Abbreviations:AAP—American Academy of Pediatrics • RBC—retail-based clinic
The American Academy of Pediatrics (AAP) opposes retail-basedclinics (RBCs) as an appropriate source of medical care forinfants, children, and adolescents and strongly discouragestheir use, because the AAP is committed to the medical homemodel. The medical home model provides accessible, family-centered,comprehensive, continuous, coordinated, compassionate, and culturallyeffective care for which the pediatrician and the family shareresponsibility. Given that the RBC is not a medical home model,the AAP is particularly concerned with the effects of the followingattributes of an RBC on health care for children and adolescents:
Fragmentation of care.
The possible effects on quality ofcare.
Provision of episodic care to children with specialhealth careneeds and chronic diseases, who may not be readilyidentifiable.
Lack of access to and maintenance of a complete,accessible,central health record that contains all pertinentpatient information.
The use of tests for the purposes ofdiagnosis without properfollow-up.
Possible public healthissues that could occur when patientswith contagious diseasesare in a commercial, retail environmentwith little or no isolation(eg, fevers, rashes, mumps, measles,strep throat, etc).
Seeingchildren with "minor" conditions, as will often be thecasein an RBC, is misleading and problematic. Many pediatriciansuse the opportunity of seeing the child for something minorto address issues in the family, discuss any problems with obesityor mental health issues, catch up on immunizations, identifyundetected illness, and continue strengthening the relationshipwith the child and family. These visits are important and providean opportunity to work with patients and families to deal witha variety of other issues.