I’m phenomenally bad at gambling for a multitude of reasons. I bet small when I should bet large. I bet large when I shouldn’t even be playing the game. I’m especially terrible at roulette because when I pick a number, usually 22, I stick with it—much longer than I should. Each time the wheel stops, on any other number, I’m disappointed, sure. But that disappointment is quickly replaced with hope that the odds of lucky …
Read MoreA New Year, and a New Era for JUCM
35,000. As I assume the role of editor-in-chief of the journal, this is the number that revolves through my head with rhythmic pops like an old, vinyl record. Cognitive psychologists estimate that that’s the number of decisions an average adult makes every day. This number may seem impossibly large at first, to the point of absurdity even. After all, that breaks down to a decision every 2 seconds. But let’s pause briefly and examine this. …
Read MoreFor Auld Lange Syne, Many Great Years
The year was 2006: Saddam Hussein was executed for crimes against humanity. The Wii gaming console debuted. Pluto lost its planetary status. High School Musical and Borat were the talk of the town in entertainment. And JUCM, The Journal of Urgent Care Medicine was born—the first and only peer-reviewed journal in the industry (which it remains to this day). Well, let’s just say that JUCM was the undisputed highlight of 2006! The whole idea for …
Read MoreThe 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 …
Read MoreVirtual Urgent Care: Boom or Bust?
Telemedicine remains a hot topic of debate in urgent care circles. In fact, it seems like every urgent care conference I attend lately has a telemedicine track or expert panel. JUCM recently featured a point-counterpoint discussion between two industry leaders, Stanford Coleman, MD, MBA, FAAP and William Gluckman, DO, MBA, FACEP—whose opinions on the topic are as well-reasoned as they are divergent. So, let me add my two cents. The discussions and analyses I’ve been …
Read MoreI’m Not a Lawyer, But I Play One…
Like many of you, the fear of a medical malpractice claim casts a wide shadow over everything I do. Like most of you, my intent is always to do no harm and provide the best care possible for every patient despite significant challenges. And like all of you, I wonder how we got to a place where any level of inaccuracy or misjudgment became a breach of the standard of care. While some reforms have …
Read MoreLongitudinal Assessment: A Dent in the ABMS Armor?
With the volume of dissent against Maintenance of Certification (MOC) now at a fever pitch, American Board of Medical Specialties (ABMS) boards are finally making changes to their recertification programs with the intent of reducing the burden on physicians. The issue could not be more acute than in urgent care, where many UCA member physicians have been practicing for years. Working outside of their specialties of training and growing more distant from the best practice …
Read MoreUrgent Care and Antibiotics: Advancing Care and Stewardship
Antimicrobial stewardship is defined as a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. Stewardship initiatives in the hospital are paving the way for the rest of healthcare through education campaigns, monitoring, and restrictions. Outpatient practice is beginning to catch up as the stories of resistance grow and the lines between nosocomial and community-acquired infections blur. …
Read MoreAnger Management: Hostile Encounters in Urgent Care
Eliminating disruption, distraction, and dissatisfaction is paramount to delivering efficient and high-quality care these days. More than ever, urgent cares are competing to differentiate themselves by moving patients through the encounter faster and with a more reliably exceptional experience. We’ve adopted slick technologies and  reconfigured work flows to improve care delivery. So, why do our teams still struggle with consistency? Why do we still see high levels of burnout and turnover—and what can we do …
Read MoreSlow Medicine: ‘Unprescribing’ America
#TimesUp; #NeverAgain; #Privacy; #OpioidCrisis; #BlackLivesMatter…. The last year has been a dramatic one for turning points in long-festering social issues. For decades, we turned our cultural cheek on problems we knew existed (misogyny and bias) or should have seen coming (opioids, mass killings and privacy). But in 2017 and into 2018 we are witnessing a tidal wave of resistance and public denunciations against the ugly side of American life. A collective enough is enough echoes …
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