Journal of Urgent Care Medicine

COVID-19: New Zealand’s Urgent Care Story

Stephen L. Adams, MBChB, FRNZCUC Like the rest of the world, New Zealand (and more particularly its healthcare system) has been changed, perhaps irrevocably, by COVID-19. Despite a relatively small direct effect on the population (0.06% infected, half of which were identified and isolated at border) with 0.0004% deaths1 (including one physician), the effects on primary care have been substantial. THE BEGINNING New Zealand clinicians were first notified of the Wuhan cluster in January 2020. …

Counterpoint: Readers React to JUCM Original Research

Andrew Grock, MD; Manuel Celedon, MD; and Jonie Hsiao, MD It was with great interest that we read Most Clinicians Are Still Not Comfortable Sending Chest Pain Patients Home with a Very Low Risk of 30-day Major Adverse Cardiac Event (MACE) by Dr. Michael Weinstock, et al in the February 2021 issue of JUCM.1 In this study, the authors surveyed attendants at an emergency medicine conference in 2018 as to their comfort level discharging patients …

An Ominous Trend For Urgent Care

To My Colleagues: I am writing to alert you to an ominous and pernicious trend in our industry that we must collectively address or we will face marginalization or even extinction in the years ahead. This may sound alarmist, but please hear me out. I opened my first clinic in 1987 when “urgent care” was barely a recognized term. I was there when the Urgent Care Association (at that time known as the Urgent Care …

Why is the Waiting Room Still Empty? Perspectives from a Pediatric Urgent Care Physician

In February 2020, the first U.S. case of community spread COVID-19 was identified at a pediatric urgent care center in Seattle, reinforcing the fact that UC is on the frontlines of healthcare. Between March and May 2020, the majority of healthcare services saw a significant downturn in volumes as patients quarantined and businesses shutdown. But as the number of domestic COVID-19 cases increased, many general urgent care centers saw unprecedented volume surges that continued throughout …

Pitfalls of Point of Care Ultrasound (POCUS)—A Perspective

Urgent message: Point-of-care ultrasound (POCUS) is well established as an imaging tool in the urgent care center. Although it is generally considered safe and easy to use, safety and hygiene considerations are frequently ignored—possibly leaving patients at risk for infection and excessive radiation exposure. Avijit Barai MBBS, MRCS, MSc, PgCertCPU, FRNZCUC; Martin Necas, MMedSonography, AMS, RDMS, MRT, RVT; and Bruce Lambie, MBBS, FACEM INTRODUCTION Point-of-care ultrasound (POCUS) is well established as an imaging tool in …

National Urgent Care Clinical Quality Metrics: ‘This is the Way’

Every system is perfectly designed to get the results it gets. This quotation, commonly attributed to Dr. W. Edwards Deming,1 has never been more relevant for urgent care (UC) than right now. Considered the original guru of quality improvement, Dr. Deming was explaining why systems must be redesigned if the desired outcomes are not being achieved. The existing “system” for measuring clinical quality in UC needs an overhaul. It is fragmented and underdeveloped, and lacks …

Making Antibiotic Resistance Awareness a Priority—A COVID-Created Opportunity

It’s a conversation I’ve had endless times. One that I’ve honed and refined stepwise over time, and one that my patients often tell me they hadn’t considered before: the appropriate use and overuse of antibiotics. And right now, with patients hyper-focused on healthy immune systems, medical providers are uniquely positioned to build antibiotic stewardship into our diagnostic process and significantly increase resistance awareness nationwide. Process and Priorities A year ago, my approach to sharing a …

Overcoming the Trauma of Making a Medical Error: Self-forgiveness is an Important Skill for Recovery

Have you ever made a mistake while practicing medicine that negatively affected somebody’s life? Even if you haven’t yet, you probably will if you practice long enough. Have you thought of how you will recover afterwards? Fatal errors can affect healthcare providers all through their career.1 Self-forgiveness after a medical error facilitates open mindedness, recovery from trauma, relief of mental and emotional anguish, re-engagement, growth, and regained appreciation for life.2 It is prudent for healthcare …

Finding Urgent Care (and the Value of Recognizing a Specialty)

I arrived in New Zealand 11 years ago, a doctor without direction and certainly with no inkling of urgent care. I was one of those doctors who had always hoped to find their ultimate career path whilst at university. Alas, whilst I was able to remove some options (here’s looking at you Ob/Gyn) no single specialty sufficiently inspired me to follow that rabbit hole through to its conclusion. So, my medical career began with an …

The Challenge of Inequity in Urgent Care Medicine: A Call to Action

Lindsey E. Fish, MD The young black couple walked into our urgent care clinic, eyes wide and filled with fear, hope, and expectation. Wrapped in her mother’s arms was their 3-day-old beautiful baby girl, a child born in the midst of two scourges—the COVID-19 pandemic that was sweeping our country and world, and the pandemic of racial inequity that was surfacing due to peaceful protests and violent riots occurring throughout our cities and rural communities …