The majority of patients using the Paediatric Emergency Department (PED) are ambulatory. The assumption is that many of these patients are utilizing additional health care resources prior to visiting the PED. We undertook a survey study to investigate why parents of previously seen ambulatory patients were using the PED. From 520 questionnaires, we identified 129 children(26%)who had used another health care resource for the same illness within the last 3 days. Of these 129 children, the primary care physician (PCP) was identified as family doctor (FD)86%, paediatrician (PD) 12% and walk-in clinic(WC) 2%. However, for this illness, the actual physician seen prior to PED visit was FD 41%, PD 14%, WC 25% and Other 20%. Of those who identified PCP as FD, 47% were seen by that physician whilst 24% had been seen at a WC. Similarly, 64% of patients whose PCP was a PD were seen by that physician vs. 14% at a WC. Parents of 94% of patients seen by PD vs 66% FD and 63% WC received explanations of their child's illness. Significantly more patients, 40% of WC vs 14% of FD and 6% of PD came for better care (p<0.05). 24% PD vs 8% FD came to the PED because their doctor's office was closed. Children presenting for a second opinion were twice as likely to have seen either an FD(26%) or WC (27%) vs PD (12%). There is no difference in prior health care utilization between groups (FD 16%, PD 18%, WC 13%)for the child who parents perceived them to be ill. In conclusion, patients using walk-in clinics are most likely to present for a second opinion and better care suggesting that parents lack confidence in the quality of care available in walk-in clinics. For parents who saw a family doctor prior to presentation at the PED, the most common issue was one of a second opinion not better care. The reason for this is unknown and requires further study. For those patients previously seen by a paediatrician, the issue becomes one of accessibility of services. Therefore, the extension of hours by paediatricians may improve access and decrease PED visits. Also, further study needs to be undertaken regarding the public's utilization and perception of walk-in clinics.