Practice Management
“Low blood sugar” was his chief complaint, but Thomas was in my urgent care (UC) mostly because he was feeling anxious. It wasn’t hypoglycemia that was making him nervous either. Thomas didn’t have diabetes or take any medication for high blood sugar. Regardless, he was wearing a continuous glucose monitor (CGM), which he lifted his shirt to show me when I entered the room. Thomas explained his primary care physician (PCP) had prescribed the device …
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Urgent message: Frequent cannabis use can lead to a syndrome characterized by severe and cyclical vomiting without other clear triggers. Termed “cannabinoid hyperemesis syndrome,” this disorder is often refractory to conventional antiemetic pharmacotherapy. Citation: Ramos J, Russell J. Emesis Ad Nauseum: A Case Report of Cannabinoid Hyperemesis Syndrome in Urgent Care. J Urgent Care Med. 2024; 18 (11): 13-18 John Ramos, MMS, PA-C, CAQ-EM, Joshua Russell, MD, MSc, ELS, FACEP, FCUCM Abstract Introduction: Cannabinoid hyperemesis …
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Commuting in Jakarta can be a nightmare. The average citizen in Indonesia’s capital city spends weeks stuck in urban transit each year. Compare this with Singapore, which is consistently rated one of the best cities in the world for commuters. The difference between the day-to-day experience of residents of each city is stark. The root cause of why these two metropolises of southeast Asia have such disparate commuter experiences lies in the contrast of how …
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Recently one evening, I meandered into a bar on iconic 6th Street in Austin, Texas— America’s epicenter for live music. Venues throughout the district feature free, live performances every night from some of the nation’s most talented musicians. On that particular evening, however, the sounds from one electric guitar coming from a small stage in a dark room cut through the humid air and grabbed my attention. I wandered in, found a seat at the …
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Joshua Russell, MD, MSc, FACEP, FCUCM “It only hurts right here,” Rich told me, pointing to a tender spot on his ribs under near his arm pit. I palpated his chest wall and observed as he winced when I hit the spot. “I just need to make sure I’m okay to go back to work.” Rich was middle-aged and had a mustache with hints of grey. He was a large man, but his potbelly was …
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Joshua Russell, MD, MSc, FCUCM, FACEP Who among us has worked a single urgent care (UC) shift without at least one patient making a humble request for a sick note to take back to work? “Can I have a work note?” It’s a simple ask. In fact, apart from medication refills, work note visits rank among the most welcomed presentations for many overworked clinicians, offering a much-needed mental reprieve and a chance to finally catch up …
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Joshua Russell, MD, MSc, FCUCM, FACEP In its most modern form, medicine revolves around action. We are trained as clinicians to assess, diagnose, and intervene, but it’s the intervention part that patients expect most. This is especially true in urgent care (UC), where patients usually present in anticipation of some swift action for whatever is bothering them. I recently saw a healthy, middle-aged man in our clinic who was complaining of some mild chest pain. …
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Joshua Russell, MD, MSc, FCUCM, FACEP Click Here to download the article PDF Sophie was back with another one of her kids in tow. This was the fifth time in a month. I could almost hear my staff roll their eyes when she walked through the door. Even though she was a denizen of the clinic, I was about to meet her for the first time because I usually covered other sites. Although I was …
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David Gahtan MS, PA-C and Joshua Russell, MD, MSc, FCUCM, FACEP Whether we like it or not, electronic medical records are here to stay. And their takeover has been swift. Over recent decades, the EMR has gone from an obscure, bare-bones, often clunky digital notepad to a ubiquitous and powerful tool which tracks enormous amounts of patient data. To continue to practice medicine, we’ve had no choice but to go along for the ride. It’s …
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Click Here to download the PDF In the macro and “dot phrase” era, there are many refrains that appear in the electronic medical record (EMR) with such regularity that we don’t even notice them anymore. Statements like All questions were answered prior to discharge, The patient verbalizes understanding and is comfortable with the plan, and Symptomatic care and over-the-counter treatments discussed are so commonly tacked onto charts that our eyes have been trained to gloss …
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