Letter from the Editor-in-Chief

It’s tax time again and that got me thinking. And thinking got me angry. And angry got me belligerent. And belligerent got me nowhere. So, I went back to thinking about it, and here’s my take: Taxes are the contributions we make to society and the government so that it functions reasonably well, preserves our fragile democracy, and supports those who need our help. Yet, as a physician in a primary care specialty, like many of you, I can’t help but feel resentful this time of year. I’m “taxed out,”Read More
Clinical practice guidelines have been gaining interest, along with a little ire, over the last decade. Fueled by Medicare reform, the Affordable Care Act, Meaningful Use, and value-based reimbursement models, clinical practice guideline development has been envisioned as a critical way to achieve consistent care quality in a cost-effective and evidence-based way. This is nothing new of course. I remember memorizing the U.S. Preventive Services Task Force Screening Guidelines in residency in preparation for boards. I recall with fascination the lectures in medical school describing how screening guidelines are developed,Read More
Much has been written of late regarding physician burnout. And why not? The rates of burnout are astronomical and the consequences are scary. Consider these statistics: Medscape Physician Lifestyle Report 2015 notes that almost half of physicians report experiencing burnout. The Physicians Foundation’s 2014 Survey of America’s Physicians reveals that physicians are far more likely to burn out than professionals in any other line of work, and that only 40% of physicians over 46 years of age describe their professional morale to be even somewhat positive. By far, the mostRead More
Blowing bubbles is fun. As a kid, I marveled at the almost magical way bubbles rose through the air, powered by a mere puff from my lungs, on a seemingly endless journey upward. And then they popped, unable to withstand the laws of nature. Market bubbles behave similarly, rising with indifference to the laws of nature. And much like their soapy namesakes, market bubbles always pop, with the remnants of their inflated selves crashing down to earth, unable to avoid the powerful forces of market gravity. Behavioral economists blame groupthinkRead More
These are by far the most frequent questions I am asked by urgent care physicians: “My primary board certification is expiring. Do I have to recertify? Which of the urgent care boards should I take?” If you have been in urgent care practice long enough, you’ll come to a painful moment of truth: Our primary board certification is in a specialty we no longer practice, covering competencies we no longer use. To make matters worse, we have not stayed up to date with the latest guidelines affecting our original specialtyRead More
With this October issue, the editorial staff is very pleased to introduce JUCM CME, a convenient and cost-effective way to meet your annual continuing medical education (CME) requirements while reading the only peer-reviewed journal about urgent care. For over 10 years JUCM, the Journal of Urgent Care Medicine, has been a reliable source for the latest and most relevant clinical and practice-management guidance in the industry. Our cover-to-cover readership regularly exceeds the benchmarks for other journals, and that reflects your desire for professional development and the quality of our journal.Read More
After years of lax oversight and insufficient skepticism from physicians, the United States is in an undeniable opioid epidemic, triggering seismic reforms and a regulatory frenzy. The scope of the problem is indeed staggering: Every 18 minutes, someone dies of opioid overdose, and half of those deaths involve prescription pills. Oversupply and ease of access have been identified as the main culprits, and much of the prevention strategy revolves around physician prescribing. New guidelines have been advocated that limit the indications for narcotic analgesics. Prescription drug databases are now operatingRead More
In my last column, I presented ways that urgent care medicine can mature as a discipline and a health-care service. I discussed opportunities for expanding our value in a changing system. This month I suggest that one such opportunity, already in the pipeline, could dynamically augment urgent care’s role in what many consider to be the number one public health crisis: type 2 diabetes. The annual incidence of prediabetes and diabetes in U.S. adults is nearly 50%, according to a study reported1 in JAMA. The World Health Organization, the AmericanRead More