Journal of Urgent Care Medicine

What can YOU do for YOU?

I know this may sound like a funny way to start a column. It’s a bit confrontational perhaps, maybe even a little insulting. Why is this guy calling me out on the carpet here? What did I ever do to him? I have been involved in organized medicine for almost 10 years, at varying levels of responsibility. If I learned one thing alone the way, it is this: If you want id one, you better …

H1N1: The Sequel

Unless you have spent the entire summer on Gilligan’s Island, I assume everyone remains attuned to the daily reports on H1N1 streaming from every which way but loose. While the prevailing opinion is that the flu season will be Superbad, it remains difficult to predict how things will play out. We will be dedicating the October issue of JUCM to pandemic flu planning, though given the likelihood of an early spike of flu, there are …

‘What to Expect When You’re Expecting’: The Birth of a Public Health Plan

With healthcare reform imminent, the question on everyone’s mind is: “How will this impact me?” While there is almost universal support for reform – what you might call the why of a healthcare fix – there is considerable disagreement about the how, when, who, and where. While the details of reform may change a bit over the next several months, there are a few things we should consider invariable: The Democrats’ solid control of the …

Of Swine Flu, ‘Chicken Little,’ and the Great Depression

History teaches us so many lessons, most of which we quickly forget until the next history-making crisis. Nothing in history is a more predictable crisis producer than “fear.” Fear sows panic, panic sows irrational behavior, and irrational behavior sows wars, economic disasters, bigotry, and protectionism. When the dust settles, we analyze our missteps and, often, recognize most of the fallout could have been avoided had we learned from history. The Great Depression was a real …

The Art of Conflict Management

Urgent care centers are fertile ground for angry patients. Our patients are often sick and in pain, they often have long waits to be seen, and they are frustrated by an inefficient healthcare system that has landed them in urgent care in the first place. Additionally, most of our patients are starting a new relationship with us, and they have not yet built any trust. Their prior healthcare experiences are most often lousy at best, …

The Responsibility of Torch Bearing

It is a time-honored Olympic tradition: passing the torch around the world from one runner to another, until it reaches the Olympic venue and lights the Olympic flame that burns for the duration of the games. It is a real privilege to carry the torch, and only a select few can be chosen for the honor. Each runner has a few simple tasks: run a few miles with the torch, try not to stumble, avoid …

Urgent Care Without a Paddle

Economy getting you down. Feeling like you’re up the veritable creek. Whether you’re an owner, manager, or practitioner, if you’re not feeling the heat, you should be. That’s not to say you should get out of the kitchen; just be a better chef. There has never been a crisis in history that did not create great opportunity for those who know how to find it. During a crisis of any kind, two classes of people …

The Only Constant is Change

As I contemplate my own professional transition, from an academic mega-hospital to a private urgent care venture, I have been through the usual rollercoaster of emotions that accompany any major life changes: Stress (physical, mental, and emotional): Change requires simultaneously managing the process you are changing from and the process you are changing to. That’s double the work. In a complex profession like ours, I think everyone will agree there’s enough stress managing just one. …

Crisis in the ER: Quantifying the Impact of Urgent Care

Much has been written lately on the growing crisis in emergency services: diversions, overcrowding, uncompensated care, lack of hospital beds, and the high cost of care in emergency department settings. Much has also been written of late about the growing crisis in primary care: poor reimbursement, declining numbers of primary care physicians and trainees, and declining access to primary care as a result. This has caused increased wait times and limited same-day availability. All of …

A Defense of Family Medicine or an Indictment of Emergency Medicine?

I expected a firm retort from our colleagues in academic and traditional family medicine with regard to my column Is Urgent Care “Real” Family Medicine? (JUCM, October 2008). Unexpectedly, however, the column brought concern from one of our urgent care colleagues with roots in emergency medicine. In his letter—excerpts from which are presented here—Dr. Bryan Dunn of Boerne/Bulverde Urgent Care in Texas writes: “Your editorial came across as a slap in the face to emergency …