In defence of walk-in clinics (kind of)

This year has produced barren winter mountains and record summer heat; similarly, the climate is changing for the ways that doctors practise. In BC we have a new agreement with the government and unprecedented levels of collaboration as we advocate for health care system improvements. Yet, as I talk with colleagues, I commonly hear a particularly pessimistic theme: the vilification of walk-in clinics. I hear how new graduates are drawn to them and away from general family practice. That they drain the system through inappropriate referrals and duplication of testing. That the quality of the doctors’ care is inferior. That there is an us and a them. And as much as I fear the effects of climate change, the vitriol with which these complaints are laid is equally frightening. We all want to give the best care we can and sustainably maximize the time we spend with our patients and our families. We want a system that incentivizes doctors to provide comprehensive care, that rewards them and their teams for being accessible in person and remotely, and that is efficient enough to increase capacity to attach willing patients to doctors. But until that system exists there will be clinics high on accessibility and low on continuity of care. Blaming them is like judging the cherry blossoms that arrived in February—they exist because the environment allows it. Instead, let’s create a system that gives owners and participants in walk-in clinics motivation to participate in longitudinal care. Let’s promote innovation, collaboration, a return to generalism, and pride in caring for our patients. Many walk-in clinics have the physical space and human resources to provide true primary care; in-deed, the GPSC incentives have already encouraged some toward this transition. There is much work ahead and we need to be collegial. Together we can change the health care climate for the better.
—Eric Cadesky, MD 
Vancouver