Walk-in clinics (WICs), appreciated for their accessibility and convenience, have become an increasingly popular healthcare option in Ontario for patients with and without primary care enrolment. Despite their utility, WICs face criticism for delivering lower-quality care compared to comprehensive, enrolment-based primary care models. Critics argue that WICs contribute to system inefficiencies and encourage practice patterns misaligned with population health goals. This study explored physician perspectives on two key outcomes often associated with low-quality care in WICs: repeat primary care visits and potentially inappropriate antibiotic prescribing. Using a qualitative descriptive approach, semi-structured interviews were conducted with Ontario-based family physicians (N = 19) who had experience practicing in both WICs and enrolment-based primary care. The findings highlight systemic challenges, including limited access to enrolment-based primary care and increasing healthcare demands, which have pushed WICs beyond their intended role. This misalignment has created tensions between their structure and purpose, resulting in visits that participants described as more transactional than those in primary care. These constraints-rooted in a lack of informational and relational continuity-often limited participants' ability to provide in-depth engagement or follow-up care. Repeat visits were frequently linked to efforts to ensure continuity for complex or chronic conditions. Similarly, participants acknowledged the reality of potentially inappropriate antibiotic prescribing, attributing it to the high patient volume, desire to satisfy patient expectations, and a tendency to "err on the side of caution" when the nature of the illness is in question. The findings underscore how health system pressures and well-intended policies, such as Ontario's primary care access bonus, can produce unintended consequences, including inequities in access and difficulties with care coordination across settings. Addressing these challenges requires reforms to better integrate WICs with the primary care system, alongside tailored training to support physician decision-making in episodic care contexts.

Copyright: © 2025 Terpou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

走诊诊所（WICs）因其便捷性和可访问性而受到患者欢迎，无论是否已注册家庭医生服务，在安大略省越来越受欢迎。尽管这些诊所非常有用，但它们也面临着提供低质量护理的批评，这种批评认为与基于注册的家庭医疗服务模式相比，WICs提供的护理质量较低。批评者认为，WICs加剧了医疗系统的效率低下，并鼓励了一些不符合公共卫生目标的实践方式。本研究探讨了家庭医生对两个通常与WICs中低质量护理相关的关键结果的看法：初次就诊后的重复就诊和可能不适当的抗生素处方情况。通过采用描述性定性方法，研究人员与19位在安大略省有经验，在WICs和基于注册的家庭医疗服务两种模式下工作的家庭医生进行了半结构化访谈。研究发现揭示了系统性的挑战，包括缺乏基于注册的初级保健服务、不断增加的医疗需求等因素，这些因素促使WICs超出了它们原本的角色。这种不一致导致了其结构与目的之间的紧张关系，造就了一种更注重交易而非持续护理性质的访问模式。由于信息和人际关系连续性的不足，受访医生常常难以提供深入的参与或后续护理。重复就诊通常是为了确保对复杂疾病或慢性病患者的持续性照护。同样，受访者承认可能不适当的抗生素处方情况，并将其归因于患者数量大、满足患者期望的愿望以及在病情性质有疑问时倾向于“谨慎行事”的倾向。研究结果强调了医疗系统压力和善意政策（例如安大略省的初级保健访问奖励）如何导致意料之外的结果，包括获得服务方面的不平等和跨机构护理协调的困难。解决这些挑战需要对WICs进行更好的整合以融入到家庭医疗服务系统中，并为医生在断续性照护环境中的决策制定提供针对性培训。