JOHN SHUFELDT, MD, JD, MBA, FACEP Maybe you read my columns in the two previous issues of JUCM and had a brief moment of self-awareness. Maybe one of your co-workers put them in your mailbox. Did you actually ask your co-workers and subordinates if you were the “cancer” I was talking about? They are not going to be honest. They care little about you and fear for their jobs, and so, are hardly going to …
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High-Risk Conditions Presenting as Back Pain (Part 3)
Urgent Message: Fever plus back pain should alert a provider to a potentially serious condition that warrants further workup. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Many high-risk conditions can present as back pain and back pain is a very frequent presenting complaint in urgent care medicine. When the back pain is associated with fever of unknown etiology or if it occurs in someone with a history of receiving intravenous (IV) …
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High-Risk Conditions Presenting as Back Pain (Part 2)
Urgent message: Significant cervical spine injuries are rare in urgent care but missing one can have serious implications for patient and provider. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP In this continuing series on back pain diagnostics in urgent care medicine, we urge providers to carefully consider any high-risk spinal conditions that could be presenting as simple back pain. Although many cases of back pain can be attributed to musculoligamentous injury …
Read MoreCuring ‘Cancer’
JOHN SHUFELDT, MD, JD, MBA, FACEP So you missed the “cancer.” Maybe you still don’t even know you missed it. At this point the patient (your business) is dying and you plod along unaware of the impending doom, like a smoker with a chronic cough. Your business is losing weight, its cheeks are sunken, skin sallow, as it grows weaker each passing month. One day soon it will start coughing up blood, and then it …
Read MoreMissing a ‘Cancer’
JOHN SHUFELDT, MD, JD, MBA, FACEP My worst fear: I miss a cancer. Of all things to miss, I worry about this the most. Miss a myocardial infarction, stroke, or appendicitis and you figure it out quickly because it smacks you right in the face. Conversely, cancer simmers along. A few months or even years go by and everything seems fine, then all hell breaks loose. The symptoms reach epic – if not life-threatening – …
Read MoreTo P.E. or not to P.E.
John Shufeldt, MD, JD, MBA, FACEP In last month’s column, I presented an overview of capital sources that can be used to fund your urgent care start-up or expansion. This month I will discuss the different sources of debt and equity capital. Much of the decision regarding which capital source is best for you is determined by your stage of development. For a startup, you will probably have to use traditional bank debt or raise …
Read MoreOverview of Urgent Care Financing
JOHN SHUFELDT, MD, JD, MBA, FACEP You’ve researched the industry, have a site picked out, and have a name reserved. Now comes the million dollar question. Wait, that is the question: Where do I get a million dollars to start an urgent care? Do you really need a million? My noncommittal “attorney answer” is: “possibly.” I have had friends lose a lot more than that before being forced to close the doors. That said, you …
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High-Risk Conditions Presenting as Back Pain
Urgent message: That back pain is common and typically without serious sequelae may result in misdiagnosis and mistreatment. ERICA MARSHBURN, BS, BA, AND JOHN SHUFELDT, MD, JD, MBA, FACEP Many high-risk conditions can present as back pain, is a very frequent presenting complaint in urgent care medicine. Most back pain is muscular in origin and responds well to conservative intervention. However, because of the frequency of the complaint and infrequency of serious sequelae, providers may …
Read MorePotential Pitfalls While Finding the Needle in the Haystack
JOHN SHUFELDT, MD, JD, MBA, FACEP It’s nearly midnight on Saturday and I am between patients in an ED on an unseasonably cold November evening in Phoenix, Arizona. Among the head bleeds, overdoses, MI’s, and strokes, I have had these chief complaints thrown at me: “Smoke inhalation after blowing out a candle” “I can’t stop playing with my number one.” “I’m here for my 40-year-old physical.” (The patient was 43.) “I fell asleep at a …
Read MoreSelling Your Urgent Care? Here’s What’s Involved
JOHN SHUFELDT, MD, JD, MBA, FACEP A large urgent care group has just offered to buy your centers. So now what? First, get some advice. This process is incredibly time-consuming inasmuch as the amount of material and the degree of detailed information required before a sale is consummated is daunting. Also, the way you position and promote your center and the thoroughness of your disclosures will speak volumes about your abilities and will ultimately be …
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