School Clinics
Increasingly, acute care clinics, which provide preventive services and care for minor illnesses, are being placed in nonresidential school facilities. Unlike the nurse’s office, where students are sent so the nurse can call home, these clinics establish a provider–patient relationship with the students. The physicians and nurses in the clinic have the same legal responsibilities that they would have in a private office. If the clinic is part of the school health program, it is the school doctor’s responsibility. If the clinic is a separate entity, it must have its own supervising physician.
Physicians overseeing a school clinic should ensure that there are proper protocols, policies, and procedures for the staff of the clinic just as they would for any other outreach clinic or physician extender. There should be formal agreements on the scope of practice within the clinic and provision for appropriate follow up for problems that go beyond this scope of practice. The physician should not lose sight of the fact that he or she is assuming all the responsibilities of the physician– patient relationship for the patients who use the clinic. This includes the duties of continued treatment and proper referral.