Joshua Russell, MD, MSc, ELS, FACEP, FCUCM Archives

Emesis Ad Nauseum: A Case Report of Cannabinoid Hyperemesis Syndrome in Urgent Care

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 …

Why Specialty Recognition Matters More Than Ever for Urgent Care

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 …

Our Success in Urgent Care is Defined by How We Play Our ‘Greatest Hits’

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 …

‘What Happens If We Do Nothing?’ Is Still the Right Question

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 …

Broader Issues Surround ‘Work Note Seeking’

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 …

What Happens If We Do Nothing?

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. …

Analogy: A Powerful and Underutilized Bedside Tool

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 …

Boost Charting Efficiency: A Sure-Fire Path to Better Job Satisfaction

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 …

It’s Time to Think Differently about Follow-up

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 …

An Itchy Back with New Moles: A Case Report of Occult Malignancy

Joshua Russell, MD, MSc, FCUCM, FACEP Key words: paraneoplastic syndrome, gastric cancer, seborrheic keratosis, case report ABSTRACT Introduction: Lesar-Trélat sign (LTS) is an infrequent paraneoplastic phenomenon associated with an array of malignancies. Given that the primary manifestation is a seemingly benign dermatologic issue, such patients may choose urgent care as their initial site of clinical evaluation. Clinical presentation: A 43-year-old man with no significant past medical history presented to UC with complaints of itching and …

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