Journal of Urgent Care Medicine

The MIPS Mess

It should not be terribly surprising to anyone that the massive government effort to incentivize quality has run into some serious challenges. Adjudicating quality has always been a briar patch of exceptions, confounders, red tape, and bias. To make matters worse, as with large government efforts, you end up with a whole bunch of unintended consequences that typically add cost and effort to the very practices that can handle it the least. As we all …

Detroit Sees an Urgent Care Boom

Detroit-area residents will have a lot more urgent care centers to choose from in the next 16 months, as Henry Ford Health System, Detroit Medical Center, Ascension Health Michigan, and Beaumont Health all have announced they’re going to build up their operations there. Beaumont has the most ambitious plans, as they work with WellStreet Urgent Care to finance and open 30 new centers by the end of next year. Analysts say the expansion plans are …

Expectations Disease

There are a few things from residency training that resonated so profoundly for me that they permeate everything I have done since. I will never forget my first delivery, not because I thought I would ever deliver babies in my practice, but because of the emotional and enduring collision of medicine and nature it represented for me. And who can forget the 36-hour shifts (now extinct) that I am quick to recount for young clinicians …

From Don’t Be Evil to Do the Right Thing: The Code of Conduct Evolution

In the year 2000, Google famously adopted the corporate code of conduct motto, Don’t Be Evil to represent its approach to both business and workplace behavior. At the time, the approach seemed sensible, but today it feels strikingly out of touch. It’s a low bar that misses the mark on one of the most pressing issues of our time: respect and freedom from harassment, at work, at home, and at play. Don’t be evil is …

Opioid Crisis: What Next, and What’s Lurking?

It pains me to write this column. The opioid epidemic is arguably the most catastrophic and enduring public health crisis since the flu epidemic of 1918—yes, even worse than the HIV/AIDS epidemic of the ‘80s. Since 2000, over 200,000 people have died from overdoses of prescription opioids alone, another 300,000 from heroin and synthetic opioids. Now synthetic fentanyl has infiltrated the market with the most toxic opioid ever known. The overdose death curve is steepening. …

Regulatory Creep: An Urgent Care Response

Connecticut Democrats Seek Regulations for Urgent Care Centers. When this alert hit my inbox, I must say it was a bit alarming. Whenever I see “urgent care” and “regulations” in the news it’s unsettling to say the least. I am probably not alone. The regulatory rumblings have come and gone before, but this one has me more concerned. Here’s a little background: Connecticut legislators and the state Department of Public Health (CDPH) have been interested …

Doing the MACRA’ena—Part II

In my last column, I tried to explain the complicated math involved in calculating the potential financial impact of MACRA/MIPS on urgent care centers. I made the case for a significant return on investment for a typical urgent care with a typical mix of Medicare patients. Of course, all of the potential return depends on implementation of practical and efficient quality improvement programs that meet the measurement and reporting expectations outlined by the Centers for …

Webinar: On-site Lab Tests Are a Clinical Imperative—and Set Your Clinic Apart from the Rest

While convenient access to quality, affordable care has been the defining characteristic of the urgent care setting from its inception, the growth of the industry has been fueled by constant innovation and responsiveness to the evolving needs and preferences of the patient. Today, that includes on-the-spot lab testing. Languishing for hours in a hospital waiting area is a miserable prospect when patients are feeling ill, so they’re likely to choose an urgent care center over …

Patient Satisfaction: The Redirection Game

In my previous column, I discussed the challenging issue of patient satisfaction and the provider behaviors that can contribute to poor service experiences. In this month’s editorial, I will pivot the discussion to the patient profiles and behaviors that can trigger negative interactions and poor service reviews. While most of us understand the importance of “customer service” in healthcare, we do not always dedicate ourselves to understanding the common traps and landmines that lead to …

Patient Satisfaction: A Collaborative Approach

Patient satisfaction surveys have driven a contentious wedge between management and clinical teams. While management is tasked with ensuring the practice is addressing patient needs and evolving consumer demands, providers are far more concerned with doing the right thing clinically (satisfaction be damned). However, with patient expectations changing, access to care improving, and practice economics eroding, we have to find a way to bridge this issue or we will quickly find ourselves locked in counterproductive …

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