About one in four Ontarians visit a walk-in clinic each year.
While the government has made access to family doctors a key priority, there is no policy framework for walk-in clinics.
Although walk-in clinics have been part of Ontario’s health care landscape for decades, they remain controversial. Walk-in clinics have generally been excluded from government efforts to improve access to primary care services, and little is known about the services that walk-in clinics provide and the reasons why patients frequent them.
In the past decade, the Ontario government has made significant reforms to primary care, including a shift toward group practice models such as Family Health Teams and away from fee-for-service medicine. However, doctors who work in walk-in clinics in Ontario continue to be paid almost exclusively by fee-for-service (i.e., a payment for each visit or service) and usually work without the help of an interdisciplinary team.
Some experts argue that walk-in clinics promote duplication of health care services and can drive up health care costs as patients seek care from multiple providers in an uncoordinated way. Yet the convenience of walk-in clinics cannot be ignored, especially for patients who do not have a family physician or cannot see their family physician when they need to.
“Bottom of the heap” when it comes to timely access to family doctors
Ontario’s Action Plan for Health Care, announced in February 2012, includes “faster access to stronger family health care” as one of the top three priorities for Ontario’s health care system.
This priority makes sense given that half of Ontarians are currently unable to obtain a timely appointment with their family doctor or a nurse when they are sick. In fact, in an international survey of fourteen countries, Canada ranks near the bottom in accessing primary care when it is needed urgently. Rick Glazier, a family doctor and researcher at St. Michael’s Hospital in Toronto says “Canada is at the bottom of the heap when it comes to timely access to care, which explains why we’re at the top of the heap when it comes to emergency department visits.”
In the United Kingdom, more than 70% of people are able to get same or next day care. The National Health Service also operates walk-in centres that focus on treating minor issues. These walk-in clinics see nearly 3 million patients per year and take pressure off traditional primary care practices as well as emergency departments. However, they are more integrated into the rest of the primary care sector than walk-in clinics in Ontario, and are often staffed primarily by nurses rather than doctors. Jonathon Tomlinson is a general practitioner (GP) who works in a family practice in Hackney, a suburb of London. His practice includes a walk-in clinic that serves both registered patients who do not have a scheduled appointment as well as patients who have never registered with the practice.
Like many family doctors in Ontario, Tomlinson believes that patients are best served when they can visit their regular practice. He notes that “if the problem is that patients aren’t getting appropriate access to GPs, the answer isn’t to go to a walk-in around the corner from the GP, it’s to fix GP practices.”
In contrast, David Peachey, a family doctor who works in a Toronto walk-in clinic and previously served as Director of Professional Affairs for the Ontario Medical Association says that “the proper role of walk-in clinics is to be a safety valve in the system, to assist traditional family medicine practices.” Yet, walk-in clinics in Ontario are not required to provide information to a patient’s regular family doctor after providing care to a patient.
The government’s Action Plan includes a commitment to improve “access to the right care, at the right time, at the right place” and notes that Ontarians have a number of different options other than emergency departments when they are in need of immediate care for non-urgent concerns. The website includes a video, reproduced below, describing the services that walk-in clinics offer, as well as a tool to locate nearby walk-in or after hours clinics. Yet the clinics themselves operate in a relative policy vacuum.
What we know (and do not know) about walk-in clinics
An annual survey conducted by the Ministry of Health and Long-Term Care until 2010 found that about 25% of Ontarians used a walk-in clinic in any given year. Tori Gass, a Ministry of Health and Long-Term Care spokesperson, noted in an e-mail to healthydebate.ca that “walk-in clinics are considered private businesses” and that the Ministry of Health and Long-Term Care “is not always made aware if a clinic closes or a new one opens.” As a consequence, the Ministry of Health and Long-Term Care does not know exactly how many walk-in clinics we have in Ontario.
Rick Glazier adds that “we have very little data on walk-in clinics in Ontario” and it is currently “not possible [for the Ministry of Health and Long-Term Care or a researcher] to easily figure out whether a primary care service was delivered in a family doctors’ office where they provide comprehensive care, or if it’s in a walk-in clinic.” We also don’t know whether patients visit the same walk-in clinic repeatedly for many years, in which case the clinics may be providing ongoing care, or whether the care is more episodic in nature.
There is also a lack of recent data describing the characteristics of walk-in clinics and the patients they serve. The most recent information about patient satisfaction and the characteristics of walk-in clinic doctors comes from the Ontario Walk-In Clinic Study, which was conducted nearly a decade ago.
Innovation to improve access to primary care
One Ontario initiative designed to improve primary care is the Learning Community organized by Health Quality Ontario. This initiative was previously known as the Quality Improvement and Innovation Partnership, and provides primary care practices with training and support for quality improvement activities. One activity supported by this initiative is Advanced Access, a scheduling philosophy that promotes same day access.
If better scheduling could improve access to family doctors, then perhaps fewer people would need to use walk-in clinics. However, many patients use walk-in clinics because they are more conveniently located than their regular family doctor, and not because their regular doctor doesn’t provide same day access. For example, someone who lives in the suburbs but works in downtown Toronto might visit a walk-in clinic near their office rather than going to their family practice closer to home.
Rick Glazier suggests that in spite of ongoing reforms and efforts to improve access to primary health care services “there will always be a need from patients for quick access to care for minor, but acute, issues.” Walk-in clinics are likely to always have a place in our health care system, and Ontario’s primary care strategy needs to consider what their optimal role should be.
The comments section is closed.
Canada is fast becoming no better than a third world country when it comes to medical services. There are few that have a “serving a higher cause” disposition and attitude. Many seem to think that are the higher cause and we should kiss up to them. All the good doctors are leaving.
In Kenora Ontario there are thousands of people without a family doctor. For those who are rostered with a family doctor there is up to a TEN WEEK wait for an appointment to see a doctor for a prescription, and that is not acceptable. It’s the same for poison Ivy, tic bites, strep throat, wound infections, ear infections, eye infections, fungal infections, etc.. It is very common in Kenora Ontario to have some doctors working for more than a month without a day off because their rosters are filled up with too many patients and too few doctors.
Reading through the comments I see one person complaining about their bronchitis turning into pneumonia and blaming the doctor at the walk in clinic. I have news for you….I knew a young man in his 30’s who had seen his family doctor for treatment and died of pneumonia. There are horror stories all over the country of people who have died that really shouldn’t have died.
Walk in clinics absolutely fill a need and provide great front line healthcare that often saves the system a lot of money. Get used to it people. For many non life threatening issues video conferencing with a doctor prevents complications that a 6 to 10 week waiting period is bound to cause in most cases.
Same day or even next day healthcare by a family doctor is not going to happen in Kenora. So you people who are talking against these walk in clinics need to re-think your perspective. Try seeing a doctor in our area of the province, and if you can’t come here, how about showing some empathy instead of paining these walk in clinics with broad brush stokes.
Greetings and sulutations to everyone involved..
I would just like to say i have been employed in Ontario Canada since i was 14 and fulltime for 20+ yrs and i have an On-going Parasite problem with no family Dr. and i visited the walkin and the Dr said it was a Callis on my foot and wrote a request for me to get orthotics!!! Are you kidding me!!! So for next couple weeks i took her word for it and seen if it would go away but low and behold the pain remained and now im showing more parasite factories …So i decided to go to Emerg where i got through triage fast then i sat there for an hr after i jus figured i was tired and frustrated by this point seeing 20 personal taking their sweet time… I have always hustled at my employment for people need their vehicles to survive. After a couple hours someone woke me up who works their and said “are you on drugs ? Thats why we havent helped you .” I was ready to explode by this rude and ignorant comment for i just came from my Employment !!. I replied no and please just let me see a Dr. to address my situation. Finally a Dr came and i explained my parasite problem and i took off my sock and said see and he looked at it from 6ft away and said “what do you want me to do? take Blood?” I nearly fell off my chair and my blood starting boiling by this time.. He finally gave me script for Amoxicillian and Fungal cream.4hrs later im leaving …RRRRRRRRRR.Now its been months and still im infested with some type of Amoeba and now entering my eyes!! Im disgusted with how these so called professionals carry themselves and conduct health care for us!!! Ive contacted my MP 3x and nothing has been done and now im in limbo and told it will take months before im considered for a family doctor… Can i please conduct my own form of justice cause this is an atrosity and they should be sued and charged for gross neglegence causing physical and mental damage beyond repair!!!… May they live long and prosper on our backs.No wonder my lower back aches from carrying these types of turtles for way too long…..God Bless
You are assuming everyone HAS a family doctor. A lack of a family doctor is mainly why walk in clinics are essential. Otherwise the patient, without a family doctor, would have no access to care except for emergency rooms. Emergency rooms would then be taking on issues like flu, medication renewals, basic blood test checks, etc. etc ( which would destroy the functioning of an emergency room). What really needs to happen, is Ontario has to attract a lot more doctors to needy areas. Doctors need to be treated well. The government has to stop spending millions on useless military vehicles, on supporting the warmongering USA, and use our tax money to invigorate the one thing we really do get here in Canada; our universal Medicare system. We do not want to be a little USA, where hundreds and thousands have no medical care ( ie; Medicare is a priority and NO privatizing)
but 30% of our taxes pays for healthcare!
I agree with most of your comments on walk in clinics. Walk in clinics actually save the government money, so family doctors should not be penalized when their patients feel a need to go to a walk in clinic rather than wait 6 to 10 weeks for an appointment. The other alternative is sit in an emergency reception area for 8 hours to see a doctor….and who wants to do that?
But did you really have to put down of the USA as warmongers? Keep that kind of rhetoric out of this and stay on topic. Thank God for Trump who is changing all that anyway.
Why are some walkin clinics government funded while others are not. I live in Bobcaygeon where the nearest hospital is a 30 minute car drive away. There is no bus service to the hospital. There is a lack of doctors, and those that are there, often only have offices hours a couple days a week. A nurse practitioner sees patients in the walkin clinic because there is no doctor to do this, and because of this, the clinic does not get government funding.
I pay the same taxes as other Ontarians so why is our area being discriminated against!
no monies should be awarded towards “walk-In” Clinics…..on the other hand “Walk-In Clinics” are nothing but “pay-day Loans” type of operations without doctors ethics or medical ethics……
All legislations including the operators of these “Walk-Ins” must be fully investigated by law….within last 3 weeks I have had to personally visit and experienced several of them along Queen Street and Main Streets in Brampton Ont…..none meet any medical standards where a doctor has no ethics and you will find an operating “Pharmacy” within the Walk-In premisis….thus is suggestive of the fact that the “walk-In” doctor and the Pharmacy Owner are in cahoots along with the”Group” that finances this shady enterpreaunership…..medicines are prescribed not according to a patients experiences with a medicine but rather according to a Computer Given Chart Medicines….I will be publishing more data regarding this since I have had vast experience with medical practitioners in Saskatoon Edmonton Winnipeg Toronto Montreal and finally since 1971 in Ottawa……..I have worked with the finest physicians (not-walk/Ins) and find Brampton to be the worst and the ugliest in medical practice and practioners
I think more information should be studied by the government as to what exactly do Walk-in clinic doctors do. I went to a walk in clinic a few times recently for the first time in my life because my doctor retired several months ago and I’ve phoned about 10 different doctors to try to get a new doctor in my area, and so far, all the doctors office I phoned, have said the doctor is not taking any new patients. I am a senior and have a few health issues. The walk-in clinic I went to have a main doctor who seems to run or own the walk-in and 3 doctors who are “family” doctors, but they don’t seem to do all services such as no yearly examinations, but are medical doctors. It is not clear to me what the “family doctors” there do exactly. they seem to do some services but not others. they do some other things besides minor health problems, but don’t do everything a primary doctor you may be with for 20 years does. I had to wait 3 hours when I first went to the walk in clinic, but next time not as long. I would prefer a “regular” family doctor who provides all services, and one who you don’t have to wait a couple of hours to see. Also, the walk in doctor I saw, was extremely busy as he usually has about 6 or more people all there to see him at the same time. with regular doctors, usually there is time scheduled between patients. that was not the case with the walk – in doctor I saw and I suspect my experience could be the same as most other walk in patients.
In my opinion, walk in clinics are doing a lot of business in Ontario, because there is a big shortage of “old style” doctors in Ontario, possibly because of many new immigrants in the last 2 years or other reasons not studied as much as they should be in order to see what can be done to get more doctors to take new patients.
There is the government plan to phone them and they will try to get you a doctor who is available to new patients, and try to match you up with them, but what I don’t like about that plan is the government want to match y ou up and you go and see the new doctor and decide to see if you are a “match” but to do that you have to give up your “old ” doctor but trying out a new doctor and for them to see if they want to keep you as a patient, takes time to get to know each other and by that time, you have left your old doctor who you may think was better for you but by that time, you can’t get back to them. that is what I don’t like about the govt. plan. I think you should be able to try out a new doctor for a certain period of time to see if you want to keep going to them, before you give up your “old doctor, so you can go back to the old doctor if need be. that seems more sensible to me and gives you a choice, instead of being stuck with a doctor you don’t want and maybe don’t want you, and you are back in the bad position of looking around for a doctor. I have looked for several months for a doctor and it isn’t easy believe me. A walk-in clinic isn’t the best setup to get a doctor, but right now, there is not much choice as far as my experience, and it’s better than nothing- at least you can try one and if you don’t like it, try another one. The walk-in clinics seem to be needed and are doing OK.
Unless family physicians start offering office hours outside of Monday to Friday 9-5 patients will always use walk in clinics. It’s a much better alternative than going to emergency rooms. I’m surprised there is even a debate over their necessity.
I agree Janice.
Janice: Walk in clincs do not renew prescriptions
I serve walk in patients in a clinic with several doctors who have full time practices.
I see their over flow of patients in a timely manner and my EMR encounter records are readily available for the patients family physician, to provide suvsequent,follow up care if needed
It’s been 3 years since this article has been written, has any new information about walk-in clinics and access been published since?
A list of walk-in clinics should be available that rates the clinics in all areas including the front office staff. I am in the process of locating a new doctor as I can no longer deal with the lack of respect that the front office staff and upper management have for the patients not to mention the apparent lack of proper record keeping. Absolutely no issues with the doctor, she is great. As patients we need to know which clinics to stay clear of.
After a terrible experience at a walk in clinic in Orangeville Ontario I can not find out who owns the clinic or who they are accountable to. The doctors yes but the owner no.
If the business is to receive public funds they need to be held accountable as well
Reading this article opened my eyes to why walk-in clinic doctors seem not to do a good job of collecting any information not really talking a patients issues seriously. To how I and others have endure and discussed the walk-in clinics lack of care has us wanting to do a documentary on Clinics and they way they treat patients of different backgrounds.
The public needs to see not hear.
I have tried to find out more about the governing of walk-in clinics – their regulations and policies, etc, but gotten nowhere. The CPSO only deal with the physicians. The Ministry of Health has nothing to say on the subject, though I got the impression walk-in clinics are seen as businesses, like restaurants. Where can one go to find out about them? They certainly aren’t geared to older people with chronic illnesses.
I went to a walk in clinic and the doctor kept looking at the floor instead of at me. I had a painful rash on my ribs and he gave me a prescription for oitment. I felt like he did not even care because he never looked at me and perhaps glanced at my rash a second. His secretary told me he was Muslim and could not look at a woman especially at Ramadam. The women working there were all devout Muslim with full head dress. This was on Sheppard Ave E at Birchmount . I ended up going to emergency when the pain got really bad and I had shingles. Doctors who refuse to look at a woman should not be allowed to practice here in Canada. What a Joke!!!!
There is a lot of this in Canada.
There are multiple “shortage” specialties, like family medicine, psychiatry and pathology, where anyone from abroad is essentially allowed to practice with relaxed standards in order to “fill the need”.
Shingles is a serious diagnosis that a first-year medical student should be able to make. This doctor clearly wasn’t paying attention. It being Ramadan is not an excuse.
Not being able to examine a patient because of religious reasons is antithetical to being a physician. I would call the CPSO and complain about this particular doctor. That kind of behavior is not accepted in medicine.
Hi My daughter and grandson went to Urgent care walk in clinic at 10 am didn’t not get to see the Doctor till 1;30 om people came into the office then went in to see the Doctor after awhile my daughter finally ask another patient if she had an appointment her reply was yes? well my grandson temp was 103 degrees and not well at all and being the age of two didn’t help because he was so cranky But I don’t understand the definition of a Walk In Clinic if these clinics are being paid by our tax dollars these Dr’s shouldn’t being using them for they’re private practices
You clearly should have gone to Emergency at a hospital .
People don’t realize that a walk-in clinic is not an alternative to a family doctor. My daughter waited almost a year for a surgeon’s visit which had been arranged by the clinic. They were new to the city then, and could not immediately find a doctor . She has such severe back damage that there is danger of permanent disability. She cannot lay down and can only sit and lean back.
Today was the visit …. she went to the surgeon’s office.
He told her that the paper request from the clinic said ‘pediatric’ and he could not help her…. go to another doctor. He DID tell her she had better get an operation soon.
My daughter came home and wept. I am furious with the lack of skill at that clinic. Unbelievable! If these are private businesses, the public should be aware…. and not think of them as a valid alternative to quality care. If they are not, they should be monitored and meet basic requirements like being able to read, write.
I feel walk in clinics are a great concept if you stop the doctors from using them as money making turnstiles and have doctors spend more time per visit with the patient. Doctors have to realize that clients are not part of a robotic process and need extra time to be examined and diagnosed properly. How to achieve this might mean more government intervention to see how these clinics are run.
The term “clients” is incorrect. This is not a business relationship. It’s patients. That’s the correct term.
I am paying the doctor for a service so the term “client” is appropriate. “Client” is also a more respectful term than “patient”.
Your response to Dr. A is incorrect. Patients are not clients in the normal sense. Patients in Canada have a RIGHT to access a doctor and receive medical attention because it’s all tax payer funded.
Referring to someone as a client rather than a patient does not show more respect, it shows their ignorance.
You are on point Judy Green! The government needs to step in. This is about our lives and longevity which we have people whom do not care playing around with for an extra dollar. It is actually scary.
You and Judy Green are obviously speaking from a very narrow scope of experience. Walk in clinics are only as good as the doctor that is serving the patient at the time. Generally they save money and more often than not they reduce the likelihood of complications that often happens if people cannot see their family doctor in a timely manner. Where I live, the wait is 6 to 10 weeks to see a family doctor. Let’s say you are an asthma sufferer and you run out of medication for whatever reason…..and you have no refills on file with your pharmacist. You phone the doctor’s office and they tell you the first opening is in 6 weeks….or even 2 weeks for that matter. Now what are you going to do? God to the emergency center and sit there for 8 hours? The walk in clinic is the perfect option. It’s fast and efficient and it saves the tax payers money.
As a resident of High Park, Toronto I had a MD I rarely visited as I worked in Don Mills and travelled by TTC so it took a bus, 3 subway systems and the King street car to get me to the MD, not easy during rush hour. I had a walk in clinic near my work in Don Mills and a walk in clinic that took appointments in the evenings in Chester Village(there are no walk in clinics open evenings or weekends in High Park). Mostly working people use walk in clinics as they need urgent care during evening or weekends and the health minister has been busily closing hospital clinics and community clinics with 600 person waiting lists are not available. Not everyone wants to go to the emergency room of a hospital if they need urgent care
I have had better healthcare at the walk-in-clinic I use than my son has at his GP. Because there are several doctors at the clinic, they tend to channel cases to the doctor with the most relevant experience. That can’t happen at the GP. Furthermore they can pull up my file each time no matter which doctor within the clinic I saw in the past. Friends have claimed a family doctor will know your situation better and provide continuity but with my son’s doctor, there is no way he knows our names without looking at the file and no way he knows the reason for our last visit. The only thing he knows is how to read his own scrawl (the clinic uses typed notes on iPads). I frankly see little argument in favour of a family practitioner. As far as whisking you in and out in a hurry, that happens at both places. I have to tell them to slow down. One thing that bothers me is the notion of “one appointment, one ailment” (or at most 2). I think that is driven by twisted incentives in the billing systems.
You’re right about your final comment. Overall, physicians are not paid to talk, think, or listen. They are paid to do. Your appointment is coded as an “encounter” with a specific reimbursement attached to it; something along the lines of 30 bucks. Whether the doc spends 2 minutes with you to refill a script, or 30 minutes with you reconciling multiple complaints, he gets the same 30 bucks.
The billing system makes it quite clear that a doctor’s mind is unimportant. This is why nobody wants to do family practice, and that those that do are forced to do this “one problem per visit” nonsense to keep their practices afloat.
The only solution to this is to increase the billing rates and to figure out a way to bill per clinical decision, not per encounter or procedure.
Exactly!
A doctor’s mind is unimportant. All that matters is throughput.
The billing system will not change. There are too many family docs for that to happen. It would bankrupt the system if they started getting reimbursed for their clinical decisions.
They’d have to start taking money from specialist billings, and that won’t happen. Certain specialties are quite politically powerful (you can tell which ones by their incomes and competitiveness).
I went to a walk- in clinic just the other day for some medication and I knew right from the start that he just wanted the money from my visit. I was at the clinic for not even 2 minutes and he said their was nothing wrong with me? He was also a real Jerk! The best part is I went to another clinic and the Doctor prescribe me a prescription,Go figure!
My fiance got fired from his family doctor for visiting the hospital to much and now he’s having a hard time getting a new doctor. I even tried to see if my doctor would take him on, but he said no. I’m afraid to go to the hospital now, cuz I don’t want to get fired from my doctor. We live in North Bay, Ontario and our doctors are in Powassan, Ontario. I finally got to see my doctor, but he doesn’t believe me about my hip giving out on me when I walk long distances. He thinks I just need exercise, but I’m very active.
I have also had issues with the medical services in North Bay, Ontario. I was accepted by a family doctor but recently received a letter stating that he has decided not to provide me with medical services anymore. No valid reason was given for this decision and I am now left without a family doctor and there aren’t any family doctors in the city taking new patients. With regards to the post above, the family doctor should not be allowed to fire you just because you went to the hospital too many times. Perhaps, s/he needs to improve upon their accessibility, or he could simply de-roster you to avoid charges to their clinic. Additionally, in North Bay, the Near North Walk-in Clinic and the hospital have ‘no opioids prescribed’ policies, which goes against College guidelines and makes it very difficult for people with chronic pain without access to a family doctor to get the help that they need.
I live in ottawa and my GP is 40 mins away by bus. She only works 3 days a week and you cannot get in for 1 to 2 weeks unless its an emergency (keep in mind I am very healthy for my age). \She is a good doctor but I broke my arm and it did not heal, I was told to apply for disability. Shes does not feel I should be on it, that I can work ( Id love to work but in ottawa I AM white and english with no degree so its been 2 years seeking work and am over 40 as well.I also have a lawsuit from the fall where I injured my arm. When I first got this doctor she gave us all a paper stating you cannot go to another clinic or doctor or she will be charged and or she will end the doctor patient relationship. She said if you cannot get into me and are too sick go to emergency. That will cost the govt 10 times more money I dont understand that. Once my eye got a bad infection and swollen very fast it was a saturday of a long weekend, my dr is closed for 3 days straight so I went to a dropin clinic 3 mins from me. She found out and got kind of mad and said \its ok this time! The thing is I do not have a car or someone to drive me to her clinic I have no family here. Its 2 buses and walking 10 mins just to get there. Your talking a 3 hrs out of your day! So I was fine then suddenly again on a long weekend my finger got a bad infection just when a heat wave was hitting so I went to emerg spent 5 hrs there. It was a purulent granuloma very sore, they treated it with cyrotherapy but did not give me antibiotics, it was infected at that time. I was told FU with your GP for 3 to 4 more treatments they even wrote in on the paper they gave me, they said they dont do those treatments at the hospital. I waited and called my GP and told the sec. all that happened and she booked me for 7 days later a monday at 100 pm. \By sunday it was very bad infected, bleeding and had bad pain from 300 am on. I changed the gauze and saw maggots in my finger!! I called telehealth they said go to emerg asap, cancel your GP appt, so I did. I got great drs there etc. The next day my GP office nurse called i dont know her, she wanted to know what was happening. I told her. She was getting snarky with me. I finished telling her and she interrupted and said I dont need to know all this! Tell me what meds they gave you so I told her. Then she said in a rude manner’ why didnt you go back to emerg? I said because they said they dont do the treatments there and to FU with my GP. Then the phone went weird and I lost her! I do not know why my drs ofrfice is turning on me I had a previous incident a few months ago and the staff ganged up on me there who I never met before about a referral the first one was lost the second one I had no confirmation the specialist ever received it as you could not call them only email. Weekly I would ask her no reply this went on for 7 weeks! So finally I lost it and said I will put a complaint in and all hell broke lose! \She contacted my GPs office and complained and made up lies that I was rude to her ( i never met her or talked on the phone). The office staff at my gps office also ganged up on me cause there were a few emails back and forth re the referral i just wanted confiramtion it was sent, I was told by ther specialist office i had to get it resent (when in fact its up to HER to do that that is her job,she is the head of referrals!! I also did this job for a year. So then I got a call from the nurse at the GPS office I was told I was rude etc. I was not rude at all! Im alone in this city so they think they can do these things. And my doctor called and tried to turn it into something else that I upset the girls at the front ( who I dont even know as I AM RARELY sick!), and they felt I was critiqing there work!! wow! People I dont know at all how it that possible?? So this last event has told me I have to get a new dr. I was declined disability because she did not answer the questions properly Im under a pain syndrome. I need a caring dr who is closer to me with later hours.
I find walk-ins to be hit or miss in terms of quality, but at least I can get in and out within the day. My family doctor has terrible hours but I swear they were the only place in the city actually accepting patients.
Here’s the thing, walk-ins are generally open from 9 – 5, sometimes even 9 – 7 on work days. I even have one near my house that is open on the weekends. My GP is closed weekends, Monday is a half day for some reason, Tuesday they are closed all day (?) not sure why. Wedensday is from 1pm to 7pm, Thusday is 9 – 3, Friday is 9 – 7. The hours are confusing, seem to change every month and aren’t actually listed anywhere for me to see.
With a walk-in, at least I can see the damn doctor.
For me, my schedule, and my family, our local walk-in clinic is the best solution to our busy and varied schedule for important, non life threatening issues.
Our family doctor was semi retired, and although he would have been my first choice, most times it wasn’t possible to see him without taking time off work or school for my sons, or waiting a week or so for an appointment. Since then I’ve signed up with the local NP clinic, with my previous physician as consultant, which is good, but if there is an urgent, non life threatening issue, I will still visit the local walk-in clinic. The last thing I want to do is wait 8 hours, possibly more, at our local hospital, and pay $4.00 per hour parking.
There is a gap between between hospitals and physicians’ practices that walk-in clinics fill, and I’m happy to continue using the walk-in clinic when needed. It’s a matter of not having to take time off work or school, lose money, and so on. The walk-in clinic is more convenient and efficient.
Where I am in Kenora Ontario the wait to see a family doctor is 6 to 10 weeks and they whine like babies if one of their patients attends a walk in clinic. They even threaten to un-roster patients who go to walk in clinics….why?….because the government docks them a small amount of bonus money…If that is the case the doctors should complain to the government instead of taking it out on patients that need to see a doctor today, not next week or 6 to 10 weeks from now. It’s all about the bottom line and not about the patients for some doctors.
Kudos for your level headed comment.
This is an important and timely discussion. We absolutely need more information about walk-ins. We need to start with a clear definition of walk-in clinics. I don’t think it’s as black and white as many people think. It may be a little bit like pornography or art in that it’s hard to define but easy to identify.
We can define emergency care. We can also define comprehensive family practice, using some sort of basket of services that is provided to patients on an ongoing basis. It’s less easy to define Urgent Care Centres. The MOHLTC has designated some places as UCCs, but others who appear to offer similar services are left out. But what is a walk-in clinic?
Some practices provide what I would call comprehensive family practice to some patients while providing walk-in type care to others. These are a sort of hybrid. And they appear to offer excellent care.
In this time of economic restraint we need to make sure that money is well spent on all types of care and that means we should evaluate the value added to the system for walk-in care. But we really need to spend some time making sure we all have a common definition that makes sense.
Lastly I would like to point out that while it makes intuitive sense that improving the access for a patient to his or her usual primary care physician or NP will decrease the demand for walk-in clinics, I’m not sure that there is a lot of evidence to support that assumption. Many physicians have worked valiantly to implement advance access or day of choice scheduling and still see their patients go to walk-ins. At some point we need to have a serious discussion about patient accountability.
The last and final time I went to a walk-in clinic I had a bad case of bronchitis that did not react to the first antibiotic used. I asked to see the same doctor who treated me three days earlier and I was told this was not permitted. I couldn’t believe that they could not understand the importance of continuity in treatment but was told that this was clinic policy. Although I felt pretty awful, I waited until the office covering for my primary doctor was open the next day and learned that I now had pneumonia. In my opinion, walk-in -clinics can provide a convenient short-term service. However their effectiveness is limited by this type of policy and exacerbated as they do not share information with other components of the system (another example of the costs of not having a comprehensive health information system).
That also happens to people who see their family doctors. Don’t let one bad experience form your opinion. Listen to those who have had good experiences too. Besides, if your bronchitis was that bad, you should have gone to the hospital. Your family doctor is as much to blame for not seeing you in a timely manner in the first place. An ineffective anti-biotic and having to switch to another is not uncommon.
Hi — this is a great & informative article. However, when I speak to my friends about healthcare or these kinds of issues, virtually all of them have gone to or still continue to go to a walk-in clinic for occasional care. No one seems to know why they should or shouldn’t go to a walk-in. The main reason my friends give is because their family physician is located farther away from their home than they wish to travel they head, instead, to the nearest walk-in. I think the real issue is most people have no idea about what their doctors or clinics provide including after-hours services or walk-ins. People just want to see a doctor quickly & go wherever is closest & most convenient at the time. I think the biggest challenge is educating the public about the variations of health services available through their own doctors/clinics. Even my own family physician, who is great, has never really explained to me how her practice works and/or what services are part of the practice. I know I get good care but am still a bit unsure about how it all works! I also wonder about the future possibility of my family physician calling me (like my dentist does) to remind me to book a physical or follow-up appointments.
Ann-Marie T
Agreed All patients should be educated on the types of primary care provided in this province. We may then actually get more people active about making it more effective. Much of the “private business model” that is Walk-in Clinics is partly extra income for primary care providers so “rocking the boat” is not on their priority list.
It is poor Acute care and poor short term diagnostic preventive care as well as extremely poor public policy. This model needs to be re-imagined. We have the infrastructure of Local Integrated Health Networks to do this.
We have a lack of public education and political will . . .
Fee-for-Service is wrong headed if cost containment and effective Health provision across the spectrum of that definition is to be embraced.
Health is NOT a business. Health for humans and the planet as a whole is a right to the best life possible.