Journal of Urgent Care Medicine

Entrepreneurism—Or, How Not to Turn a Lot of Money into a Little

Throughout history, entrepreneurs have faced harsh critics. From Shakespeare’s The Merchant of Venice through Oliver Stone’s movie Wall Street (“greed is good, greed works.” etc.) entrepreneurial efforts are cast in a dim light. To paraphrase Lifebook founder Job Butcher, though, “no other social system can compete with the free market, entrepreneurial system in terms of productivity, raising living standards, and creating prosperity … Yet, despite its overwhelming contributions, some elements of society still associate profit-making …

A Short Course in Tort

John Shufeldt, MD, JD, MBA, FACEP I just completed teaching a semester of Health Law and Ethics at the W.P. Carey School of Business at Arizona State University. Over the next few months in this column, my goal is to distill te 40-hour course down to a few pages chock full of practical legal information. Lesson 1: Torts A tort is a civil wrong committed against a person or property interest for which the court …

Safety First When Consummating Relationships with Vendors

JOHN SHUFELDT, MD, JD, MBA, FACEP One of my favorite Seinfeld exchanges is this prickly dialogue between George and his fiancée, Susan, regarding his disdain for (and challenge with) condoms: GEORGE: Oh, no, no … condoms are for single men. The day that we got engaged, I said goodbye to the condom forever. SUSAN: Just once … for the make-up sex. GEORGE: Make-up sex? You have to have that right after the fight, we’re way …

Beware the BFRF!

John Shufeldt, MD, JD, MBA, FACEP Remember the scene in Ghostbusters when Gozer (the Gozarian) asks Ray Stantz if he is a “god?” Stantz, compulsively honest, says, “No.” Gozer says, “Then die,” as he tries to blow them off the roof of the building. After recovering, Peter Venkman yells at Stantz, “If someone asks if you are a god, you say YES!” The question Gozer asked Stantz was a red flag – one of those …

A Patient with Suspected Pulmonary Embolism

Urgent message: High degree of suspicion combined with thorough history and proper use of available tests can help the clinician identify patients in need of emergent referral. John Shufeldt, MD, JD, MBA, FACEP and Kelli Hickle Introduction A 47-year-old woman with a diagnosis of ovarian cancer developed an acute onset of mild shortness of breath two days after being discharged for a work-up of symptomatic ascites. Her medical history was significant for obesity and recent …

How to Say ‘Farewell and Adieu’ to Owning Your Business

John Shufeldt, MD, JD, MBA, FACEP How do you know when it’s time to cut bait? Remember the scene in Jaws when Chief Martin Brody (Roy Scheider) is throwing fish guts into the ocean and comes face to face with the shark? He remarks, somewhat casually. “You’re going to need a bigger boat.” Despite the fact that everyone in the theater is yelling “run for your life,” the trio then decides to continue after the …

EMTALA and Transferring Patients to the Emergency Department

JOHN SHUFELDT, MD, JD, MBA, FACEP I was an emergency medicine resident on the south side of Chicago in the mid-1980s and, truth be known, I sometimes played inappropriate practical jokes on residents at other area trauma centers. One of my favorites was calling over the “patch phone” with a report that a patient whose penis was “Lorena Bobbitted” by a pit bull was en route; the paramedics were bringing in both the patient and …

Strategies on Responding to Variable Patient Acuity and Flow

JOHN SHUFELDT, MD, JD, MBA, FACEP Over the years, I have worked with a variety of providers who exhibited significantly disparate skill levels in their ability to manage patient flow. Practicing good medicine is a given; some have been amazingly intelligent providers who make House look like a PG1 psychiatry resident from a non-accredited medical school. Their only downside was that they were pathetically slow, or communicated at the level of a mollusk. Effective and …

Managing Through Change

JOHN SHUFELDT, MD, JD, MBA, FACEP The urgent care sector in particular, and healthcare in general, is undergoing a sea change—a phrase that has its origins in Shakespeare’s The Tempest: Full fathom five thy father lies Of his bones are coral made Those are pearls that were his eyes Nothing of him that doth fade But doth suffer a sea-change Into something rich and strange. Shakespeare was referring to the corpse of Ferdinand’s father being …

Medical Search Firms: Match Making Comes to Medicine

JOHN SHUFELDT, MD, JD, MBA, FACEP Recently, a friend called to tell me he was going to the airport to meet a woman he met online. He described her as tall, blonde, athletic and, based upon her e-mails and witty repartee, very smart. He brought the photo she e-mailed so he would recognize her when she walked through the gate. Oddly, he never did see her walk off the plane; however, he felt a tug …