Re: [Talk-us] When is your doctor a clinic?

[Michael Patrick]

There are international taxonomies that define standards for the various
terms involved in healthcare provision ( like
*https://www.hl7.org/about/index.cfm?ref=nav*
 ). These are important for
many reasons, like Drs Without Borders may draw personnel from many
countries and integrate with local medical staff. For example:

*Definition:  *A facility or distinct part of one used for the diagnosis
and treatment of outpatients. "Clinic/center" is irregularly defined,
either including or excluding physician's offices and allied health
professionals, sometimes being limited to organizations serving specialized
treatment requirements or distinct patient/client groups (e.g., radiology,
poor, public health). *Source: * *Rhea, Ott, and Shafritz, The Facts On
File Dictionary of Health Care Management, New York: Facts On File
Publications, 1988; Lexikon: Dictionary of Health Care Terms, Organizations
and Acronyms for the Era of Reform, The Joint Commission on Accreditation
of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 185*"

( from
https://www.hl7.org/documentcenter/public/standards/vocabulary/vocabulary_tables/infrastructure/vocabulary/nuccProviderCodes.html
)

United Nations Standard Products and Services Code (UNSPSC)  at
https://catalog.data.gov/dataset/unspsc-codes ) has a medical portion, but
fairly limited.There are some sites with easier to use interfaces:
http://www.wpc-edi.com/reference/codelists/healthcare/health-care-provider-taxonomy-code-set/

Yes, it's complicated. Most things in the real world are.

Michael Patrick
Data Ferret

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Re: [Talk-us] When is your doctor a clinic?

[Greg Morgan]

Brian,

That's my US American understanding of a clinic.  A clinic is not a
hospital and not a "doctors office".  But If I cannot get into my doctor or
if an individual does not need to go to the emergency room of a hospital,
then a clinic is a place to go.  For example, Honor Health is part of a
hospital system.  They are adding these "clinic" type places all over the
place as in here
https://www.mapillary.com/app/?lat=33.6404930901=-112.0118460302=17=FJ_1oHqz8x2c1-PziWhxSQ=photo=0.4913798647410984=0.548466145091522=0
In this case, they bought out another clinic and replaced it with their
Honor Health brand.

You will need to zoom in on this image
https://www.mapillary.com/app/?lat=33.67662935172414=-111.97772731602434=17=sEr2RqD5xZYGSZGEej8oJw=photo=0.8085766039159952=0.517578833862374=2.486737400530504
There
is also surgery center's.  Still not a hospital but invasive procedures are
performed at these locations.  A surgery center is cheaper than a hospital
per insurance dictates.  In this case you could go while with POIs.  Some
of these surgery centers are next to a string of retail POIs or may be in
the same wing of a building with retail space.

Don't know.  Some day I will sit down and map those.  I am just not
interested at the moment.

Regards,
Greg




On Fri, Jan 24, 2020 at 6:33 AM Brian Stromberg 
wrote:

> When I hear “clinic” in reference to a healthcare facility, I think of
> “urgent care” clinics, and I think there are about six urgent care clinics
> within a 20 minute drive of my local hospital. These are usually staffed
> with nurses and Physicians Assistants rather than MDs. It’s pretty common
> in the US for people to use these rather than the local emergency room, or
> even in lieu of a primary care doctor. Having them on OSM seems important
> if people need immediate care that doesn’t rise to the level of a hospital
> visit. For example, I took my mother to one near me when she had a fall (at
> her request, I might have preferred an actual hospital, but it wasn’t a
> great time to argue...). They often serve you faster and there is less
> administrative processing involved.
>
> Just wanted to share an American perspective.
>
> On Fri, Jan 24, 2020 at 7:56 AM Philip Barnes 
> wrote:
>
>> On Fri, 2020-01-24 at 00:51 +0100, Frederik Ramm wrote:
>> > Hi,
>> >
>> > On 1/23/20 22:42, Paul Johnson wrote:
>> > > There may be a disconnect with what the US (or that spammer)
>> > > means.
>> > > Could I get a clarification on the difference between "doctors" and
>> > > "clinic" as you understand it?
>> >
>> > Personally (and in my country - Germany) there's precious little I
>> > would
>> > tag as a clinic; in everyday language we use the (german version of)
>> > the
>> > word clinic more or less synonymous with "hospital", with the
>> > possible
>> > exception that we'd also apply clinic to something that deals
>> > exclusively with non-illness-related things like e.g. a beauty clinic
>> > or
>> > a drug rehab clinic. In my language, a clinic would always be
>> > something
>> > where you can (and usually do) have a bed and stay for longer until
>> > the
>> > treatment is over. A building with a couple of different medical
>> > practitioners might be a "Gemeinschaftspraxis" ("shared practice") or
>> > perhaps an "Ärztehaus" (doctors' house) but not a "Klinik". Then
>> > again
>> > these would hardly ever be open 24/7...
>> >
>> > I'm not trying to apply my understanding of medical establishments to
>> > the US - just asking what the general understanding is on your side
>> > of
>> > the pond. Does Jmapb's distinction sound more or less ok for others
>> > too?
>> > He wrote:
>> >
>> Even in the UK, where OSM originated, clinics are quite rare.
>>
>> A clinic is where outpatients go, usually referred by their doctor to
>> see a specialist.
>>
>> The on the ground reality is that most clinics take place within
>> hospitals.
>>
>> Standalone clinics do exist, there is one in my town, but will tend not
>> to exist in larger towns or cities which have hospitals.
>>
>> HTH
>> Phil (trigpoint)
>>
>>
>>
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Re: [Talk-us] When is your doctor a clinic?

[Brian Stromberg]

I think the same rule about MD oversight applies where I live, but I have
never seen an MD at a clinic. PAs and RNs are more than enough for me. I
don't need credentials as long as there is competence =)

For sure, we have those clusters of health services, although I've always
seen that as a separate type of thing; an expression of location efficiency
rather than a type of service. Clinics are more of a middle ground between
a traditional practice and an emergency room. I've gone to them for a
fever, a broken hand, an injured mother, and a few other reasons. My
impression is that they are also more accessible for low-income or other
marginalized members of the community, so I think they play an important
role (which makes them worthy of being properly mapped).

--
Brian


On Fri, Jan 24, 2020 at 9:10 AM Kevin Kenny  wrote:

> On Fri, Jan 24, 2020 at 8:33 AM Brian Stromberg
>  wrote:
> > When I hear “clinic” in reference to a healthcare facility, I think of
> “urgent care” clinics, and I think there are about six urgent care clinics
> within a 20 minute drive of my local hospital. These are usually staffed
> with nurses and Physicians Assistants rather than MDs.
>
> In my state, a nurse-practitioner or a physician's assistant has to
> work under the supervision of an MD, so there's generally at least one
> doc at an urgent care clinic. Still, you're right that for routine
> matters a patient probably won't need to see the MD.  I know that I've
> seen NP's at my doc's office, and they've ordered radiology and lab
> work, and prescribed. (If the radiology or labs had shown anything out
> of the ordinary, they'd have bucked it up to a doc.)
>
> Your area doesn't also have numerous multi-specialty 'health centres?'
> Places where they consolidate radiology, lab, endoscopy, outpatient
> surgery, orthopaedics, ...?
>
> --
> 73 de ke9tv/2, Kevin
>
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Re: [Talk-us] When is your doctor a clinic?

[Brian Stromberg]

Sorry for the flurry of emails. This is all to say that I agree with
Jmapb's description.

--
Brian


On Fri, Jan 24, 2020 at 9:35 AM Brian Stromberg 
wrote:

> I think the same rule about MD oversight applies where I live, but I have
> never seen an MD at a clinic. PAs and RNs are more than enough for me. I
> don't need credentials as long as there is competence =)
>
> For sure, we have those clusters of health services, although I've always
> seen that as a separate type of thing; an expression of location efficiency
> rather than a type of service. Clinics are more of a middle ground between
> a traditional practice and an emergency room. I've gone to them for a
> fever, a broken hand, an injured mother, and a few other reasons. My
> impression is that they are also more accessible for low-income or other
> marginalized members of the community, so I think they play an important
> role (which makes them worthy of being properly mapped).
>
> --
> Brian
>
>
> On Fri, Jan 24, 2020 at 9:10 AM Kevin Kenny 
> wrote:
>
>> On Fri, Jan 24, 2020 at 8:33 AM Brian Stromberg
>>  wrote:
>> > When I hear “clinic” in reference to a healthcare facility, I think of
>> “urgent care” clinics, and I think there are about six urgent care clinics
>> within a 20 minute drive of my local hospital. These are usually staffed
>> with nurses and Physicians Assistants rather than MDs.
>>
>> In my state, a nurse-practitioner or a physician's assistant has to
>> work under the supervision of an MD, so there's generally at least one
>> doc at an urgent care clinic. Still, you're right that for routine
>> matters a patient probably won't need to see the MD.  I know that I've
>> seen NP's at my doc's office, and they've ordered radiology and lab
>> work, and prescribed. (If the radiology or labs had shown anything out
>> of the ordinary, they'd have bucked it up to a doc.)
>>
>> Your area doesn't also have numerous multi-specialty 'health centres?'
>> Places where they consolidate radiology, lab, endoscopy, outpatient
>> surgery, orthopaedics, ...?
>>
>> --
>> 73 de ke9tv/2, Kevin
>>
>
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Re: [Talk-us] When is your doctor a clinic?

[Kevin Kenny]

On Fri, Jan 24, 2020 at 8:33 AM Brian Stromberg
 wrote:
> When I hear “clinic” in reference to a healthcare facility, I think of 
> “urgent care” clinics, and I think there are about six urgent care clinics 
> within a 20 minute drive of my local hospital. These are usually staffed with 
> nurses and Physicians Assistants rather than MDs.

In my state, a nurse-practitioner or a physician's assistant has to
work under the supervision of an MD, so there's generally at least one
doc at an urgent care clinic. Still, you're right that for routine
matters a patient probably won't need to see the MD.  I know that I've
seen NP's at my doc's office, and they've ordered radiology and lab
work, and prescribed. (If the radiology or labs had shown anything out
of the ordinary, they'd have bucked it up to a doc.)

Your area doesn't also have numerous multi-specialty 'health centres?'
Places where they consolidate radiology, lab, endoscopy, outpatient
surgery, orthopaedics, ...?

-- 
73 de ke9tv/2, Kevin

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Re: [Talk-us] When is your doctor a clinic?

[Kevin Kenny]

On Fri, Jan 24, 2020 at 7:56 AM Philip Barnes  wrote:
> A clinic is where outpatients go, usually referred by their doctor to
> see a specialist.
>
> The on the ground reality is that most clinics take place within
> hospitals.

My primary care physician works out of a clinic. My family and I have
had a number of specialist referrals from him over the years, many to
the same clinic. It's got radiology (X-ray, ultrasound, CT, MR) on
site, a clinical lab, and a variety of specialty departments:
paediatrics, podiatry, dermatology, endocrinology, haematology,
orthopaedics, oncology, gastroenterology (they can do EGD or
colonoscopy on site), and so on. It's not a hospital and cannot admit
patients overnight. (It does have a limited 24-hour operation; there's
an 'urgent care' department.)

I recently had a scan done at a local hospital, but that was simply
that the radiology department there could schedule it at a more
convenient time. Apart from one emergency visit, it was the first time
I'd been to a hospital in over twenty years. Everything that could be
done on an outpatient basis was done somewhere else. (Even the
emergency visit was unusual circumstances. I needed an emergent
consultation with an ophthalmologist, and it's hard to raise one on
Christmas Day. He still talks about that one, several years later.
It's the only time in his career that he's performed three emergency
surgeries in the same day.)

Clinics like this are quite common in American cities. Some are
hospital outreach, where they've moved outpatient departments off
site. Some are stand-alone. The stand-alone ones often bear the names
of insurance networks: "Community Care Physicians", "Capital District
Physicians' Health Plan", and so on, because many exist so that the
practices can consolidate their billing and insurance negotiations.

-- 
73 de ke9tv/2, Kevin

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Re: [Talk-us] When is your doctor a clinic?

[Brian Stromberg]

When I hear “clinic” in reference to a healthcare facility, I think of
“urgent care” clinics, and I think there are about six urgent care clinics
within a 20 minute drive of my local hospital. These are usually staffed
with nurses and Physicians Assistants rather than MDs. It’s pretty common
in the US for people to use these rather than the local emergency room, or
even in lieu of a primary care doctor. Having them on OSM seems important
if people need immediate care that doesn’t rise to the level of a hospital
visit. For example, I took my mother to one near me when she had a fall (at
her request, I might have preferred an actual hospital, but it wasn’t a
great time to argue...). They often serve you faster and there is less
administrative processing involved.

Just wanted to share an American perspective.

On Fri, Jan 24, 2020 at 7:56 AM Philip Barnes  wrote:

> On Fri, 2020-01-24 at 00:51 +0100, Frederik Ramm wrote:
> > Hi,
> >
> > On 1/23/20 22:42, Paul Johnson wrote:
> > > There may be a disconnect with what the US (or that spammer)
> > > means.
> > > Could I get a clarification on the difference between "doctors" and
> > > "clinic" as you understand it?
> >
> > Personally (and in my country - Germany) there's precious little I
> > would
> > tag as a clinic; in everyday language we use the (german version of)
> > the
> > word clinic more or less synonymous with "hospital", with the
> > possible
> > exception that we'd also apply clinic to something that deals
> > exclusively with non-illness-related things like e.g. a beauty clinic
> > or
> > a drug rehab clinic. In my language, a clinic would always be
> > something
> > where you can (and usually do) have a bed and stay for longer until
> > the
> > treatment is over. A building with a couple of different medical
> > practitioners might be a "Gemeinschaftspraxis" ("shared practice") or
> > perhaps an "Ärztehaus" (doctors' house) but not a "Klinik". Then
> > again
> > these would hardly ever be open 24/7...
> >
> > I'm not trying to apply my understanding of medical establishments to
> > the US - just asking what the general understanding is on your side
> > of
> > the pond. Does Jmapb's distinction sound more or less ok for others
> > too?
> > He wrote:
> >
> Even in the UK, where OSM originated, clinics are quite rare.
>
> A clinic is where outpatients go, usually referred by their doctor to
> see a specialist.
>
> The on the ground reality is that most clinics take place within
> hospitals.
>
> Standalone clinics do exist, there is one in my town, but will tend not
> to exist in larger towns or cities which have hospitals.
>
> HTH
> Phil (trigpoint)
>
>
>
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Re: [Talk-us] When is your doctor a clinic?

[Philip Barnes]

On Fri, 2020-01-24 at 00:51 +0100, Frederik Ramm wrote:
> Hi,
> 
> On 1/23/20 22:42, Paul Johnson wrote:
> > There may be a disconnect with what the US (or that spammer)
> > means. 
> > Could I get a clarification on the difference between "doctors" and
> > "clinic" as you understand it? 
> 
> Personally (and in my country - Germany) there's precious little I
> would
> tag as a clinic; in everyday language we use the (german version of)
> the
> word clinic more or less synonymous with "hospital", with the
> possible
> exception that we'd also apply clinic to something that deals
> exclusively with non-illness-related things like e.g. a beauty clinic
> or
> a drug rehab clinic. In my language, a clinic would always be
> something
> where you can (and usually do) have a bed and stay for longer until
> the
> treatment is over. A building with a couple of different medical
> practitioners might be a "Gemeinschaftspraxis" ("shared practice") or
> perhaps an "Ärztehaus" (doctors' house) but not a "Klinik". Then
> again
> these would hardly ever be open 24/7...
> 
> I'm not trying to apply my understanding of medical establishments to
> the US - just asking what the general understanding is on your side
> of
> the pond. Does Jmapb's distinction sound more or less ok for others
> too?
> He wrote:
> 
Even in the UK, where OSM originated, clinics are quite rare.

A clinic is where outpatients go, usually referred by their doctor to
see a specialist. 

The on the ground reality is that most clinics take place within
hospitals. 

Standalone clinics do exist, there is one in my town, but will tend not
to exist in larger towns or cities which have hospitals.

HTH
Phil (trigpoint)



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