Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: “Convenience Clinics” Caring for Increasing Numbers of Children

“Parents complain that pediatricians, wary of COVID, shift kids to urgent care,” according to a recent Kaiser Health News article. The practice has apparently become so prevalent that the American Academy of Pediatrics has issued a statement recommending that pediatricians “provide care for the same variety of visits that they provided prior to the public health emergency.”

The academy has expressed its concern about “unintended consequences of referrals, such as the fragmentation of care and increased exposure to other illnesses, both caused by patients seeing multiple providers; higher out-of-pocket costs for families; and an unfair burden shifting to the urgent care system as illnesses surge.” To help address these issues, the academy has produced guidelines for pediatricians on how to safely see children who possibly have COVID without exposing them to other patients and medical staff.

It’s important to note that even prior to the pandemic, urgent care and retail clinics were seeing an increasing number of pediatric patients. In 2019, one in four children were seen at either an urgent care clinic or retail clinic, according to the National Center for Health Statistics; this is a significant increase over previous years.

“The level of convenience in accessing health care may be a factor for parents when choosing to seek care for their children at urgent care centers and retail health clinics,” said the authors. Not having to schedule an appointment and convenient clinic hours are frequently cited as reasons for using “walk-in” clinics.

The NCHS researchers also discovered that insured children went to urgent care clinics at a higher rate than children who were not covered by either private or public insurance.

When interviewed by MedpageToday, Missouri pediatrician Dr. Amanda Montalbano said that “this snapshot of pre-pandemic urgent care and retail clinic usage will likely change as a result of many pediatricians and convenience clinics transitioning to telehealth” during the pandemic. Dr. Montalbano expects the “ramp-up of telemedicine is going to change how, when, and where parents are able to access care for their children.” She says this will be “a game changer in how kids are triaged,” not only today but in the future.

“Although it’s preferable to have kids seen by pediatricians in their medical home,” the American Academy of Pediatrics “endorses urgent care clinics as a ‘safe, effective adjunct to, but not a replacement for, the medical home or emergency department’.”