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New Walk-in-Clinic Standards Causing Confusion for Patients Seeking Medical Treatment

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Recently, headlines were made when several local walk in clinics turned away patients who were not under the ongoing care of one the clinic's physicians. 

On July 28, 2015, H.M. Oetter Registrar of the College of Physicians and Surgeons of British Columbia released a statement to explain the misperceptions about the updated standard regarding walk-in clinics.  

In it, she clarified 3 "misperceptions" about the standard:

1. That the standard is new;

2. That the standard has a "one visit" rule; and

3. That the standard says that patients get to choose a primary care physician at the clinic

She stated that in June, 2015 the Executive Committee approved an amended professional standard entitled Walk-in, Urgent Care and Multi-physician Clinics and contrary to what has recently been reported in the media, this standard is not new. The revised document merges and modestly revises two earlier, separate standards developed in 2008, and reiterates one basic principle that every physician must abide by: that the medical care of a patient, and not the setting of a medical practice, must guide the ethical, professional and clinical decisions around the provision of appropriate medical care.

This means that a patient is owed the same standard of care from a family physician whether treatment is being sought at a solo practice or a multi-physician clinic. While walk-in clinics may typically treat less severe medical episodes, patients who do not have a dedicated family physician and who are in need of longitudinal medical care should not be made to feel like they are on an assembly line for hurried and potentially compromised treatment.

With respect to the "one-visit" rule, she stated that all patients do not automatically become permanent patients of the clinic at the time of their first visit. Patients who do not identify a family physician and who regularly attend the same walk-in, urgent care or multi-physician clinic must be assumed to be receiving their primary health care from that clinic. The physicians and medical director are responsible for ensuring these patients are offered longitudinal medical care, including the provision of appropriate periodic health examinations and follow-up.

As in the past, a patient attending repeatedly at one clinic, essentially receiving all of his/her care there, is undeniably already accessing longitudinal primary care from that group of physicians. Providing such a patient with episodic care exclusively is inadequate.

Lastly, with respect to the patient's choice of care provider, Dr. Oetter stated that no individual physician working in a walk-in clinic is obliged to take a patient exclusively, nor can a patient demand that a particular physician working at a walk-in clinic become their dedicated family physician. The updated standard does not require that the ongoing care at a walk-in clinic be provided by only one physician, but rather all of the physicians and medical director collectively. The clinic must ensure there is a unified patient record that is accessed by all physicians at every visit.

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