JOHN SHUFELDT, MD, JD, MBA, FACEP In the late 1970s I read a book by Samuel Shem called The House of God. The book is about an intern in a New York hospital during his first year of residency. His senior resident, “The Fat Man,” coins a number of laws about surviving residency. One of them—“If you don’t take a temperature you can’t find a fever”—can be extrapolated to all sorts of questions, tests, and …
Read MoreWhat Does Obamacare Mean for the Urgent Care Industry?
JOHN SHUFELDT, MD, JD, MBA, FACEP Chief Justice Roberts, writing for the majority, published the Supreme Court’s decision in National Federation of Independent Business v Sebelius on June 28, 2012. With a few exceptions, the decision upheld the bulk of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare. In the next few paragraphs I will attempt to make some sense out of the ruling and how, if applicable, it applies to …
Read MoreDUI: Rules of the Road
JOHN SHUFELDT, MD, JD, MBA, FACEP Oh crap! The flashing red lights illuminating the interior of Eric’s car snapped him back to reality. He had lived through a tough year – passed his family medicine boards, finished residency, separated from his wife and ultimately went through a contentious divorce. Eric’s first post-graduate job ended poorly after he was caught up in owner infighting and left as the practice he joined dissolved. Suffice it say, Eric …
Read MoreOn Rock Bands, Plane Crashes, SWAT Teams and Codes
JOHN SHUFELDT, MD, JD, MBA, FACEP I’ve had the great pleasure of seeing Bruce Spingsteen and the E Street Band perform live a number of times since the mid-70s. Yes, I started being a “groupie” while still in diapers (no, not Depends). What amazes me still is the obvious teamwork among band members and crew. Bruce can change an introduction, set list, or song on the fly by simply looking a certain way at Roy …
Read MoreSister Morphine
JOHN SHUFELDT, MD, JD, MBA, FACEP The hard core rockers amongst us know that Sister Morphine was written and recorded by Marianne Faithful while she was dating Mick Jagger during the time he and the Stones were recording Let it Bleed in 1969. Marianne’s version tanked early, but the song was later covered by the Stone and received more acclaim. Parenthetically, she did not receive credit until the Stones’ 1998 No Security album. The song …
Read MoreIt’s You
JOHN SHUFELDT, MD, JD, MBA, FACEP Maybe you read my columns in the two previous issues of JUCM and had a brief moment of self-awareness. Maybe one of your co-workers put them in your mailbox. Did you actually ask your co-workers and subordinates if you were the “cancer” I was talking about? They are not going to be honest. They care little about you and fear for their jobs, and so, are hardly going to …
Read MoreCuring ‘Cancer’
JOHN SHUFELDT, MD, JD, MBA, FACEP So you missed the “cancer.” Maybe you still don’t even know you missed it. At this point the patient (your business) is dying and you plod along unaware of the impending doom, like a smoker with a chronic cough. Your business is losing weight, its cheeks are sunken, skin sallow, as it grows weaker each passing month. One day soon it will start coughing up blood, and then it …
Read MoreMissing a ‘Cancer’
JOHN SHUFELDT, MD, JD, MBA, FACEP My worst fear: I miss a cancer. Of all things to miss, I worry about this the most. Miss a myocardial infarction, stroke, or appendicitis and you figure it out quickly because it smacks you right in the face. Conversely, cancer simmers along. A few months or even years go by and everything seems fine, then all hell breaks loose. The symptoms reach epic – if not life-threatening – …
Read MoreTo P.E. or not to P.E.
John Shufeldt, MD, JD, MBA, FACEP In last month’s column, I presented an overview of capital sources that can be used to fund your urgent care start-up or expansion. This month I will discuss the different sources of debt and equity capital. Much of the decision regarding which capital source is best for you is determined by your stage of development. For a startup, you will probably have to use traditional bank debt or raise …
Read MoreOverview of Urgent Care Financing
JOHN SHUFELDT, MD, JD, MBA, FACEP You’ve researched the industry, have a site picked out, and have a name reserved. Now comes the million dollar question. Wait, that is the question: Where do I get a million dollars to start an urgent care? Do you really need a million? My noncommittal “attorney answer” is: “possibly.” I have had friends lose a lot more than that before being forced to close the doors. That said, you …
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