Journal of Urgent Care Medicine

The Power of Innocence in Medicine

Lee A. Resnick, MD, FAAFP Medicine, from time to time, calls for reflection. The hangover from arduous shifts, the mind-numbing regulatory “whack-a-mole,” the technology treadmill and the career second-guessing, all contribute to an epidemic of lost perspective in our profession. In an effort to manage an avalanche of competing interests, physicians often sacrifice themselves to the point of burnout and self-destructive behavior. Without perspective, these burdens soon overwhelm even the hardiest among us. We become …

Security Risk Assessment: Protecting Patients and Practice

Securing protected health information (PHI) is a goal we all share. Collectively, however, we are relatively clueless about how to achieve this, largely because of the massive amount of technology that almost all of us have adopted. A simple understanding begins with the most basic categorization of the technology that we use to store, transfer, and manage PHI: Software and hardware. Hardware includes all devices (desktops, laptops, routers, EKGs, and mobile devices) that store or …

Are we all ‘criminals’?

Show of hands…how many of you consider yourselves “compliant” with the array of regulations, laws and so-called “guidelines” you work under? Most of the time? Some of the time? Never? Now, let me pose the question a different way: How many of you think you can always, or even most of the time, remain in compliance and have a successful practice? Or, consider the question presented this way: How many of you think you can …

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 …