Practice Management
Countless times over the last year I have heard variations on a “we can’t” theme. It’s a specific and focused “we can’t” related to the services we are not able to provide to our urgent care patients. “We can’t do that test.” “We can’t use that medication in clinic.” “We can’t have our medical assistants do that.” Sadly, it is purely a reflection of education and training. However, as opposed to responding with increased training …
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It is an absolute honor and pleasure to serve as the new Editor In Chief of The Journal of Urgent Care Medicine (JUCM). To begin, I want to thank Joshua Russell, MD, for his incredible work with the journal over the last 5 years. His effort, dedication, and endless hard work have forever changed the direction of JUCM and shaped its future. It is my sincere hope to continue his impactful work by publishing meaningful …
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At least once a month, a friend or family member will text me—often for the first time in years—to share the summary of a recent visit to their local urgent care (UC). While these texts are universally unsolicited, I genuinely love receiving them. The unfiltered perspective cannot be matched by even the most sophisticated electronic medical record analytics or patient experience reports. This is because the stories they share with me, while anecdotal, provide a …
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In a prior editorial, I described the case of Thomas, a young man among the “worried-well,” who presented to urgent care (UC) with anxiety related to an alarm that sounded as a result of a malfunction of a continuous glucose monitor (CGM), which was prescribed despite his lack of a diagnosis of diabetes, out of concern for abnormal blood glucose levels.[1] The underlying issue prompting his visit was not hypoglycemia but what I refer to …
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“Low blood sugar” was his chief complaint, but Thomas was in my urgent care (UC) mostly because he was feeling anxious. It wasn’t hypoglycemia that was making him nervous either. Thomas didn’t have diabetes or take any medication for high blood sugar. Regardless, he was wearing a continuous glucose monitor (CGM), which he lifted his shirt to show me when I entered the room. Thomas explained his primary care physician (PCP) had prescribed the device …
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“Do as little as necessary, not as much as possible.” This is the mantra I recite throughout every urgent care shift without fail—that’s how mantras work after all. Hearing the word “mantra” might conjure images of a placid-faced yogi seated in the lotus position for some, but a mantra needn’t serve only spiritual practice. A well-conceived mantra can also prove useful when deployed in any context where we might benefit from being reminded frequently to …
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Recently one evening, I meandered into a bar on iconic 6th Street in Austin, Texas— America’s epicenter for live music. Venues throughout the district feature free, live performances every night from some of the nation’s most talented musicians. On that particular evening, however, the sounds from one electric guitar coming from a small stage in a dark room cut through the humid air and grabbed my attention. I wandered in, found a seat at the …
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Joshua Russell, MD, MSc, FACEP, FCUCM “It only hurts right here,” Rich told me, pointing to a tender spot on his ribs under near his arm pit. I palpated his chest wall and observed as he winced when I hit the spot. “I just need to make sure I’m okay to go back to work.” Rich was middle-aged and had a mustache with hints of grey. He was a large man, but his potbelly was …
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Joshua Russell, MD, MSc, FCUCM, FACEP Who among us has worked a single urgent care (UC) shift without at least one patient making a humble request for a sick note to take back to work? “Can I have a work note?” It’s a simple ask. In fact, apart from medication refills, work note visits rank among the most welcomed presentations for many overworked clinicians, offering a much-needed mental reprieve and a chance to finally catch up …
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Joshua Russell, MD, MSc, FCUCM, FACEP In its most modern form, medicine revolves around action. We are trained as clinicians to assess, diagnose, and intervene, but it’s the intervention part that patients expect most. This is especially true in urgent care (UC), where patients usually present in anticipation of some swift action for whatever is bothering them. I recently saw a healthy, middle-aged man in our clinic who was complaining of some mild chest pain. …
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