JOHN SHUFELDT, MD, JD, MBA, FACEP The one thing I have left out has been… well…sex. Sex has over the years I have attempted to cover it all. Drugs, rock and roll, BFRF (big F-ing red flag), airplane crashes, you name it. Sex has always been a challenging and awkward subject or me. In fact, I cried the first time I had sex—thank God I was alone. Anyway, speaking of God, my challenges with this subject …
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Stevens-Johnson Syndrome
Urgent message: Early diagnosis is crucial in patients with this rare – but potentially fatal—condition. RACHEL CETTA, BSBE, MSBE, and JOHN SHUFELDT, MD, FACEP Overview Stevens-Johnson Syndrome (SJS) is a rare and potentially life-threatening condition. While the exact etiology is unclear, SJS often is associated with an adverse drug reaction to an assortment of drugs ranging from nonsteroidal anti-inflammatory drugs (NSAIDs) to anticonvulsants.1 SJS involves blistering and sloughing off of necrosed skin, leaving a burn-like …
Read More‘Why Can’t We All Get Along?’
JOHN SHUFELDT, MD, JD, MBA, FACEP It’s not often you get to quote the late Rodney King, but there it is. Mr. King’s quote was made famous during the Los Angeles riots, which were arguably incited by the acquittal of the police officers accused of excessive force during Mr. King’s arrest. In 1860, a book review on medico-legal jurisprudence argued that “law and medicine had evolved into mutually incompatible professions.”1 One hundred and sixty-two years …
Read MoreWhat You Don’t Know
JOHN SHUFELDT, MD, JD, MBA, FACEP In the late 1970s I read a book by Samuel Shem called The House of God. The book is about an intern in a New York hospital during his first year of residency. His senior resident, “The Fat Man,” coins a number of laws about surviving residency. One of them—“If you don’t take a temperature you can’t find a fever”—can be extrapolated to all sorts of questions, tests, and …
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Ludwig’s Angina
Urgent message: Thoroughly evaluate patients who complain of dental or oral pain. CHRISTOPHER MCKENNA and JOHN SHUFELDT, MD, JD, MBA, FACEP Ludwig’s angina is a serious and potentially life-threatening connective tissue infection found on the floor of the mouth and in the deep neck spaces. More specifically, it is a bilateral infection of the submandibular space. The two compartments affected are the sublingual space and the submylohyoid space.1 This condition usually presents in individuals who …
Read MoreWhat Does Obamacare Mean for the Urgent Care Industry?
JOHN SHUFELDT, MD, JD, MBA, FACEP Chief Justice Roberts, writing for the majority, published the Supreme Court’s decision in National Federation of Independent Business v Sebelius on June 28, 2012. With a few exceptions, the decision upheld the bulk of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare. In the next few paragraphs I will attempt to make some sense out of the ruling and how, if applicable, it applies to …
Read MoreDUI: Rules of the Road
JOHN SHUFELDT, MD, JD, MBA, FACEP Oh crap! The flashing red lights illuminating the interior of Eric’s car snapped him back to reality. He had lived through a tough year – passed his family medicine boards, finished residency, separated from his wife and ultimately went through a contentious divorce. Eric’s first post-graduate job ended poorly after he was caught up in owner infighting and left as the practice he joined dissolved. Suffice it say, Eric …
Read MoreOn Rock Bands, Plane Crashes, SWAT Teams and Codes
JOHN SHUFELDT, MD, JD, MBA, FACEP I’ve had the great pleasure of seeing Bruce Spingsteen and the E Street Band perform live a number of times since the mid-70s. Yes, I started being a “groupie” while still in diapers (no, not Depends). What amazes me still is the obvious teamwork among band members and crew. Bruce can change an introduction, set list, or song on the fly by simply looking a certain way at Roy …
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High-Risk Conditions Presenting as Back Pain (Part 4)
Urgent message: Back pain with incontinence and focal neurological changes are red flags for serious conditions. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Low back pain is a common presentation in the urgent care setting and it is important for providers to be aware of signs and symptoms that could indicate a more serious condition than nonspecific muscular pain. Be sure to make a thorough evaluation of your patients and pay …
Read MoreSister Morphine
JOHN SHUFELDT, MD, JD, MBA, FACEP The hard core rockers amongst us know that Sister Morphine was written and recorded by Marianne Faithful while she was dating Mick Jagger during the time he and the Stones were recording Let it Bleed in 1969. Marianne’s version tanked early, but the song was later covered by the Stone and received more acclaim. Parenthetically, she did not receive credit until the Stones’ 1998 No Security album. The song …
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