As a practicing pediatrician for fifty years, I am greatly concerned about the spread of Retail Clinics. These are staffed by nurse practitioners who do not have adequate pedatric training to care for ill children. Children can become sick very quickly and if for example a bulging ear drum is missed because a nurse does not know how to clean out an ear canal, mastoiditis or meningitis could result. I have worked with two nurse practitioners and neither one had had pedatric training. One missed a very bad ear infection because she had no idea how to remove wax from an ear canal. Ear infections are very common in children and can lead to serious illnesses or deafness, if left untreated or if they are allowed to rupture. Doctors are supposed to supervise the nurses, but they are not on-site and may be in charge of several clinics that are far apart.
The American Academy of Pediatrics issued a policy statement on September 14, 2006 stating their strong opposition to these clinics. However, the clinics continue to multiply in Target and Wal-mart stores and even in big drug stores. Children should never, ever be taken to these clinics. Even ER doctors usually have very little pediatric training, but at least they have many more years of medical training than nurse practitioners. Nurses are a very important part of our medical system, but should not be on their own diagnosing and treating children.
One excellent pediatrician told me a doctor friend had taken a job overseeing many of these clinics. I asked her how he could do this ethically and her answer was "Money". I am afraid it will take the deaths of a few children and major lawsuits before children are no longer cared for in these clinics.
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