Letters from the Editor-in-Chief

“Do as little as necessary, not as much as possible.” This is the mantra I recite throughout every urgent care shift without fail—that’s how mantras work after all. Hearing the word “mantra” might conjure images of a placid-faced yogi seated in the lotus position for some, but a mantra needn’t serve only spiritual practice. A well-conceived mantra can also prove useful when deployed in any context where we might benefit from being reminded frequently to act differently than if left to the mercy of our habits or human nature. Clinical …
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Recently one evening, I meandered into a bar on iconic 6th Street in Austin, Texas— America’s epicenter for live music. Venues throughout the district feature free, live performances every night from some of the nation’s most talented musicians. On that particular evening, however, the sounds from one electric guitar coming from a small stage in a dark room cut through the humid air and grabbed my attention. I wandered in, found a seat at the bar, and took in the guitarist’s performance. He was nothing short of a master. His …
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Joshua Russell, MD, MSc, FACEP, FCUCM “It only hurts right here,” Rich told me, pointing to a tender spot on his ribs under near his arm pit. I palpated his chest wall and observed as he winced when I hit the spot. “I just need to make sure I’m okay to go back to work.” Rich was middle-aged and had a mustache with hints of grey. He was a large man, but his potbelly was overshadowed by his towering height. He had a polite, unassuming demeanor and came in wearing …
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Joshua Russell, MD, MSc, FCUCM, FACEP Who among us has worked a single urgent care (UC) shift without at least one patient making a humble request for a sick note to take back to work? “Can I have a work note?” It’s a simple ask. In fact, apart from medication refills, work note visits rank among the most welcomed presentations for many overworked clinicians, offering a much-needed mental reprieve and a chance to finally catch up with charting. However, while the path of least resistance (ie, providing the note without …
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Joshua Russell, MD, MSc, FCUCM, FACEP In its most modern form, medicine revolves around action. We are trained as clinicians to assess, diagnose, and intervene, but it’s the intervention part that patients expect most. This is especially true in urgent care (UC), where patients usually present in anticipation of some swift action for whatever is bothering them. I recently saw a healthy, middle-aged man in our clinic who was complaining of some mild chest pain. He wore a white, pristinely starched shirt and tie with suspenders and cufflinks. I could …
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