Practice Management
The patient is a 36-year-old male who presents with left hip pain for “years.” The pain is motion- or position-related and over time there has been occasional pain in his buttock, back, and thigh. Additionally, he has stiffness, clicking, locking, and catching. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: Urgent care providers need to be vigilant for more than acute coronary syndrome, pulmonary embolism, and thoracic aortic dissection when patients present with chest pain—such as this 20-year-old who developed pneumomediastinum while smoking marijuana. Xiangyang Jiao, MD Case Presentation A 20-year-old female presented to urgent care for pleuritic chest pain and shortness of breath for about 2 hours. The chest pain was located in the upper and mid chest, was dull, pressure like, …
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In the article Your Best Investment Is Growing Your Own Business (page 25), Alan A. Ayers, MBA, MAcc makes the case that this could be an ideal time for urgent care operators to bet on their own future growth and success by investing back into their business. For one thing, the COVID-19 pandemic appears to be winding down in the U.S., with our industry having made tremendous progress in earning what Urgent Care Association CEO …
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Urgent message: Musculoskeletal pain is a common urgent care complaint, with x-rays very commonly ordered. However, a “normal” image does not necessarily support eliminating what could be a serious injury from the differential diagnosis. Arun Sayal, MD, CCFP(EM) Citation: Sayal A. When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging. J Urgent Care Med. 2022;16(7):13-16. Medical tests lie. Not intentionally, of course, but their result may not align with reality. A test may …
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Pediatric Pneumonia Signs and Symptoms of Cauda Equina Syndrome Removing ‘Stuck’ Rings Central vs Peripheral Acute Vertigo Zinc and Viral RTIs in Adults Nathan M. Finnerty, MD, FACEP; Joshua W. Russell, MD, MSc, FAAEM, FACEP; and Brett C. Ebeling, MD How Long Should Pediatric Pneumonia Be Treated? Take-home point: Lower-dose and shorter-duration amoxicillin treatment was noninferior to standard regimens for outpatient treatment of community-acquired pneumonia (CAP) in this trial. Citation: Bielicki JA, Stӧhr W, Barratt …
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KEY QUESTIONS What phenomenon explains the ST elevations in this ECG? What are the features of this condition? What is the clinical significance of this phenomenon?
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The patient is a 27-year-old man who complains of severe ankle pain and immobility after stumbling while on a hike. He fell approximately 1 foot onto a rock, landing with his foot in a forced flexion position. View the image taken and consider your next steps, along with possible diagnoses.
Read MoreThe Protecting Medicare and American Farmers from Sequester Cuts Act was signed into law on December 10, 2021. This law addresses the reduction in the 2022 Conversion Factor set by the Physician Final Rule, as reported in my December column, increasing the 2022 Conversion Factor by 3%. The new conversion factor becomes $34.61 compared to $34.89 in 2021. With the increase in Relative Value Units on most E/M codes, the impact to 2022 rates becomes …
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Sal D’Allura, DO, FAAFP “It’s lonely being the defendant in a medical malpractice case.” Truer words were never spoken. At some point in our careers, the majority of us will be named in a medical negligence case. The unfortunate reality is that medicolegal issues will arise as a part of our professional lives along with a multitude of negative emotions (which inevitably spill over into our personal lives) when we stand accused. These negative feelings, …
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Urgent message: The depth of COVID-19 testing data specific to the pediatric urgent care market provides insights into the capability of the broader urgent care industry to play a significant role in public health in the United States. David J. Mathison, MD, MBA It’s easy to forget how 24 months ago the urgent care industry was amidst one of the worst influenza seasons in recent memory. Then in February 2020, the first cases of COVID-19 …
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