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Joseph Toscano, MD, on the Role of Urgent Care Medicine in Covid-19 Testing

Joseph Toscano, MDInitially, like everyone else in medicine and business, urgent care operators and clinicians were very uncertain as to how to operate with this new infectious disease, Covid-19, in the mix. How would we treat our usual patients? How would we evaluate patients for Covid? How would we protect staff? Would there be enough PPE (personal protective equipment)? In essence, we innovated—developing processes for patient screenings prior to visits using AI (artificial intelligence) and telemedicine triage, opening tents for testing and patient care, providing separate care locations to limit contagion, and sourcing and preserving PPE in new ways. As an essential part of the healthcare system, urgent care centers (UCCs) are now providing safe testing and further evaluation for sicker Covid patients.

While most hospital emergency patient volumes are about 20% to 30% lower than usual, UCCs are bursting at the seams, with the usual complement of patients, as well as patients who want or need Covid-19 testing. UCCs have not only filled a testing void, but they have also figured out how to safely see all their usual patients.

Testing at UCCs offers patients the benefit of expanded health care. So, if someone who needs to be tested exhibits symptoms that require medical evaluation, a UCC is preferable to a testing center, where the only capability is to obtain and send a specimen for testing. At a UCC, there are clinicians available to evaluate patients for complications of Covid, such as low oxygen levels, dehydration, pneumonia, and cardiac diseases. Another major benefit is that some UCCs offer rapid testing, an option that seems to be less available at places that offer testing alone and have no health care professionals available to discuss test results and their implications with patients.

Will the Pandemic Change Urgent Care Centers?

The Covid-19 pandemic has affected the entire healthcare system, from patients and healthcare operations to protective measures and finances. Lessons learned will shape our response to any new emerging disease. We will simply be more prepared. Many healthcare professionals think that we should be and have been just as careful, in terms of contagion-limiting processes, with seasonal flu or any infectious illness. Much of our response in the past has been reactive—as with Ebola, for example. Hopefully, the current processes and innovations take hold even as the health risks of Covid-19 have been resolved.

Joseph Toscano, MD, a leader in urgent care medicine, is a Diplomate of the American Board of Physician Specialties® (ABPS).

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Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine
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