Are walk-in clinics good for you?

The doctor isn't always in

When you walk into a clinic, chances are you won't be seen by a doctor. Most clinics are managed by nurse practitioners or physician's assistants and don't have a doctor present at all. This helps the clinics keep down costs -- in turn translating into lower bills for consumers -- but it may mean the personnel lack the training or expertise to diagnose your condition. (Some states, such as California, require that drugstore health clinics have at least one supervising physician.)

Not that you're guaranteed to see a physician if you go to your regular doctor's office, anyway. According to the Massachusetts Medical Society survey, 41% of the state's residents had a medical appointment in which they saw a nurse in 2007. More than a third of those patients (35%) did so because they couldn't get an appointment with a doctor.

Clinics don't have your records

If you have a chronic condition, such as hypertension, asthma or diabetes, watch out: Clinics don't have your medical records and typically don't share the information about your visit, including the medications prescribed, with your doctor unless you specifically request it.

This can be downright dangerous. "A medication could be prescribed that conflicts with something (the patient) is taking if they don't communicate that information," says Dr. Bruce Auerbach, an emergency practitioner and the president of the Massachusetts Medical Society.

Continuity of care is the main reason why the American Academy of Pediatrics discourages parents from taking their children to walk-in clinics, says Dr. Robert Corwin, a pediatrician in Rochester, N.Y., and the chairman of New York state's Immunization Advisory Council. Even if a child has a minor condition, pediatricians may use those visits as a platform to discuss other health care issues, such as catching up on your child's immunizations or identifying undetected illnesses, he says.

Prescriptions mean profits

Eric Nixon, a sales rep in Winston-Salem, N.C., used to frequent walk-in clinics several years ago, when he didn't have health insurance. Convenience and fast access aside, he was pleased with the prescriptions: Much more often than "regular" doctors, he would get a strong antibiotic "that would take care of just about anything," he explains.

Meanwhile, his family doctor, he says, would start with a low dose and tell him to come back if he had further problems.

The clinic's prescription may sound like a cost saver, but readily dispensing strong antibiotics can be dangerous, Auerbach says. (We've all heard of the superbug.) It could also make even more money for the companies that own the clinic, because patients are likely to fill that prescription at their pharmacy.

"There's the concern that the entity that is making the recommendation for the patient to purchase something is also the entity that is selling the product," Auerbach says. "So there's a potential conflict of interest there."

This article was reported and written by Aleksandra Todorova for SmartMoney.

Published May 20, 2008

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