A man with a sore throat walks into a clinic, no appointment needed, the wait time posted on a screen. An hour later, he has seen a doctor, received a diagnosis, and left with a prescription. Simple, convenient, and available when he needed it. A woman without a family doctor uses walk-in clinics for all her healthcare - a different provider each time, no one who knows her history, no continuity of care. Her diabetes is managed piecemeal, her records scattered, her care fragmented. A family physician worries about patients seen at walk-in clinics - tests ordered without context, referrals made without knowledge of history, the care disconnected from the ongoing relationship she tries to build. A walk-in clinic doctor sees forty patients in a shift, the volume required for the business model, the visits brief by necessity. A parent brings a sick child to a walk-in clinic on a Sunday when their family doctor's office is closed, grateful for the option even if the care is impersonal. Walk-in clinics, providing episodic care without appointment to whoever arrives, fill gaps in Canadian primary care. How these clinics function affects both access and care quality.
The Case for Walk-In Clinics
Advocates argue that walk-in clinics provide valuable access. From this view, walk-ins serve unmet needs.
Walk-in clinics provide access. For those without family doctors, walk-in clinics are healthcare access. Without walk-in options, many would have nowhere to go.
Convenience matters. Same-day access without appointment, extended hours, and multiple locations serve patients who cannot navigate traditional scheduling. Convenience is not just preference but affects whether people get care.
Walk-ins reduce emergency department use. Minor conditions addressed at walk-in clinics might otherwise go to emergency departments. Walk-ins serve appropriate triage function.
From this perspective, walk-in clinics are valuable part of the primary care landscape providing access and convenience.
The Case for Comprehensive Care
Others argue that walk-in clinics are problematic substitute for proper primary care. From this view, episodic care is inferior to continuity.
Continuity matters for outcomes. Research shows that continuous relationship with a primary care provider produces better outcomes. Walk-in care lacks this continuity.
Fragmented care causes problems. Different providers each time means no one knows the patient's full story. Important context is missed. Care is reactive rather than proactive.
Walk-ins may be inefficient. Duplicate testing, missed diagnoses, and lack of follow-up can occur when no one has ongoing responsibility. What seems efficient may not be.
From this perspective, walk-in clinics are symptom of primary care failure that should be addressed by improving access to continuous primary care.
The After-Hours Role
Walk-in clinics serve important after-hours function.
From one view, after-hours access is important. When family doctors' offices are closed, patients still get sick. Walk-in clinics provide important coverage outside business hours.
From another view, after-hours care should be connected to regular care. Information from after-hours visits should reach the regular provider. Coordination matters.
How after-hours care is organized shapes walk-in clinic role.
The Quality Question
Walk-in clinic care quality is variable.
From one perspective, walk-in clinics provide good care for appropriate conditions. Minor acute illness can be well-managed in walk-in settings. Quality concerns are overstated.
From another perspective, volume pressure, lack of context, and limited follow-up affect quality. Walk-in care is fine for simple problems but may not serve complex patients well.
How quality is ensured shapes walk-in care value.
The Business Model
Walk-in clinics have particular economics.
From one view, fee-for-service incentivizes high volume. Seeing many patients quickly is financially rewarded. This may not align with quality.
From another view, walk-in clinics operate within the system they are given. Business models reflect billing structures. Changing incentives would change behavior.
How clinics are paid shapes how they operate.
The Physician Perspective
Walk-in clinic practice is different from family practice.
From one perspective, walk-in work is demanding but offers flexibility. Some physicians prefer it. Different practice models suit different providers.
From another perspective, walk-in work may contribute to physician availability problems. Physicians who might provide comprehensive care instead do walk-in work. System effects should be considered.
How walk-in practice is viewed shapes physician career choices.
The Canadian Context
Walk-in clinics are common across Canada. They vary from small offices to large chains. Quality varies. Some are connected to family practice rosters; many are standalone. Virtual walk-in options have expanded. Provincial approaches to walk-in clinics differ. Some encourage integration with primary care; others allow fragmented operation. Walk-in clinics serve many without family doctors. They are part of the primary care landscape even if not the ideal form of care.
From one perspective, walk-in clinics provide valuable access that should be supported.
From another perspective, walk-in clinics are symptom of primary care failure that should be addressed.
How walk-in clinics fit in the system shapes primary care access.
The Question
If walk-ins provide access, if continuity matters, if convenience has value, if fragmentation has costs - what role should walk-in clinics play? When someone without a family doctor uses walk-in clinics for all their care, is that adequate? When a walk-in visit misses something a regular provider would have caught, who is responsible? When high volume is required for business viability, what quality is possible? When after-hours care happens at walk-in clinics, how is information shared? When we speak of primary care reform, what happens to walk-in clinics? And when someone needs care right now, what options should exist?