Journal of Urgent Care Medicine

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 …

What’s In a Test? The Psychology of Patient Expectations

Lee A. Resnick, MD, FAAFP The impact of patient expectations and pressures on high utilization rates in this country is a subject of significant discussion but surprisingly little study. A literature review produces scant evidence of scientific inquiry in this area. And yet, most clinicians would say that patient expectations are perhaps an even stronger motivation for utilization than fear of malpractice suits. In an ever-competitive, service- oriented industry like urgent care, this can only …

Physicians Criticizing Physicians: A Two-Headed Snake

Lee A. Resnick, MD, FAAFP In the Hippocratic Oath it is written and we are bound: “To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art if they …

Dare We Doubt the Wisdom of Patient Empowerment?

Lee A. Resnick, MD, FAAFP “Patient empowerment,” “patient-centered care, “patient-focused care,” and “shared medical decision-making” are among a growing number of terms intended to shift the power and control of healthcare decisions from physicians to patients. The concepts are, for all intents and purposes, accepted as “good.” It is merely assumed that empowered patients are better off than those who defer control of their healthcare decisions to their clinicians. Despite an almost revolutionary change in …

The ED Utilization Debate: Can a Shell-Game Redirect the Scrutiny?

Lee A. Resnick, MD, FAAFP You might not expect one of our most prestigious medical journals to be susceptible to scientific sleight of hand. But the JAMAeditorial board apparently fell victim to just that in publishing the latest in a string of self-serving, extraordinarily biased “studies” supported by the American College of Emergency Physicians (ACEP), entitled “Comparison of Presenting Complaint vs Discharge Diagnosis for Identifying “Nonemergency” Emergency Department Visits.” The study’s objective was to determine …

Judgment Day

Lee A. Resnick, MD, FAAFP Carl Jung said, “We should not pretend to understand the world only by the intellect. The judgment of the intellect is only part of the truth.” In medicine, reliance on intellect alone is a significant danger. Ignorance of cultural, social, and even psychological context can mislead the clinician and risks misdiagnosis and error. Yet the very basis of medical decision-making is rooted in the rule of intellect. Evidence-based medicine is, …

“You Can’t Always Get What You Want…” “…but You Get What You Need!”

Lee A. Resnick, MD, FAAFP Love, politics and drugs were the subjects of Mick Jagger’s self-reflection in the 1960s rock anthem, “You Can’t Always Get What You Want.” Since then, the song’s chorus has been reproduced and repurposed into everything from parenting advice to sociology lectures. Mick’s personal struggles with drugs and other temptations are referenced frequently as the artistic purpose of the song, and while he may not have intended greater ideological meaning, I …

Patient Portals Part II: ‘Who’s That Practice Behind the Curtain?’

Lee A. Resnick, MD, FAAFP I proposed a systematic approach intended to in my last column, I discussed the decision- making process around patient portals and mitigate risk, ensure security, and manage access. A portal, by definition, is an‘entrance‘— a virtual access point to a practice, its staff and patient medical records. The most common access point is a practice’s website and well-designed one can enhance access, improve efficiency, and help sell your practice to …

Electronic Patient Portals: Access or Anarchy?

I to choose a direction of flow that least the “path of least resistance” is a physical property that represents an object’s tendency impedes its forward momentum. No other healthcare entity has better captured this principle than urgent care. In traditional health systems, patient flow is infamously disrupted by obstacle some regulated, some self-imposed, some unavoidable. These “flow disrupters” are the very reason urgent care exists. Consider this: Nothing we offer in urgent care is …