Hey, Mr. Tax Man!

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 …

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Clinical Practice Guidelines: Holy Grail or Holy %&$#[email protected]?

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. …

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How to Avoid Burnout? The Answer Is in the Exam Room

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 …

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Bubble, Bubble, Toil and Trouble?

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 …

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Maintenance of Certification: The Odyssey Continues

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, …

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Introducing JUCM CME

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 …

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There Ain’t No Shame in Pain

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 …

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Urgent Care 2.0: A Paradigm Shift?

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 …

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The Secret of Success: Caring Is Believing

Dr. James Gore, an old friend and an urgent care pioneer, shared those words of wisdom with me during a recent conversation. We were discussing the current state of health care and the challenges we face in urgent care with the rabid market activity we are seeing. We chatted a bit about the new faces and the outside interests entering the industry, and we laughed about all the mistakes being made by people looking for …

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Time for Urgent Care to Grow Up

I never thought I’d quote the rap artist Kamari aka Lyrikal, but I was drawn to his words of wisdom while preparing for this column: “The hardest part about growing up is letting go of what you were used to, and moving on with something you’re not.” As the “children” of urgent care, we have seen an adventurous and revolutionary spirit create an industry and discipline from scratch. We cared about things our “parents” dismissed …

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