In Ontario, do walk-in clinics complement—or compete with—primary care?

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  1. Graham W S Scott

    The only justification for Walk-in Clinics is the failure to have in place readily available Primary Care clinics. This is a serious policy failure in Ontario. Ontarians should have ready access and their engagement with a clinic should be recorded as part of their medical record. digital access and telemedicine all can provide effective solutions. Tthe problem rests in not having the policy flexibility and payment incentives that encourage primary care clinics that provide 24/7 access and appropriate record communication with the rest of the healtjh care system.

    • Lilian

      Here, here. Convenient office hours for family doctors are often inconvenient for patients and / or their caregivers. Quite frankly, family docs should take a page out of community pharmacy playbooks. If I can see a pharmacist at 8 PM on a Friday night, why can’t I see a family doctor? Maybe doctors should start to have offices in pharmacies and be more accessible to the public. We need interprofessional primary care hubs in places that are accessible to patients.

  2. Ed Weiss

    I’m a family doctor who practices in Toronto. I do think there is a role for walk-in clinics in our system, especially if it is to fill gaps in access, but only if they are done right. I completely agree with Dr. Glazier that in the context of an existing patient-physician relationship, the lack of continuity between walk-in clinics and a patient’s own family doctor can lead to serious trouble down the line. And while we all have horror stories about patients who were seen at a walk-in clinic only to be given an grossly incorrect diagnosis, this is not to say that walk-in docs are inherently inferior — only that without the insight that a patient’s history and context provides, it can be easy to be led astray and come to the wrong conclusion.

    I think, at minimum, that walk-in clinics should:

    1. Have access to the Ontario Laboratory Information System (OLIS) and ConnectingOntario (hospital record database) so that previous results can be accessed and duplication avoided.

    2. Maintain a list of family doctors in the area taking patients, so that those people who use a walk-in clinic and do not have a family doctor can find one.

    3. Identify a patient’s family doctor and communicate with them about the visit (unless the patient specifically requests otherwise).

    4. Avoid underhanded techniques, like asking patients to fill out rostering forms, which effectively “deregister” the patient from their family doctor.

    5. Avoid promotion of volume-based service. It’s not uncommon to see advertisements for walk-in clinics seeking doctors to “see up to 20 patients an hour.” This is not good medicine, even if it’s very lucrative.

  3. Paul Anderson

    Unfortunately, yes. Ontario does need walk-in clinics. If it were the case that the local GP’s office could always see patients in a timely manner, we wouldn’t need walk-in clinics. If it were the case that the local GP’s office was always able to take on new patients, we wouldn’t need walk-in clinics. If your GP never became burned out from working too large a practice, or less attentive or even somewhat blasé from treating the same patients for too many years, we wouldn’t need walk-in clinics. Walk-in clinics are an unfortunate necessity. Were it not for the quick action of doctors I have met in in walk-in clinics over the years, I might have lost a leg or even died by now.

  4. PS Bregmam

    Many people think of primary care as 1 or 2 doctors. Patients worried about convenience or travel time may be more interested in looking for a primary care practice if info about office hours and any arrangements for after hours or need urgent care. If a practice has a large number pf patients who commute an hour between work and home a link to an urgent care or walk in clinic.

  5. Vivian

    I’d like to offer a patient perspective on walk-in clinics. When I don’t feel like tolerating my family physician’s impolite behavior and ignorant comments, I am willing to wait two hours and take my chances at the walk-in clinic because there is a chance I may get a kind, curious person who will listen intently without interrupting and do a few tasks for me. Since our health system treats us like children and we need a GP to make specialist referrals for us, if my family GP refuses to do a referral for me, then I will ask for a referral from the walk-in GP. There are many advantages for patients to going to a walk-in clinic that is not at all connected to the family GP and there are advantages for patients to not having a central electronic health record system. If a doctor I see thinks I’m an anxiety ridden mess that is wasting their time, even if that is far from the case, and they write that opinion in a central system, every doctor I see after that who reads that note will be swayed by that opinion and likely not take me seriously and then my health suffers. If I want an independent, second opinion, I’ll go to a walk-in clinic. I’ve had some good experiences at walk-in clinics, but sometimes the provider will not help me with anything and will just say, “See your family doctor for everything”, which is hardly realistic and wastes my time and the doctor’s time. I don’t like the FHO, FHT system at all because it makes me feel trapped and if I decide to go to a walk-in clinic, they get mad at me. It’s an awful feeling. I don’t think they have the right to trap me and force me to sign enrolment forms when it takes three weeks to get an appointment and they don’t have extended hours at their office. They stop answering the phones at 4:00 PM for heaven’s sakes and the phone hours on Friday are almost non-existent. Right now, I see my family doctor on a fee for service basis even though she is in a FHO because I don’t want to feel trapped and she doesn’t want to be penalized for outside use. It works for us and I would encourage other patients to do the same if they feel trapped by the current system.

    • J

      You are so right! Thank you. My relationship with my family doctor is tainted because she got mad I went to a clinic. I’ve lost confidence in my family doctor as a result and no longer feel comfortable.

  6. Wendy Agardi

    In the past year I visited a walk in clinic i had some on going issues brought them to my Dr and tgey were passed by I took it to the walk in clinic and they actually found what was wrong and it changed my lufe. I was diagnosed with NAFLD non alcoholic fatty liver disease. My Family Dr brushed it off My symptoms were a full year running and he never persued my complaints. Im so Very greatful for walk in clinics and I choose to go to one before I even think of my Long term Family Dr.

  7. Bud

    I finally got a family doctor and had to sign a paper saying I would not use a walk-in clinic as it would cost him money. He only works 3 1/2 days a week. Phones aren’t answered after 4 p.m. No access on weekends or evenings. When I asked him what I should do if I needed medical care outside his hours, he said “Go to the emergency room at the hospital”. What a waste of taxpayers money. Maybe that is one of the reasons emergency rooms are full. What does a visit to the emergency room cost the health system? $500??? And how much money would my doctor lose if I used a walk-in clinic…$33. Sickening.

  8. Nat Jones

    Maybe if family doctors listened to their patients and were not afraid to send you for tests instead of saying you are just fine when really you have stage 3 Hodgkin lymphoma ppl would not go to walk in clinics but unfortunately my doctor thought he was God and missed my son’s cancer.

  9. John

    Walk in clinics help prevent Family Doctors from burning out.

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