I got my first guitar when I was 14. It was an Alvarez acoustic with an electric pick-up, and I played it every day—at least for a while. I thought it would make me cool and make the girls take notice. But after about a year, when neither of those things had happened, I just about gave up the guitar for good. There simply wasn’t much joy in always playing alone. What revived and has sustained my interest was joining some of my high school friends and forming a band.

This awkwardly revealing story about my adolescence illustrates an important aspect of our biology. We are built to connect and collaborate. There is an intangible power in the chemistry of gathering together and interacting in real time, like playing in a band. That’s why “Getting the Band Back Together” was the perfect theme and metaphor for the UCA Annual Convention this May; it was the UCA’s first in-person gathering in over 3 years. And it was clear we all needed it.

I think one of the most pernicious lies we told ourselves during the lockdown days of the early pandemic was that virtual conferences were a suitable surrogate for meeting in-person. I confess I subconsciously bought into this belief as well; it was easier than despairing over the “new normal” we found ourselves perpetually stuck in. I even went so far as to revel in the money I’d save by doing my CME virtually: no hotels, flights, or car rentals. I convinced myself it was actually a win. However, while attending the conference, I was disabused of that flawed notion on day one.

There are moments of inspiration and collaboration only accessible through gathering in real life. Until very recently in human history, in fact, this is the only way that simultaneous interaction was even possible. While it can be helpful for our safety (like during a pandemic, for example), overreliance on virtual community ultimately detracts from our collective progress and well-being.

To be certain, it’s not all bad that we’ve fumbled through the process of “leveraging” technology to make remote meeting possible. It does solve certain problems. Researchers can now advance medical science through multicenter randomized controlled trials across continents. Patients with limited mobility or who live in extremely rural areas can now easily access healthcare services from their own homes when previously tremendous efforts were required to seek care.

These uses of technology are much better than nothing, but a surrogate for face-to-face human interaction they are not.

Meandering through the exhibition spaces and lecture halls of Caesar’s Palace, I was struck with a profound realization that I never experienced during any of the virtual urgent care conferences: feeling as though I’m part of a community—the urgent care community. On a cognitive level, the “we are in this together” reality in the face of COVID was something I understood to be true in my prefrontal cortex, however; I hadn’t felt it to be true until the symposium.

This sense of isolation is exacerbated because the default state of UC is fairly fragmented. We all practice in a siloed fashion within our centers. We may be members of listservs, Facebook groups, and WhatsApp group texts, but these don’t provide true community. These are seldom the venues where brainstorming breakthroughs or effective networking take place. Rather, they are technological solutions for highly practical discourse. We can ask very specific questions (eg, Do we still have lidocaine with epi?) and get rapid responses (eg, Yeah. Bottom shelf in the med room). While effective, it is highly impersonal and about as intimate Morse code. The camaraderie afforded through live gathering has always been irreplaceable. I’d just forgotten how it felt.

Moreover, it was surprising how much more impactful it was when seeing the hundreds of faces of members of my community surrounding me rather than looking at an equally long list of webinar attendees. It was a highly visible representation of how UC and the involvement of members of the community has grown over recent years. The first UCA (UCAOA, at the time) meeting was held in 2005 and about 200 people attended. The conference in Vegas this May was the largest ever, with attendance exceeding a thousand for the first time. I put faces to names of people who I had collaborated with (nominally) for years. On several of these occasions, we accomplished more in envisioning and planning our mutual future efforts during a 10-minute conversation than we had over years of emailing back-and-forth.

Conversely, seeing the group’s membership splayed out before me in this fashion, I also realized that while we’ve come quite far as a community, we still have tremendous unrealized potential. The UCA’s membership has grown exponentially, but there are nearly 14,000 UC centers in the U.S. alone and tens of thousands of UC clinicians worldwide. The attendance represents a relatively small fraction of the global UC community when considered in these terms.

It’s almost as though we have reached the halfway point of a marathon. We’ve come so far and yet we have so far left to go. Both perspectives are simultaneously true, and we should be mindful of which one we put our focus on day-to-day. If you’re among those discouraged that UC still has not received its due respect as a distinct specialty or a site where high-quality, cost-effective care is rendered, it’d be wise to remind yourself of just how much progress we’ve made. If you’re among those motivated by the vision of everything that UC could be, turn your attention on the road ahead. And when your mood changes, try the other point-of-view.

For many of you, however, it’s likely that neither of these perspectives describes your mindset as it relates to UC. Clearly, based on UCA membership and attendance at national conferences, it seems most common that UC providers see themselves first and foremost as clinicians: people who show up to their shifts, see patients, go home, and repeat. And there’s certainly nothing wrong with faithfully working your schedule and leaving thoughts of urgent care at work. Perhaps you value other pursuits or don’t find working in UC to be an important part of your identity. Or, perhaps, working within organizations towards bigger goals in the past, you’ve burned yourself out by overcommitting to various task forces and committees. There’s an overabundance of clinical shifts that need coverage and UC wouldn’t function without our clinicians.

There is another group, however, I’d like to draw attention to: those of you who are still playing guitar alone and who’ve never before tried joining with the band. Playing guitar alone as a hobby was boring to me, but playing the guitar alone for a job, 40+ hours/week, would have been soul crushing. That’s what it often can feel like clocking in-and-out, shift after shift, without an experience of community. We are predisposed to isolation simply by virtue of working in UC, but humans were built to play together. There’s low-hanging joy waiting to be found when we meet and discover common ground and unified purpose. So, if you find yourself languishing or burnt out (as so many of us do right now), the antidote may very well lie in running towards the UC community rather than backing away from it. We’ve come a long way, but we also have far to go, so we need all the help we can get. Plus, the more of us playing together, the better the harmony.

Playing in the Band
Joshua Russell, MD

Joshua Russell, MD, MSc, FAAEM, FACEP

Quality and Provider Education, Legacy - GoHealth Urgent Care, is affiliated with the University of Chicago Medical Center in Vancouver, WA, and is Editor-in-Chief of JUCM.
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