What Does An After Hours Clinic Do?

Amanda R. Pratt
What Does An After Hours Clinic Do?

An “after hours clinic” is one that attends to medical problems that arise between 5:00 p.m. and 8:00 a.m., on weekends and holidays, which could well be adequately treated by the patient’s primary care team/doctor, but which, because of the hours in which the condition arises, the patient cannot attend with them.

In other words, an after hours clinic is one that is open beyond “normal” working hours. It is designed to provide medical care for acute illnesses, such as minor injuries or diseases, coughs, colds, sore throats, sinus infections, ear infections, fever or flu-like symptoms, rashes, or other skin irritations, among other illnesses. They can diagnose and treat most conditions, and most of these clinics have labs and X-rays. You can see a doctor, a physician assistant (PA), or a certified nurse practitioner (CNP).

After-hours care usually includes the following features: Safe and timely triage; accessibility for patients; continuity and coordination with the patient’s regular primary care physician (either offered by the patient’s primary care physician or linked to the patient through the transfer of information when clinically necessary, e.g., before follow-up with the primary care physician is required); avoids GP burnout (i.e., burnout as a result of prolonged stress or frustration); maximizes quality for patients (including patient satisfaction), and is financially sustainable (has persevered over time despite the financial problems of the current payment system).

Besides providing access to after-hours care at individual primary care facilities, it also often includes telephone access and extended hours of operation, which could eliminate many costly emergency department visits and expedite continuity of service. And while access to after-hours care is vital to patients, physicians providing 24/7 care struggle to avoid burnout. Problems in ensuring access and continuity have stimulated patient-centered medical home (PCMH) initiatives and, recently, the Comprehensive Primary Care Initiative under the ACA to include “access to 24-hour care” as a goal. For example, the National Committee for Quality Assurance’s Medical Home measurement instrument refers to “providing an urgent telephone response within a specified time frame, with clinical support available 24 hours a day, seven days a week” as part of its qualification criteria. It is not designed to be used as a substitute for a visit to your regular physician. After-hours care does not provide routine immunizations, nor does it fill out medications or forms for ongoing problems. They do not have access to more advanced radiological studies, such as CT scans or MRIs. If you require any of these services, you will need to see your primary care physician. They also do not deal with more critical problems, such as stroke, heart attack, or significant trauma.

If you are not sure where to go, you can go to a health care center after hours, and if they determine that your problem is too severe for that setting, they will arrange for you to be seen in the emergency room.

If you have chest pain or pressure, seizures or loss of consciousness, severe abdominal pain, sudden paralysis or difficulty speaking, if your child has a fever of 100.3 and is younger than 2-3 months of age, difficulty breathing, shortness of breath, post-operative complications or any time you feel your problem is life-threatening, please go to the Emergency Room.

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