Doctors at walk-in clinics must deliver the same quality of patient care as in other settings, the BC College of Physicians and Surgeons has warned members.
The unusually strong reprimand issued in the college's quarterly newsletter cites a long litany of problems at some walk-in clinics, including doctors failing to follow-up patients, test results, diagnoses and treatment; failing to send visit summaries to the patient's primary care physician (if there is one); and failing to ensure availability after-hours.
The college also issued guidelines for patient record-keeping at clinics, while requiring them to treat patients who come in “on 3 or more occasions for similar or related complaints, particularly in the absence of an identified family physician,” as if they are the primary care provider.
The stern warning was the result of “a series of complaints over a long period of time,” coming from both patients and primary care physicians, College Deputy Registrar Dr. Doug Blackman told CMAJ.
When informed of the complaints, physicians would invariably plead that it wasn't their responsibility, said Blackman. “As often as not a physician would say, ‘yes, I didn't do such and such — but I only work at a walk-in clinic,' or, ‘yes, the patient was really sick — but we only work at a walk-in clinic.' That wasn't an excuse.”
“I don't know that anybody's died, but we as a college ... aren't waiting until somebody dies until we respond,” added Blackman. Like its counterpart in Alberta, the college was especially critical of the practice of restricting patients to “1 complaint per visit,” and argued that walk-in clinics should be considered the primary care providers for patients who visit 3 times.
But BC Medical Association President Margaret MacDiarmid says some patients use walk-in clinics near their workplace, while having a primary care physician near their home. In such instances, she said, no one wants the walk-in facility designated for their primary care.
A college reprimand may make the job of finding a family doctor more difficult, MacDiarmid said, adding that many family physicians felt “attacked” by the college's missive. “It's good we have constructive ideas from our regulatory body, but we should ensure that we don't make the job so difficult, nobody wants to do it.” — Deborah Jones, Vancouver, BC