In-store clinics' edge: Less waiting

LETTER — Posted Nov. 20, 2006

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Regarding "In-store clinics hurt primary care" (Letters, Oct. 2): The condemnation, by G. Michael Summer, MD, of Lewisville, N.C., of in-store clinics (staffed by mid-level providers) has some validity, but here's the reason most people go to these clinics: They are sick or injured now, but can't get an appointment with their primary care physician (or one of their doc's mid-levels) until next Thursday. I work at a walk-in university clinic, and we see many students, faculty and staff who preface their visit with an explanation similar to that.

As a provocative note, it is disturbing to find, during our brief first encounters, that "our patient's doctor" has provided significantly deficient (and far from "primary") care. We're talking basic things, like recommending a patient whose blood pressure is always "borderline" log their blood pressure at home, or discussing with a patient that the discoloration around their neck (acanthosis nigricans) may have serious implications.

If primary care is in trouble, it is not due to predatory outside forces -- it is due to physicians' failure to provide true primary care.

Iris P. Gonzalez, MD, Topeka, Kan.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/11/20/edlt1120.htm.

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