AAP Principles Concerning Retail-Based Clinics
Retail-Based Clinic Policy Work Group
Abbreviations: AAP—American Academy of Pediatrics • RBC—retail-based clinic
The American Academy of Pediatrics (AAP) opposes retail-based clinics (RBCs) as an appropriate source of medical care for infants, children, and adolescents and strongly discourages their use, because the AAP is committed to the medical home model. The medical home model provides accessible, family-centered, comprehensive, continuous, coordinated, compassionate, and culturally effective care for which the pediatrician and the family share responsibility. Given that the RBC is not a medical home model, the AAP is particularly concerned with the effects of the following attributes of an RBC on health care for children and adolescents:
- Fragmentation of care.
- The possible effects on quality of care.
- Provision of episodic care to children with special health care needs and chronic diseases, who may not be readily identifiable.
- Lack of access to and maintenance of a complete, accessible, central health record that contains all pertinent patient information.
- The use of tests for the purposes of diagnosis without proper follow-up.
- Possible public health issues that could occur when patients with contagious diseases are in a commercial, retail environment with little or no isolation (eg, fevers, rashes, mumps, measles, strep throat, etc).
- Seeing children with "minor" conditions, as will often be the case in an RBC, is misleading and problematic. Many pediatricians use the opportunity of seeing the child for something minor to address issues in the family, discuss any problems with obesity or mental health issues, catch up on immunizations, identify undetected illness, and continue strengthening the relationship with the child and family. These visits are important and provide an opportunity to work with patients and families to deal with a variety of other issues.
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