It has been hard not to notice the new growth on the health care landscape. Over the past months, quick-care clinics have sprouted up in your local pharmacies, supermarkets and retailers. These retail-based clinics offer service for simple medical problems while you shop.

These new clinics may be convenient, but a big question remains: Do you shop for your child’s medical care the same way you shop for tomatoes or a toothbrush? The answer seems obvious. Although quickstop clinics may offer more convenience, they are lacking in characteristics PIP finds essential for good medical care.

We believe health care for your children should be accessible, family-centered, comprehensive, compassionate, coordinated and continuous. It is an active collaboration where both health-care provider and family share responsibility. Partners in Pediatrics, along with the American Academy of Pediatrics (AAP), is concerned about how retail-based care will affect health care for children and adolescents. We are concerned about the following issues:

• Fragmentation of care. Whenever your child is seen at a retail-based clinic, there is no guarantee that a record of the diagnosis and treatment performed at the visit will make it into your child’s chart. This makes it hard to make recommendations about “too many sore throats” or “too many ear infections.”
  
• Effects on quality of care. The majority of the time when your child is seen in a quick clinic, attention is paid to just one area. Your child is not looked at as a whole person. We believe that there is more to your child than a set of ears or tonsils. A health problem in one area of the body may impact many other parts of the body.
  
• Episodic care for children with special needs and chronic diseases, whose total medical picture may not be readily apparent. Many of the children we see in clinic have special needs or complex health problems. Some are major, some minor. When we make a recommendation regarding your child, whether it is a treatment decision or a suggestion regarding behavior, it is always done with the knowledge of who your child is and what makes your child different than other children.
  
• Lack of access to a central health record. A medical record is the history of your child’s growth, development and well-being. It should follow your child in health care settings. Medical records are so important to us that we try to have them available to providers regardless of which PIP clinic your child visits. We do this because we believe that the history of your child’s health can affect what is happening to your child now.
  
• The use of tests for the purposes of diagnosis without proper follow-up. When a test is performed in our office, we make sure there is follow-up after that test. This may be done by phone or at an office visit. When tests are performed at a retail-based clinic, there is no guarantee that we will have the results of those tests to discuss with you. At some clinics, there is not even a way to call and get a copy of those tests when your child is at our office.
  
• The possible public health issues that could occur when patients with contagious diseases (such as fever, rash, mumps, measles, strep throat and others) are in a commercial, retail environment with little or no isolation. When you visit a multi-use store for health care, there is a very real possibility that germs will be spread on objects that have little to do with providing health care. They can be on grocery carts or toys that were touched by a contagious child. Even when your primary goal in visiting a store is to shop and not to be seen at a quick clinic, your child is still susceptible to the germs that are left randomly elsewhere in that store.
  
• Seeing children with “minor” conditions, as will often be the case in a retail-based clinic, is misleading and problematic. We use the opportunity while seeing your child for minor issues to address issues in the family, discuss any ongoing problems (such as obesity or mental health issues), catch up on immunizations, identify undetected illness and continue strengthening the relationship we have with you and your child. Also, problems that seem “minor”, such as a cough, may be indicative of a more significant problem, like asthma. Office visits are important and provide us an opportunity to work with patients and families to deal with a variety of other issues.

Retail-based clinics may well be a fact of life. We, at Partners in Pediatrics, encourage you to support our model of child and adolescent care. That model consists of a central health care site that provides a healthy, supportive, knowledgeable environment for your family.