Written by Richard Lander MD
Why should I bring my child to the pediatrician when he/she is sick? It is so much easier to run over to the local retail-based clinic (RBC) at the pharmacy where there is lots of parking, I don’t need an appointment and while I’m there I can pick up tissues, milk and medicine. Right?
Here are six reasons why going to a RBC may not be in the best interest of your child’s health.
1 – Most RBCs are not Staffed with Board-Certified Pediatricians
Your child will probably be diagnosed and treated by a nurse practitioner or physician’s assistant. Imagine that you are concerned about your child and therefore a little distracted and forget to mention that your child has allergy to an antibiotic. This could have a bad outcome. If you are at your pediatrician’s office, that allergy information is kept in your child’s chart.
2 – You Can’t Call The RBC in the Middle of the Night
Now imagine that your child’s condition worsens at midnight. The RBC you visited earlier is now closed and so you can’t ask for further advice. On the other hand, had you called your doctor earlier and then required additional help later in the evening, you would be able to receive consistent medical advice because your doctor or a covering doctor is on call 24/7. The American Academy of Pediatrics has always stressed the importance of continuity of care. It’s what I want for my children; it’s what I want for your children.
3 – RBCs Have Age Restrictions
Many RBCs have an age below which they will not treat a patient. What will you do if two of your children are sick — take one to your doctor and the other to the RBC?
4 – RBCs Can’t Handle Complex Medical Issues?
Worse still, the RBC cannot deal with complex medical issues. If you visit the RBC with a problem that is beyond the scope of their training and knowledge, they will tell you to see your doctor or send you to the emergency room.
5 – RBC Provides No Continuity of Care
Let’s think about vaccines. Your child needs a flu vaccine as well as one or two other immunizations. Many of the RBCs are only prepared to give the flu vaccine. If you are receiving the flu vaccine at the RBC and all other immunizations at your pediatrician’s office, no one will complete your [child’s] vaccination record. Again this speaks to a lack of continuity of care. This fragmented record keeping could cause trouble in the future.
6 – An RBC’s Not Your Medical Home
Your pediatrician’s office should be your child’s medical home. Your pediatrician has cared for your child’s physical and mental well being since birth. At your pediatrician’s office you received vision and hearing screening, and we assessed your child’s fine and gross motor skills. Your pediatrician has checked for autism and ADHD, asked you questions relating to your child’s growth and development and if there was a concern, and addressed it. When a behavioral problem at school or home arose, it is your pediatrician who thought about the possible medical conditions that could cause these behavioral changes. Will your RBC help you with your child who is crying out for attention secondary to a new baby at home or to parental discord? Will your RBC talk to your teenager about depression, alcohol, drugs or tobacco use? If your child has a GI problem, a broken arm, a heart condition or a blood disorder, will your RBC recognize the problem and send you to an appropriate specialist? Would you want the recommendation of a competent specialist to come from your RBC or from your doctor who knows you and your family’s medical history?
Your pediatrician provides your children with vaccines after they have looked at the medical research. He/she does not give vaccines because a corporate entity (RBC) made the decision to do so. Your pediatrician went to medical school for four years and then did a pediatric residency for an additional three years and continues to both attend medical conferences and read the medical literature to make ensure that he/she remains current and ahead of the curve. One of the national RBC chains has the tag line “You’re sick, we’re quick.” Is that the kind of medicine your loved ones deserve?
Dr. Lander has been practicing pediatrics for 32 years in New Jersey and is the immediate past chairman of the American Academy of Pediatrics Section on Administration and Practice Management. He says if he had to do it all over again he wouldn’t hesitate to be a pediatrician.