Clinic

For other uses, see Clinic (disambiguation).

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File:VelikiVrag-Medpunkt-1435.jpgA medpunkt (health care access point) delivers primary health care to the residents of the village of Veliki Vrag in Nizhny Novgorod Oblast, Russia Freud's couch used during psychoanalytic sessions File:GreenwichSurgeryClinic bordercropped.jpgThe entrance to a surgery clinic in Greenwich, London.

A clinic or outpatient clinic are originally small private or public health facility that provide health care for ambulatory patients or clients in a community, in contrast to inpatients treated in a hospital. Some grow to be institutions as large as major hospitals, whilst retaining the name Clinic. General practice clinics are run by one or more general practitioners or practice managers. Physiotherapy clinics are usually operated by physiotherapists and psychology clinics by clinical psychologists, and so on for each health profession. Some clinics are operated in-house by employers, government organizations or hospitals and some clinical services are outsourced to private corporations, specialising in provision of health services. In China, for example, owners of those clinics do not have formal medical education. Health care in India, China, Russia and Africa is provided to vast rural areas by mobile health clinics or roadside dispensaries, some of which integrate traditional health practices. In India these traditional clinics provide ayurvedic medicine and unani herbal medical practice. In each of these countries traditional medicine tends to be an hereditary practice.

The function of clinics will differ from country to country. For instance, a local general practice run by a single general practitioner will provide primary health care and will usually be run as a for-profit business by the owner whereas a government specialist clinic may provide subsidized specialized health care.

Some clinics function as a place for people with injuries or illnesses to come and be seen by triage nurse or other health worker. In these clinics, the injury or illness may not be serious enough to warrant a visit to an emergency room, but the person can be moved to one if required. Treatment at these clinics is often less expensive than it would be at a casualty department. Also, unlike an ER these clinics are often not open on a 24 x 7 x 365 basis. They sometimes have access to diagnostic equipment such as X-ray machines, especially if the clinic is part of a larger facility. Doctors at such clinics can often refer patients to specialists if the need arises.

## Contents

* 1 Etymology
* 2 Types of clinics
* 3 Examples of clinics
* 4 Issues
* 4.1 Show rate for appointments
* 5 References
* 6 See also

## Etymology

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The word derives from the Greek klinein meaning to slope, lean or recline. Hence kline a couch or bed, klinikos sloping or reclining and to Latin clinicus [1]. An early use of the word clinic was, 'one who receives baptism on a sick bed' [2]. Psychoanalytic clinics tradtionally have the patient reclining on a couch to undergo analysis.

## Types of clinics

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* In the United States, a free clinic provides free or low cost health care for those without insurance.
* A Retail Based Clinic is housed in supermarkets and similar retail outlets providing walk in health care, which may be staffed by nurse practitioners.
* A general out-patient clinic is a clinic offering a community general diagnoses or treatments without an overnight stay.
* A polyclinic is a clinic, hospital, or school where many diseases are treated and studied.
* A fertility clinic aims to help those couples and individuals to become pregnant. An abortion clinic is a medical facility providing certain kinds of outpatient medical care, including abortion to women. Such clinics may be public medical centers or private medical practices.
* A specialist clinic is a clinic with in-depth diagnosis or treatment on diseases of specific parts of the body. This type of clinic contrasts with general out-patient clinics, which deal with general diseases.

## Examples of clinics

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* Tavistock Clinic part of the Britain NHS, was founded in 1920's one of its most celebrated members was R D Laing.
* San Francisco's Suitcase Clinic is a prime example of a free clinic.
* Christian Medical College & Hospital in Vellore, India has extensive roadside dispensaries and began as a one bed clinic in 1900.
* The Edmonton Clinic is a joint venture of the University of Alberta and a government health care body Capital health, expected to be completed in 2011.
* The Shyness Clinic founded by Zimbardo to assist those disabled by public or private shyness.
* La Borde clinic in the Loire valley France, is an innovative psychiatric clinic where patients are liberated to actively participate in the running the facility.
* The Mayo Clinic and Cleveland Clinic are two comprehensive health care systems. Both began as much smaller group practices that have grown into large medical programs in the United States, whilst retaining their names.

## Issues

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### Show rate for appointments

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The no-show rate for clinics is about 23%[3] to 15%[4].

A common reason for now showing for an appointment is the patient's forgetting they have an appointment[5].

Regarding predictors of no show rates;

* Patient characteristics[3]:
* Younger patiients
* Minority demographics
* Lower socioeconomic status

* Appointment characteristics[3]:
* Appointment lead time (time interval between the date when the appointment is made and the actual appointment date) is the most important factor. Lead time intervals greater than 3 days increase the rate of no-show[6]
* Prior missed appointments by the patient

* Clinic characteristics
* Patients' relations with clinic staff[7]
* Patients' sense of belonging[7]

Interventions in high-risk populations have reduced show rates to:

* 18%[8]
* 15%[9]
* 7% (started at 10%)[6]

## References

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1. ↑ 'Origins - a short etymological dictionary of modern English' by Eric Partridge Book club associates 1966
2. ↑ Webster's Revised Unabridged Dictionary (1913 )[1]
3. ↑ 3.0 3.1 3.2 Dantas LF, Fleck JL, Cyrino Oliveira FL, Hamacher S (2018). "No-shows in appointment scheduling - a systematic literature review". Health Policy. 122 (4): 412–421. doi:10.1016/j.healthpol.2018.02.002. PMID 29482948.CS1 maint: Multiple names: authors list (link)
4. ↑ Parsons J, Bryce C, Atherton H (2021). "Which patients miss appointments with general practice and the reasons why: a systematic review". Br J Gen Pract. 71 (707): e406–e412. doi:10.3399/BJGP.2020.1017. PMC 8103926 Check `|pmc=` value (help). PMID 33606660 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
5. ↑ Kaplan-Lewis E, Percac-Lima S (2013). "No-show to primary care appointments: why patients do not come". J Prim Care Community Health. 4 (4): 251–5. doi:10.1177/2150131913498513. PMID 24327664.
6. ↑ 6.0 6.1 DuMontier C, Rindfleisch K, Pruszynski J, Frey JJ (2013). "A multi-method intervention to reduce no-shows in an urban residency clinic". Fam Med. 45 (9): 634–41. PMID 24136694.CS1 maint: Multiple names: authors list (link)
7. ↑ 7.0 7.1 Lafferty M, Strange W, Kaboli P, Tuepker A, Teo AR (2022). "Patient Sense of Belonging in the Veterans Health Administration: A Qualitative Study of Appointment Attendance and Patient Engagement". Med Care. 60 (9): 726–732. doi:10.1097/MLR.0000000000001749. PMC 9378705 Check `|pmc=` value (help). PMID 35880766 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
8. ↑ Cruz HE, Gawrys J, Thompson D, Mejia J, Rosul L, Lazar D (2018). "A Multipronged Initiative to Improve Productivity and Patient Access in a Federally Qualified Health Center Network". J Ambul Care Manage. 41 (3): 225–237. doi:10.1097/JAC.0000000000000230. PMC 6085125. PMID 29847409.CS1 maint: Multiple names: authors list (link)
9. ↑ Mehra A, Hoogendoorn CJ, Haggerty G, Engelthaler J, Gooden S, Joseph M; et al. (2018). "Reducing Patient No-Shows: An Initiative at an Integrated Care Teaching Health Center". J Am Osteopath Assoc. 118 (2): 77–84. doi:10.7556/jaoa.2018.022. PMID 29379973.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

## See also

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* Abortion clinic
* Free clinic
* Clinical Management System

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