Longitudinal Assessment: A Dent in the ABMS Armor?

With the volume of dissent against Maintenance of Certification (MOC) now at a fever pitch, American Board of Medical Specialties (ABMS) boards are finally making changes to their recertification programs with the intent of reducing the burden on physicians. The issue could not be more acute than in urgent care, where many UCA member physicians have been practicing for years. Working outside of their specialties of training and growing more distant from the best practice standards therein, recertification is an increasingly more difficult exercise. Additionally, the pressure for active board …
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Urgent Care and Antibiotics: Advancing Care and Stewardship

Antimicrobial stewardship is defined as a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. Stewardship initiatives in the hospital are paving the way for the rest of healthcare through education campaigns, monitoring, and restrictions. Outpatient practice is beginning to catch up as the stories of resistance grow and the lines between nosocomial and community-acquired infections blur. We all have a role to play in stewardship, and with education and careful communication, …
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Anger Management: Hostile Encounters in Urgent Care

Eliminating disruption, distraction, and dissatisfaction is paramount to delivering efficient and high-quality care these days. More than ever, urgent cares are competing to differentiate themselves by moving patients through the encounter faster and with a more reliably exceptional experience. We’ve adopted slick technologies and  reconfigured work flows to improve care delivery. So, why do our teams still struggle with consistency? Why do we still see high levels of burnout and turnover—and what can we do to stem the tide? Variance from standard practice is a well-known contributor to risk and …
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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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