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Debunking misperceptions about the updated standard regarding walk-in clinics

Misperception 1: The standard is new

To ensure quality of care in all practice settings in British Columbia, this past June the Executive Committee approved an amended professional standard entitled Walk-in, Urgent Care and Multi-physician Clinics. 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.

Misperception 2: The standard has a “one visit” rule

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.

Misperception 3: The standard says that patients get to choose a primary care physician at the clinic

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. 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.

Overall, the updated standard outlines and strengthens the language on the expectations of physicians and the medical director. It also retains the requirement that clinics must have on-site access to PharmaNet and document appropriate review in the patient’s medical record. Accessing PharmaNet will help prevent situations like the one reported by CBC’s Go Public recently: Regulators’ investigation into prescription fraud identifies 150 health professionals. The College encourages registrants to review the revised standard: Walk-in, Urgent Care and Multi-physician Clinics.

While resolving health resourcing issues falls primarily with the provincial government, the College and physicians across the province have a role to play in ensuring that British Columbians are receiving the highest quality medical care possible—whatever the practice setting.

H.M. Oetter, MD

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