

DEAR READER: You ask a timely question. More and more Americans are turning to retail health clinics — walk-in medical facilities located in pharmacies, grocery stores and retailers. My one-sentence answer to your question is that it’s a shame they have become necessary. That’s because I believe the best answer is for every person to have a primary care physician who knows them, and to bring all health problems to that doctor.

So why are people going to these walk-in clinics? The most obvious reason is that we haven’t trained enough primary care doctors, and the ones we have are very busy. As the number of primary care doctors shrinks, patients must wait longer to see a doctor for simple problems such as sinusitis or a urinary tract infection.

No one likes to wait. You can walk into a retail health clinic without an appointment, and many clinics are open nights and weekends. What’s more, health insurance covers all — or a percentage — of the costs of services provided at these clinics, just as it does for care delivered at a doctor’s office.

If you’re hurting and your own doctor is not available, retail health clinics have their place. They are most appropriate when you have a simple health condition that needs immediate medical attention — a respiratory or urinary tract infection, for example. But it’s important that your medical record from this visit reaches your primary care doctor, and that often doesn’t happen.

For more complicated or ongoing medical issues, health clinics are not a substitute for a doctor’s office. The doctors, nurse practitioners and physicians’ assistants in those clinics probably won’t have access to your records. They won’t know what medical conditions you have, the results of your laboratory tests, the medicines you’re on or whether you have drug allergies. They need to know that information to give you good care.

“What’s the problem,” you might ask? “I can simply give them that information.” Maybe. But ask yourself if you could, right now off the top of your head, list all of your medical conditions, the results of your most recent laboratory tests, all of the medicines you are taking (and the doses), and every drug you have had an allergic reaction to.

Retail health clinics are often staffed by nurse practitioners, not doctors. Nurse practitioners are required to follow specific care guidelines, and they must keep meticulous records on the care they’ve provided.

Any time you visit a health clinic, get a printed copy of your health record. Health clinics keep excellent medical records. But it’s up to you to make sure they get to your primary care doctor so that all of your health records are in one place.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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