JOHN SHUFELDT, MD, JD, MBA, FACEP It’s nearly midnight on Saturday and I am between patients in an ED on an unseasonably cold November evening in Phoenix, Arizona. Among the head bleeds, overdoses, MI’s, and strokes, I have had these chief complaints thrown at me: “Smoke inhalation after blowing out a candle” “I can’t stop playing with my number one.” “I’m here for my 40-year-old physical.” (The patient was 43.) “I fell asleep at a …
Read MoreAequanimitas*
“Thou must be like a promontory of the sea, against which, though the waves beat continually, yet it both itself stands, and about it are those swelling waves stilled and quieted.” —Marcus Aurelius It is important to reflect occasionally on where one’s path began inasmuch as we owe a debt to those who have advanced our current purpose, whether family, business, or profession. The goal of this reflection should hopefully include an appreciation of …
Read MoreSelling Your Urgent Care? Here’s What’s Involved
JOHN SHUFELDT, MD, JD, MBA, FACEP A large urgent care group has just offered to buy your centers. So now what? First, get some advice. This process is incredibly time-consuming inasmuch as the amount of material and the degree of detailed information required before a sale is consummated is daunting. Also, the way you position and promote your center and the thoroughness of your disclosures will speak volumes about your abilities and will ultimately be …
Read MoreAre Urgent Cares Liable?
JOHN SHUFELDT, MD, JD, MBA, FACEP Full disclosure: I was not always the smooth, confident provider I hope I am today. No, there was a time when I would say or do things while practicing medicine that would shine a bright light upon my medical inexperience, naiveté, or general ignorance. To wit, the emergency medicine residents where I trained were pressed into servitude twice yearly to go out to the local high schools and perform …
Read MoreHow to Get Sued for Malpractice: Four Studies In Self-Destruction
JOHN SHUFELDT, MD, JD, MBA, FACEP In the past, I have written about how to avoid getting named in a medical malpractice action. But it can often be instructive to view things from the opposite perspective. So this time, let’s turn it around and actually try to get named in a malpractice suit. It usually only takes one of the following misadventures: Practice bad medicine and have a bad outcome Practice good medicine, communicate/document poorly, …
Read MoreEvery Man His Own Doctor
JOHN SHUFELDT, MD, JD, MBA, FACEP While treating patients in the emergency department, I occasionally marvel at the changes I have witnessed over my 25 years in medicine. Sometimes I think, “Thank God I did not treat you 25 years ago, because if I had, I would have done (fill in the blank), it would not have worked, and you would have probably hated every second of it.” I am as old as Moses, so …
Read MoreMalpractice Insurance: A Primer for Urgent Care Clinicians
JOHN SHUFELDT, MD, JD, MBA, FACEP The possibility of being sued for medical malpractice, while not a pleasant prospect, is not something that should be causing you sleepless nights. Much like flood insurance, malpractice insurance exists for times when an unexpected event occurs and may require some payment for damages. Your goal should simply be to have adequate coverage for those times. And, let’s face it, there may be such times. Good providers do get …
Read MoreThe Unsociable Network
JOHN SHUFELDT, MD, JD, MBA, FACEP I work with a non-physician professional in the emergency department. She is very intelligent, practical, and always helpful. There is only one small issue: many of her posts on her Facebook page are overtly anti-patient. She frequently rants about the stupid patients, how “bad” the clientele we treat act and how, ultimately, they get what they deserve. Despite her obvious intelligence, she has not realized that what she posts …
Read MoreAccountable Care Organizations, Where do Urgent Care Centers Fit?
JOHN SHUFELDT, MD, JD, MBA, FACEP Under the Affordable Care Act, the Centers for Medicare and Medicaid Services will pioneer a number of new projects which affect the delivery of healthcare in the United States. Among these projects, the most ambitious is the proliferation of the Accountable Care Organizations (ACOs). Other initiatives include pay-for-performance (P4P) and quality improvement agendas proffered by organizations responsible for accreditation, all focusing on clinical delivery pathways or “care paths.” The …
Read MoreLike Super Good Written, Verbal and Non-verbal Communication and Stuff
JOHN SHUFELDT, MD, JD, MBA, FACEP I will begin this short essay by admitting that I am not always the best or most appropriate in terms of my style or manner of communication, which is no news to my two relatives who make up half the readership of these articles. I have also learned over the years to take most things with a grain of salt (particularly if it is followed by a shot of …
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