Clinic

A medpunkt (health care access point) delivers primary health care to the residents of the village of Veliki Vrag in Nizhny Novgorod Oblast, Russia.

The entrance to a surgery clinic in Greenwich, London.

Polyclinic in Chemnitz, German Democratic Republic

Polyclinic in Písek, Czech Republic

Polyclinic in Vilnius-Viršuliškės, Lithuania

Children Polyclinic in Moscow-Novokosino

Military Polyclinic in Legionowo, Poland

A clinic (or outpatient clinic or ambulatory care clinic) is a healthcare facility that is primarily devoted to the care of outpatients. Clinics can be privately operated or publicly managed and funded, and typically cover the primary healthcare needs of populations in local communities, in contrast to larger hospitals which offer specialised treatments and admit inpatients for overnight stays. Most commonly, the word clinic in English refers to a general medical practice, run by one or several general practitioners, or a specialist clinic. Some clinics grow to be institutions as large as major hospitals, or become associated with a hospital or medical school, while retaining the name “clinic."

Overview

Clinics are often associated with a general medical practice, run by one or several general practitioners or 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. There were 659,596 village clinics in China in 2011.^[1] 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 a hereditary practice.

Etymology

The word clinic derives from the Greek klinein meaning to slope, lean or recline. Hence kline is a couch or bed, klinikos is sloping or reclining and Latin is clinicus.^[2] An early use of the word clinic was, 'one who receives baptism on a sick bed'.^[3]

Function

The function of clinics differs from country to country. For instance, a local general practice run by a single general practitioner provides primary health care and is usually run as a for-profit business by the owner, whereas a government specialist clinic may provide subsidised specialised health care.

Some clinics function as a place for people with injuries or illnesses to come and be seen by a 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 transferred 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.

Large outpatient clinics ("polyclinics")

Large outpatient clinics can be as large as hospitals and are sometimes called "polyclinics" (or erroneously "policlinics").

In many languages besides English, there is a single term used for both outpatient departments of hospitals and independent outpatient clinics. This term is etymologically related to the English term policlinic, in which the morpheme poli- means "city", "community", "nation" (cf. "metropolis", "political"). Policlinic is however not used in UK English;^[4][5] in US English it used only very rarely, only by members of the medical profession, and usually only when referring to the outpatient departments of European hospitals.^[6] It is pronounced exactly like the more common term polyclinic, whose spelling arose due to confusion caused by the identical pronunciation^[7] and which is used to refer to several different kinds of health care institutions (see Polyclinic (disambiguation)) but not to outpatient departments of hospitals.

So both policlinic and polyclinic are in fact false friends of the single term used in many languages besides English to refer to both kinds of institutions.^[8] Many non-native speakers, even in the medical profession, nevertheless use these English terms erroneously and instead of the more common terms "(independent) outpatient clinic" (often called simply "clinic") on the one hand and "outpatient department", "outpatient ward" or "(hospital) outpatient clinic" on the other.

Function

Typical large outpatient clinics house general medical practitioners (GPs) such as doctors and nurses to provide ambulatory care and some acute care services but lack the major surgical and pre- and post-operative care facilities commonly associated with hospitals. Besides GPs, a polyclinic can house outpatient departments of some medical specialties i.e. gynecology, dermatology, ophthalmology, ENT, neurology, pulmonology, cardiology, endocrinology etc. In some university cities polyclinics house outpatient departments of all the teaching hospital in one building.

Internationally

Large outpatient clinics are a common type of healthcare facility in many countries incl. France, Germany (long tradition), Switzerland, and most of the countries of Central and Eastern Europe (mixed Soviet-German model), as well as in former Soviet republics such as Russia and Ukraine;^[9] and in many countries across Asia and Africa.^[10] Recent Russian governments have attempted to replace the polyclinic model introduced during Soviet times with a more western model. However, this has failed.^[11] India has also set up huge numbers of polyclinics for former defence personnel. The network envisages 426 polyclinics in 343 districts of the country which will benefit about 33 lakh (3.3 million) ex-servicemen residing in remote and far-flung areas.^[12] Polyclinics are also the backbone of Cuba's primary care system and have been credited with a role in improving that nation's health indicators.^[13]

Types

Storefront clinic in Manhattan

There are many different types of clinics providing outpatient services. Such clinics may be public (government funded) or private medical practices.

• A CLSC are in Quebec; they are a type of free clinic funded by the provincial government; they provide service not covered by Canada's healthcare plan including social workers
• In the United States, a free clinic provides free or low-cost healthcare 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 offers general diagnoses or treatments without an overnight stay.
• A polyclinic provides a range of healthcare services (including diagnostics) without need of an overnight stay
• A specialist clinic provides advanced diagnostic or treatment services for specific diseases or parts of the body. This type contrasts with general out-patient clinics.
  • A sexual health clinic deals with sexual health related problems, such as prevention and treatment of sexually transmitted infections.
  • A fertility clinic aims to help women and couples to become pregnant.
  • An abortion clinic is a medical facility providing abortion and related medical services to women.
  • An ambulatory surgery clinic offers outpatient or same day surgery services, usually for surgical procedures less complicated than those requiring hospitalization.

Examples

• Tavistock Clinic, part of the British NHS, was founded in the 1920s. One of its most celebrated members was R D Laing.
• The Suitcase Clinic, the Berkeley Free Clinic, and the Haight Ashbury Free Clinic are examples of free clinics.
• 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 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 of the facility.
• The Mayo Clinic, Cleveland Clinic, Marshfield Clinic and Lahey Clinic are examples of comprehensive health care systems, all having begun as much smaller group practices that have since grown into large medical programs in the United States, whilst retaining their names.
• The Gary Burnstein Community Health Clinic, a non-profit, volunteer-supported Free Clinic in Pontiac, Michigan.
• The Balaji Physiotherapy & Rehabilitation Clinic "for muscle, joint, back pain, stroke and spine rehabilitation treatments"^[14] in Jodhpur, Rajasthan, India.

See also

Wikimedia Commons has media related to Clinics.

• Healthcare provider
• Health center
• Health systems management
• Healthcare system
• Nurse-led clinic
• Polyclinics in England
• Walk-in clinic

References

External links

• Ideas from Darzi: Polyclinics