Why Pediatric Patients should not obtain Routine Medical Care at Pharmacy Clinics like The Minute Clinic (CVS), Take Care Health (Walgreens), and other walk-in clinics.

There has been an evolution of the services provided in Pharmacies over the past few decades. Pharmacies started as a local pharmacist that spent time teaching their clients, families and providing extra counseling care. Pharmacies also had some over the counter (OTC) medications available for patients. The pharmacy evolved into a “mini-grocery store” driven by high volumes of Prescriptions. Counseling at the Pharmacy changed today to providing more patient handouts to a point that most patients pick up their medications without speaking to a pharmacist. No physician would ever sell or consider selling tobacco products at or close to a Medical Facility. Pharmacies sell tobacco products including cigarettes. How can a pharmacy try to be a medical facility and/or treat patients? Here are some conflicts that Walk-in clinics found in Pharmacies have with good Pediatric Care:
1. Obtaining care at a walk-in clinic disrupts the continuity of care provided in the Pediatric Medical Home. Solid Pediatric Management principles minimize the chance that Patients over use Emergency Rooms, Medications (such as anti-biotics) as well received duplicate care.
2. The Pediatrician insures that the patient is up to date on their vaccines and does not receive duplicate vaccinations. Some continuity of care issues can occur with walk-in clinics including: the clinic providing an additional vaccine that the patient received on their last visit to the Pediatrician, disruptions in flow of information – the walk in clinic forgets to identify the primary care practice or the patient does not provide this information so the information is not in the medical record.
3. The Nurse Practitioner (NP) usually has a broad knowledge but limited knowledge in Pediatrics. The NP might not have the skill to identify a significant health issue that appears during an encounter in the pharmacy. She/he does have training and oversight by a Pediatrician in a Pediatric office. They might be performing this work as weekend work.
4. The walk in clinic does not know the history of the patient to provide optimal treatments. For instance, the NP at the clinic would not be aware of the number of visits to an Allergist for a patient’s asthma and if a patient has the tendency to move from mild coughing to severe asthma. The NP might in this case only provide a beta agonist and cough syrup vs. an anti-inflammatory Medication.
5. The Walk-in clinic might over prescribe certain Medications (like antibiotics) which are not necessarily in the best interest of the patient (good for a pharmacy though).
When a patient is on vacation outside of their home town is probably an appropriate example of when a patient might need to leverage a walk-in clinic. If a walk-in clinic is a health care facility, then they should accept all insurances including Medical Assistance as well as not be located in a pharmacy that sells tobacco products. As large institutions test and try to make money with walk in clinics, it is unclear on the future these pharmacy clinics have in the health care system.