A 28-Year-Old Boxer with Wrist Pain After a Bout

A 28-Year-Old Boxer with Wrist Pain After a Bout

The patient is a 28-year-old male with right wrist pain after a boxing match. He reports that he felt “a pop” and immediate pain along the ulnar aspect of his wrist after throwing a punch. He has no past medical history and takes no medications.               View the x-ray 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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Managing Concussions in Acute Care

Managing Concussions in Acute Care

Jordan Wackett MD, MPH, Joshua Kornegay, MD, Craig Rudy, MD The most recent recommendation from the Concussion in Sport Group calls for 24-48 hours of rest and a graded return to activity (unrestricted once asymptomatic)2. Unfortunately, asymptomatic from a concussion standpoint is not always obvious, which can make the new recommendation difficult to implement as patients may remain symptomatic while adhering to rest. Symptomatology is often multifactorial and they may be instructed to rest despite …

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A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis.               View the image taken and consider what your diagnosis and next steps …

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A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …

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New Technical Corrections Issued by the AMA Explained

On March 9, 2021, the American Medical Association updated the new evaluation and management (E/M) coding guidelines with technical corrections. These clarifications apply to the office visit codes 99202–99215 and are retroactive to January 1, 2021. In the past few months there has been industry confusion over whether a test can be counted under the data element for the E/M level when the practice is also billing for the test. The AMA has answered this …

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Do Respiratory Outpatient Clinics Decrease Bronchiolitis Reevaluation Rates? Observational Data from a Quality Improvement Project

Do Respiratory Outpatient Clinics Decrease Bronchiolitis Reevaluation Rates? Observational Data from a Quality Improvement Project

Urgent message: Establishing respiratory outpatient clinics has been shown to decrease reevaluation rates for patients with bronchiolitis, especially in children aged <12 months and/or those who receive suctioning during their initial urgent care encounter. Prema D. Souza, MD; Aimy Patel, MD; Brian Lee, PhD; and Amanda Nedved, MD Citation: Souza PD, Patel A, Lee B, Nedved A. Do Respiratory Outpatient Clinics Decrease Bronchiolitis Reevaluation Rates? Observational Data for a Quality Improvement Project. J Urgent Care …

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Seven Digital Marketing Tactics for Every Urgent Care Center

Seven Digital Marketing Tactics for Every Urgent Care Center

Urgent message: Urgent care operators are spending an increasing amount of their marketing budget on seven digital tactics. Fortunately for those working in healthcare, there will never be a shortage of patients. People will always come down with illnesses, and minor injuries won’t go away anytime soon. That being said, it can still be difficult to get people in the door of your specific urgent care center. Although it often gets neglected, proper marketing is …

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IgA Vasculitis in Children: Beyond the Rash

IgA Vasculitis in Children: Beyond the Rash

Urgent message: This is the urgent message about a truly urgent case presentation concerning a pediatric patient in an urgent care center. Diana Sofia Villacis Nunez, MD; Amit Thakral, MD, MBA; and Pareen Shah, MD CASE PRESENTATION A 12-year-old previously healthy female presents with a 5-day history of lower extremity rash and low-grade fever (100.6°F). A month earlier, she had a self-resolving viral upper respiratory infection. The rash is described as mildly pruritic, dark red …

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A Crisis of Trust

The conversation was going nowhere. After 15 minutes of explaining my concerns about the possibility of COVID-19, the lack of indication for antibiotics, the unreliability of rapid testing, I was no closer to satisfying my patient, Mrs. Fletcher, than when I first introduced myself. Joan Fletcher was a 40-something working mother of three who came to urgent care on a mission, as many patients do. The reason for her visit: an antibiotic prescription and a …

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