Journal of Urgent Care Medicine

Acute Rheumatic Fever

Urgent message: Patients with seemingly unusual conditions do present to urgent care, underscoring the need to always take a thorough history for all “red flag” symptoms. LEE A. RESNICK, MD, FAAFP Introduction While the incidence of acute rheumatic fever has declined significantly in developed countries over the last several decades, sporadic cases do still occur. Diagnosis may be difficult due to the non-specific symptoms and the lack of experience with the condition amongst most urgent …

Risk Mitigation in Urgent Care: Part 3

Lee A. Resnick, MD, FAAFP In my previous column, I discussed three core areas where risk and potential liability exposure lurk and ways to mitigate that risk. This month, the last in the three-part series, I will focus on specific clinical policies and procedures that can effectively reduce liability risk and enhance patient safety, quality and patient satisfaction…the holy grail of high-performing practices. Eliminating ‘Pre-triage’ The term “pre-triage” is used to describe the all-too-common practice …

Risk Mitigation in Urgent Care: Part 2

Lee A. Resnick, MD, FAAFP My previous column presented the building blocks of a risk mitigation framework for your practice. This column specifies high-risk areas of urgent care practice that create exposure for both owner and clinicians and suggests ways to mitigate that risk. Charting / Documentation: Your best defense when there is a bad outcome is documentation. The chart should clearly communicate your decision-making. The “standard of care” is not a guarantee against harm. …

Risk Mitigation in Urgent Care: Part I

Lee A. Resnick, MD, FAAFP Editor’s Note: This is the first of a two-part column that examines ways to reduce liability in the urgent care setting. Our discipline is evolving rapidly and best practices are beginning to be defined. Staying abreast of practice standards for urgent care and implementing a disciplined risk mitigation plan will help your practice avoid the disruptive burdens of a medical malpractice lawsuit. The urgent care approach to risk management should …

MOC…Part Duhhh!

Lee A. Resnick, MD, FAAFP I first wrote about the disaster that is Maintenance of Certification (MOC) in June 2012. As a refresher, MOC was adopted by all 24 American Board of Medical Specialties (ABMS) member boards in 2006. The move was promoted under the guise of a commitment to quality care and best practices. Despite no clear evidence that MOC works to achieve these goals, the requirements were adopted without debate. That’s right, the …

Patient Satisfaction Surveys: Seeing Opportunities in Our Failures

Lee A. Resnick, MD, FAAFP It is well known, and exhaustively preached, that a satisfied customer will tell 2-3 people while a dissatisfied one will tell 8-10 (with some estimates as high as 20). Measuring and tracking patient satisfaction has become a focus of most every practice owner, much to the chagrin of their employees, who often view this as a way to publicly embarrass and unfairly harass the staff. And yet, whether we are …

Where Do We Go From Here?

Lee A. Resnick, MD, FAAFP As I was writing this column about visioning for the new year in urgent care, I couldn’t help but think of the Alan Parsons Project tune, “Where Do We Go From Here?” Opportunity abounds but risk remains, and there are gaps, so we must not pursue opportunity blindly. Consider the following: Urgent Care Achievements Strong organized medicine representative (UCA and its branches) Proven, stable trade association (UCA) Conferences Education Vendor …

The Urgent Care Foundation: Building a Stronger Specialty

Lee A. Resnick, MD, FAAFP The discipline of urgent care medicine remains in its developmental infancy. While the strong consumer-driven market lurching toward efficient and cost-effective health care delivery systems has supported astounding industry growth, our discipline continues to struggle to define itself. Like all new specialties, urgent care medicine has, in fits and starts, made efforts to evolve an identity, but despite early gains, it’s been an up and down effort. Most every urgent …

Urgent Care Under Fire: Is This a Trend?

Lee A. Resnick, MD, FAAFP Well-meaning or not, government regulation of health care is always cause for concern among practicing physicians. No other profession is exposed to the layers of oversight that physicians endure—from OSHA to HIPAA, from Stark to Anti-kickback laws, the OIG and Medicare, just to name a few. Individual health care bills pile on to create a practice environment so mired in regulation that it would paralyze health care delivery to adequately …

Regional Health System Integration: Charting Your Course

Lee A. Resnick, MD, FAAFP These are indeed stormy and transformational times. While no one can seem to agree on the political path to reform, change is nonetheless happening at a rapid pace in health care. Previous efforts to manage health care costs and quality on a national scale sunk at sea (the HMOs and Managed Care Organizations of the 80s and 90s). But the current path to reform appears unstoppable to me, regardless of …