LocumLife - August 2008 - (Page 20)

rgent Care board-certified in family practice or emergency medicine, or double-boarded in internal medicine and pediatrics,” explains Ms. Kloehn.“A certain comfort level in treating both children and adults is necessary because these centers see the whole spectrum of the population. Furthermore, you need to have your BLS (Basic Life Support), ACLS (Advanced Cardiac Life Support), and PALS (Pediatric Advanced Life Support) certifications. Though it may not be required, having your ATLS (Advanced Trauma Life Support) can also be beneficial. A person may walk through the door who should have gone to the emergency room, in which case, you would potentially need to handle a life-threatening situation.” PERSONALIZED CARE Kevin Bowers, DO, took his first urgent care opportunity in June 2007, and has been providing locum tenens services full-time ever since. “Prior to this, I practiced emergency medicine in a multi-clinician group that contracted with hospitals,” says Dr. Bowers, who has 7 years experience in emergency medicine and critical care, and 2 years in urgent care. “Now, I can be involved in other pursuits, both in Locum tenens professionals fill the gap and outside of medicine. Basically, I try to keep things varied, which is why I like this lifestyle.” Currently, Dr. Bowers is fulfilling an ongoing contract arranged by Suwanee, Georgia-based Harris Medical Associates.“I provide services for an urgent care group in the Midwest that owns nine facilities,” he explains.“They are stand-alone clinics accepting patients on a walk-in basis, and I am usually the only physician. Double shifts last from 8:30 a.m. until 10:00 p.m., and single shifts begin with the changeover at 3:30 p.m. On a double shift during the winter cold and flu season, I have seen as many as 117 patients in a day. Right now, during summer, the patient load is somewhat less. You may see 70 patients during a double shift, and 35 to 40 patients during a single shift. At this time of year, I see a lot of lacerations, bumps and bruises, contusions, fractures, and possible concussions.” Dr. Bowers notes the universal benefits of this specialty. “Urgent care fulfills a large need and fits all players—the insurers, the patients, and emergency departments, which are stressed out trying to handle these cases that need to be seen, but do not qualify as high morbidity. People choosing urgent care will not only have reduced wait times, but also lower costs, which is especially important for uninsured patients. Individuals trying to see a family doctor will also wait longer and not have the expanded treatment options.” What challenges do urgent care physicians face? “Follow-up care can often be difficult,” explains Dr. Bowers.“If you are seeing a patient with blood pressure or cardiac problems on a Friday night, you know she won’t be able to see her regular provider until Monday. Ask yourself what you would want if this were your wife or child. Often, you have to err on the side of caution and refer the patient to the ED for what is most likely a non-threatening condition, but possibly a life-threatening condition.” Dr. Bowers also emphasizes the need to know your limits. “The drawbacks of urgent care are patient load and the concern about what you can and cannot do, with regard to your assistants, their training level, your equipment, and what you have available,” he states. “There is a baseline level of training you need, so you have to know how good you are and when to refer. For example, if you are a resident taking a moonlighting opportunity, you will likely need to refer out frequently. If you have been doing emergency medicine or family practice for 20 years, then you will have that level of comfort and can work accordingly.” He continues, “It can also be a challenge to see patients as fast as you can while still providing www.LocumLife.com A Primer raditionally considered a sub-specialty of emergency medicine by the American Medical Association, urgent care has made inroads into the mainstream. Established in 1997, the American Academy of Urgent Care Medicine has set standards, provided continuing medical education, and worked with AMA and other groups to promote recognition and professional development.To this end, the Academy has been successful in establishing urgent care medicine as a selfdesignated/practice specialty code by the AMA and has partnered with Ohio State University to launch the second urgent care medicine advanced training program in the U.S. Two other fellowships—University Hospitals Medical Practices Program in Cleveland, Ohio, and, more recently, University of Illinois College of Medicine Program in Rockford, Illinois—have been developed in partnership with the Urgent Care Association of America. In addition, a growing number of physicians are applying for certification in urgent care/ambulatory medicine through the American Board of Urgent Care Medicine. Since the Board’s inception 9 years ago, more than 1,000 physicians have become certified. T 20 LocumLife AUGUST 2008 http://www.LocumLife.com

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LocumLife - August 2008

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