The roots of urgent care trace back to the industrial clinics of the early 20th century designed to treat injured workers quickly and minimize downtime. The urgent care model re-emerged in the 1970s as a response to overcrowded emergency departments and the inability of primary care offices to handle acute, non-life-threatening issues such as walk-ins or after-hours care. Initially met with skepticism and branded by many as "doc-in-a-box,” today urgent care is a $50 billion industry in the U.S. with more than 11,000 centers nationwide. Urgent care is the go-to for routine needs as 45% of young adults lack a primary care provider (PCP). Urgent care may be a better option than the emergency room, but is it better than primary care if primary care was revitalized? We examine that question and more on this episode.

Most rashes are benign. If they are viral, they resolve spontaneously, and if they are bacterial they may require antibiotics. However, some rashes have been more elusive to understand and treat. These more chronic skin rashes are long-lasting, often inflammatory disorders requiring ongoing management to control symptoms like itching, redness, and pain. Common types include eczema, psoriasis, acne, and rosacea. Their underlying cause is complex, driven by autoimmune responses, genetics, and environmental triggers. These conditions significantly impact quality of life, necessitating personalized, long-term treatment.

Cataracts, which are the age-related changes of the eye’s natural lens, are the leading cause of reversible blindness worldwide and among older adults in the U.S. As proteins in the lens break down over time, they cause the lens to be less transparent and less able to change its shape. The lens can’t contract into a ball for near vision or flatten for distant; images become cloudy, blurry, less bright, and less colorful. Untreated advanced cataracts can lead to total blindness, which amazingly can still be reversed with surgery. Current estimates are that four million cataract surgeries are performed annually in the U.S., and the surgery is considered the safest invasive procedure done on humans. On this episode, we'll take a deep dive into the most common surgery performed in the U.S. today.

The US rural healthcare crisis is a quiet emergency affecting roughly 60 million people — one-fifth of the population — who face higher mortality rates, systemic hospital closures, and severe specialist shortage. Over 700 rural hospitals (roughly 30% of the national total) are currently at risk of closing due to financial shortfalls. Since 2005, more than 190 rural hospitals have closed while another 25% have closed their maternity wards. While 20% of Americans live in rural areas, only 10% of US physicians practice there. Rural residents face higher rates of premature death from heart disease, cancer, and stroke compared to their urban counterparts. Suicide rates are significantly higher in rural areas, particularly among adult men and children. While only one-third of motor vehicle accidents occur in rural areas, they account for two-thirds of all accident-related deaths. This episode explores the rural healthcare crisis.

The facts are staggering. Lung cancer remains the number one cancer killer of both men and women. 230,000 new lung cancer diagnoses are expected in the US this year. The average annual cost of treating advanced or metastatic lung cancer is astronomical, often exceeding $200,000 per year. Lung cancer screening with low-dose CT scans is severely underused in the U.S. with less than 20% of the millions of eligible high-risk former and current smokers getting tested. Lung cancer screening works. It’s safe and effective. It saves lives. It saves healthcare dollars as the cost of treating advanced cancer continues to skyrocket. On this episode, we'll try to understand how to increase use of this inexpensive test that can save more lives and money than any other in healthcare.

One hundred years ago, medical researchers noted that upper-body obesity was associated with high blood sugar (diabetes), high blood pressure (hypertension), and hardening of the arteries (atherosclerosis.) Fifty years later the term "metabolic syndrome" was coined. In 1988, a prominent researcher introduced Syndrome X, in which he claimed that the underlying problem with obese, diabetic, hypertensive patients with heart disease was related to the body becoming unresponsive or resistant to the effects of their own insulin. The X was used to highlight insulin resistance was then a medical mystery. Today, we've come to understand insulin resistance as the underlying mechanism causing type 2 diabetes, obesity being its primary cause.

The American healthcare system is in crisis characterized by high and rising costs, fragmentation, poor access to care, administrative complexity, and workforce shortages. Costs are passed on via ever rising premiums, deductibles, and out-of-pocket expenses for insured individuals. Meanwhile, factors like administrative burden, a fee-for-service model, and limited access to primary care contribute to widespread medical debt and a fear of financial ruin for many who are underinsured or uninsured. Our once admired healthcare system is failing despite the U.S. spending much more per capita on healthcare than other wealthy nations. On this episode, we see how all this is affecting people personally.

Among the many reasons I chose the specialty of medical oncology is that cancer can present anywhere in the body, manifest any symptom, affect anyone, and its clinical course often presents conundrums for our inner Sherlock Holmes or Dr. House. “The Weekly Check-Up” radio show launched the year I retired from my clinical practice. I didn't realize how important a role it would play in my continued sanity as I navigated the next phase of my professional career. Like my cancer practice, “The Weekly Check-Up” callers cover the entirety of human anatomy and physiology, and there is always a puzzle to solve. This episode features a diverse set of topics that keep the radio show and these podcasts both entertaining and informative. - Dr. Bruce Feinberg, host of “The Weekly Check-Up Podcast.”