Understanding and coordinating today’s medical services.
When it comes to accessing health care, parents and caregivers may find today’s options confusing. Here is what you need to know regarding where to take your child.
Convenient Care Clinics
Convenient care clinics (CCCs) — also called retail-based clinics (RBCs), urgent care centers or walk-in clinics — have grown over the past five years. RBCs are often found in supermarkets, pharmacies and other similar retail locations, while urgent care centers are typically freestanding buildings along with walk-in clinics.
Urgent care centers are different from RBCs in that they treat patients with an illness or injury that requires immediate attention but is not life-threatening — such as sprains, strains, lacerations, contusions, back pain and fractures. Both provide a limited scope of primary care services. No appointment is necessary, and fees are generally posted, with some clinics and centers accepting insurance.
Pediatric Primary Care Providers
Pediatric Primary Care Providers (PPCPs) are doctors or nurse practitioners with specialized training in pediatric care of children from birth to 21 years of age. These providers take care of your children for both well and sick visits, focusing on wellness and prevention. Most insurance companies will have the parent and/or caregiver pick a PPCP depending on their plan.
PPCPs assess each patient and compare that patient to the developmental norms for children, which change rapidly as they grow. These providers know to screen for certain types of illnesses unique to the pediatric population, to encourage receiving immunizations, which may prevent diseases, and to follow up for their routine visits as well as sick visits. The PPCP keeps a thorough history of the patient and family so that it can be reviewed easily and updated with each visit.
There is a big difference between caring for a two-year-old patient and a 47-year-old patient. Children are not “little adults” and, therefore, it is important that they are cared for by someone who specializes in pediatrics. PPCPs are well versed on pediatric dosages of medications, as well as normal vs. abnormal development.
The Importance of the Medical Home
The National Association of Pediatric Nurse Practitioners (NAPNAP), along with the American Academy of Pediatrics (AAP), supports a model of care called the medical home.
The AAP developed the medical home as a model of delivering primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective to every child and adolescent.
The pediatric medical home is a family-centered partnership that provides uninterrupted care with appropriate support to sustain optimal health care outcomes for children. A medical home facilitates an integrated health system with an interdisciplinary team of patients and families, PPCPs, specialists and subspecialists, hospitals and healthcare facilities, public health and the community.
Medical homes address preventative, acute and chronic care from birth through transition to adulthood. The patient-centered medical home (PCMH) was introduced in 2007, and is a model of health care that emphasizes personal relationships, team delivery of care, coordination across specialties and care settings, quality and safety improvement, and open access to quality care.
Continuity of Care
PPCPs responsible for managing the health care of children may occasionally need to use the resources of urgent care facilities after hours. When such clinics are necessary, it is imperative that parents and caregivers call their primary care provider (PCP), who can refer the family to a pediatric-based CCC to stabilize and manage the child.
It is important for your child’s provider to have his complete health record prior to prescribing or treating him for any illness or event. Although most CCCs ask questions about your child’s history, they do not have a complete record of medical history and allergies. Unfortunately, these providers are then asked to make a diagnosis based on incomplete information. For this reason it is vitally important that any CCC have a collaborative relationship with the PPCP.
* Sick visits as well as yearly routine care — physicals, immunizations and developmental assessments — give your PCP an opportunity to stay current on the events in the life of your family and your child as well.
* Your PCP knows your child and family and can take into account your child’s history when providing all services.
* It is always best when children’s health care providers work together in order for patients to have continuity of care and access to providers that are well trained in pediatric care.
Tips for Parents and Caregivers
To help parents and/or caregivers understand when it is appropriate to use CCCs for children and make sure they are well aligned with their child’s PPCP, the following tips are provided.
* Know your PPCP’s regular hours of operation.
* Talk with your child’s PPCP at your next visit and be sure you understand the after-hours procedure.
* Know what number to call in case your PPCP’s office is closed (after-hours number).
* Call your PPCP prior to taking your child to any convenient care center.
* Call your PPCP with questions and/or concerns to obtain advice prior to reaching out to a provider who is unaware of your child’s history.
* Get advice from your PPCP regarding whether or not a convenient care center or an emergency room is necessary.
Cheri Barber, DNP, RN, CRNP, is Past President of NAPNAP and the Coordinator of the PNP Program at UMKC. She is also a PPCP at Pediatric Medical Associates.