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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Monday, September 24, 2007

Walk-in clinics rank lower on patient satisfaction in Canadian study

Talking about the healthcare systems in Canada and the United States has always been a case of compare and contrast, and not just for Michael Moore in "Sicko." A study published today on what patients in Ontario thought about where they received urgent care may be relevant to the current Massachusetts debate on allowing walk-in clinics inside retail stores, but with some caveats.

Like its neighbor to the south, Canada is also suffering from a shortage of primary care physicians. But unlike doctors in the United States, some physicians in Ontario are required by their contracts to provide care after hours, usually until 8 p.m. on weekdays and for a half-day on the weekends. The majority of family practice doctors in the province are moving toward that model, study author Michelle Howard of McMaster University in Hamilton, Ontario, said in an interview.

Even so, some patients still go to independent walk-in clinics or hospital emergency departments for urgent care. A study in today's Annals of Family Medicine surveyed them on which kind of care they liked the best.

Seeing or speaking on the telephone with one's own family physician scored the highest, followed by going to the after-hours clinic affiliated with their doctor. Next came the emergency departement and then a health information telephone service staffed by nurses. Walk-in clinics finished last.

"It wasn't surprising that people were more satisfied if they had gone to their own family physician," Howard said. "I think this lends support to the idea that the (after-hours) service is really valued by patients."

The walk-in clinics in the study were standalone venues staffed by doctors, so they are different in two respects from the MinuteClinics that CVS Corp. hopes to set up inside its drug stores with nurse practitioners or physician assistants seeing patients. The Massachusetts Department of Public Health has held two public hearings on proposed rules governing retail clinics and will bring its findings before the Public Health Council in November at the earliest.

Howard said the Canadian survey of 1,342 patients in Thunder Bay, Ontario, was part of a larger study to test the hypothesis that if family physicians are available after hours, people might be less likely to go to a hospital emergency department. That study is not yet complete.

Posted by Elizabeth Cooney at 06:00 PM
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