John Shufeldt, MD, JD, MBA, FACEP A 34-year-old patient presents with an acute exacerbation of chronic low back pain. A cursory review of his medical records done before seeing him reveals that he has had multiple visits to your urgent care for a variety of complaints including: Flank pain and blood in his urine Dental caries Gout Headache Low back pain Knee strain He typically shows up about 5 minutes before closing and is always …
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The Role of Ultrasound for Soft Tissue Infections in the Urgent Care Setting
The Role of Ultrasound for Soft Tissue Infections in the Urgent Care Setting Urgent Message: Abscess evaluation is one of many diagnostic applications of ultrasound that could improve patient care in the urgent care setting. Authors: Staci Shepard, MS-4, and John Shufeldt, MD, JD, MBA, FACEP Staci Shephard is a fourth-year medical student at Creighton University School of Medicine. John Shufeldt, MD, JD, MBA, FACEP, is CEO of Urgent Care Integrated Network and sits on …
Read MoreMedical Malpractice Insurance: Read the Fine Print
JOHN SHUFELDT, MD, JD, MBA, FACEP Our emergency medicine group was informed that a new corporate mandate will force us to nearly double our malpractice coverage from $1 million for each occurrence and $3 million in yearly aggregate ($1M/$3M) to $2M/$4M. This mandate came despite our group’s low malpractice claims history, a higher burden of proof for plaintiffs in the state where we practice, and a very “doctor-friendly” malpractice environment in our county. To my …
Read MoreMalpractice Trends in Urgent Care and Retail Medicine
JOHN SHUFELDT, MD, JD, MBA, FACEP with ANDREW SNIEGOWSKI, RN, JD CANDIDATE 2014 Over the last 6 years I have written a number of articles on medical malpractice in urgent care medicine. The good news is that I am seeing fewer cases despite the fact that there are more urgent care centers and more patient visits. The bad news is that I am still seeing the same fact patterns time and again. Failure to diagnose …
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Treating the Self-Harming Patient in the Urgent Care
JOHN SHUFELDT, MD, JD, MBA, FACEP He watched her walk through the door at the end of a long, busy day. She was an attractive, well dressed, athletic-looking young lady with a warm smile, the kind of girl he’d want his teenage son to date someday. “Slam dunk,” he thought. “This will be a quick visit and I’ll still get out on time.” The front office team registered her quickly. He suspected that they, too, …
Read MoreObamaCare Update or Fear and Loathing: The Affordable Care Act
JOHN SHUFELDT, MD, JD, MBA, FACEP In the conclusion of my October 2012 column on ObamaCare I wrote that no matter the outcome (of the presidential election) our future will not be boring. Fourteen months later, it has not been boring and we are just around the corner from imposing the individual mandate (aka tax penalty) on those who don’t have minimal insurance coverage. However, before we cross the starting line let’s review a bit …
Read MoreHelp me understand…
JOHN SHUFELDT, MD, JD, MBA, FACEP lease don’t share this with anyone but truth be told, I love paramedics. I sometimes thought I had it bad (I really didn’t think that, but it makes the story better if I sound tragic) treating the myriad disenfranchised in an inner city ED until I talked with the paramedic who wrestled the feces-covered, bath salts and meth-using, naked, combative maniac who was my patient the previous night. (The …
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Urgent Care Management of Needlestick Injuries: Part 2
Urgent message: Response to a needlestick with potential for HIV exposure requires understanding of both state laws on HIV testing and the latest USPSTF guidelines for post-exposure management. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEPTwo police officers arrive at your urgent care site with a handcuffed, bloodied prisoner. One officer tells you that the person in custody “spit on me” during the altercation. The officer goes on to tell you that the …
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Urgent Care Management of Needlestick Injuries: Part 1
Urgent message: Needlestick injuries are common and require a prompt response based on an understanding of the latest USPHS guidelines and informed consent and counseling of the patient. MAYA HECK, MS-2 and JOHN SHUFELDT, MD, JD, MBA, FACEP Your center is fortunate to contract with a variety of different business to provide employee health services. A local homeless shelter is one of the clients to whom your center provides new hire physicals, drug screens and …
Read MoreUsing Physician Extenders
JOHN SHUFELDT, MD, JD, MBA, FACEP You breathe a deep sigh of relief after learning that you were not the treating provider of a patient who came into your urgent care center and had an unexpected bad outcome. The patient was seen by your mid-level provider who works on opposite days from you in your center. As documented in the medical record, the patient sounds benign: a 28-year-old female who presented with continued sinus symptoms …
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