Slow Medicine: ‘Unprescribing’ America

#TimesUp; #NeverAgain; #Privacy; #OpioidCrisis; #BlackLivesMatter…. The last year has been a dramatic one for turning points in long-festering social issues. For decades, we turned our cultural cheek on problems we knew existed (misogyny and bias) or should have seen coming (opioids, mass killings and privacy). But in 2017 and into 2018 we are witnessing a tidal wave of resistance and public denunciations against the ugly side of American life. A collective enough is enough echoes across most every city and small town. We are exasperated, frustrated and increasingly skeptical of …
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Chasing Flu: Predictably Unpredictable

I have managed urgent cares for nearly 20 years and can officially say that predicting flu is for fools! Perhaps I should have known—after all, the CDC, WHO, ACIP and even Google all get it wrong, with spectacular consistency. Despite all the research, public and private money, and sophisticated analytics, we just can’t seem to find a way to predict the behavior of a fairly banal collection of viral RNA wrapped in a host membrane and coated with docking proteins. Perhaps Bezos and Musk will put humans on Mars before …
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The Change Gang: Adopting a Disruptive Culture

We’ve all heard it: Why do we have to change? This is the way we’ve always done things! Change is difficult, even for those of us who embrace it. But it is especially difficult for non-owner employees. After all, why welcome the discomfort and uncertainty of change if there is no upside to your personal bottom line? This is perhaps one of the biggest challenges we face as the urgent care industry matures and competition for a finite number of patients increases. If we don’t differentiate, we die. But getting …
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Hiring Right Requires the Right Approach

Employing an organizational psychologist or paying for expensive employee screening services is simply not in the cards for most urgent care centers. Yet, hiring “right” is perhaps the most important thing we do and the implications on our practices are considerable. Here are just a few of the areas most impacted by our talent acquisition success (or failure): Risk, quality, and liability Patient satisfaction Operations and work flow Culture Now let’s look a little more deeply at each. Risk, quality and liability: This is our core covenant with patients. We …
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Expectations Disease

There are a few things from residency training that resonated so profoundly for me that they permeate everything I have done since. I will never forget my first delivery, not because I thought I would ever deliver babies in my practice, but because of the emotional and enduring collision of medicine and nature it represented for me. And who can forget the 36-hour shifts (now extinct) that I am quick to recount for young clinicians with the perfunctory “back in my day….” There were, of course, specific patients whose stories …
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