Practice Management
A 29-year-old man presents to urgent care on a Saturday with pain in his left foot after playing tennis. A series of x-rays is ordered. Review the images below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Differential Diagnosis Diagnosis The correct diagnosis is an avulsion fracture of the base of the 5th metatarsal. The x-ray shows transverse lucency at the base of …
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A 27-year-old female with history of asthma presents to urgent care on a Friday morning with dyspnea for 1 day. She denies palpitations, syncope, or chest pain. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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By comparing 2022 and 2024 hourly compensation data from the Urgent Care Association (UCA) Clinician Compensation Benchmarking Report, data shows that there has been a 15% increase in nurse practitioner (NP) and physician assistant (PA) pay. Meanwhile, there was an average 19% increase in physician (MD and DO) pay.1 In 2024, the median reported hourly base compensation (excluding bonuses and incentives) showed an increase compared to 2022 rates across all clinician types. This rise likely …
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I hope you have had a wonderful holiday season and that your centers are full of patients…but also that you and your colleagues have managed to stay healthy! For the Urgent Care Association (UCA), the College of Urgent Care Medicine (CUCM), the Urgent Care College of Physicians (UCCOP), and the Urgent Care Foundation (UCF), Q1 is Urgent Care Convention ramp-up time, leading toward our favorite time of year when we all get to gather and …
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Hematoma Blocks Effective for Closed Forearm Reduction Take Home Point: Hematoma blocks are an effective method of achieving analgesia to facilitate closed reduction of forearm fractures. Citation: Pitman G, Soeyland T, Popovic G, et al. Hematoma block is the most efficient technique for closed forearm fracture reduction: a retrospective cohort study. Emerg Med J. 2024; 41:595–601 Relevance: Adequate closed reduction of wrist and forearm fractures acutely after injury is important to reduce risk of complications …
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A 16-year-old girl presents to urgent care with complaints of fever, chills, and a diffuse sunburn-like rash that developed over the past day. The patient underwent septoplasty 2 days prior for a deviated septum, and nasal packing was utilized to manage her postoperative bleeding. On examination in urgent care, she was febrile to 104°F (40°C), tachycardic, and hypotensive. Widespread erythematous blanching macules and patches were seen. View the image below and consider what your …
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In a prior editorial, I described the case of Thomas, a young man among the “worried-well,” who presented to urgent care (UC) with anxiety related to an alarm that sounded as a result of a malfunction of a continuous glucose monitor (CGM), which was prescribed despite his lack of a diagnosis of diabetes, out of concern for abnormal blood glucose levels.[1] The underlying issue prompting his visit was not hypoglycemia but what I refer to …
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Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC The American Medical Association (AMA) added a Telemedicine Services category to the Evaluation and Management (E/M) section of the Current Procedural Terminology (CPT) code set. Codes are divided up by the technology used and the patient type (ie, new vs. established). These codes are for synchronous, real-time interactive encounters between the provider and the patient. Codes are leveled by medical decision making (MDM) or time, which is similar …
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One Medical, under the Amazon umbrella since February 2023, is now facing a lawsuit related to the death of a patient who was treated virtually by a One Medical provider. The 45-year-old patient complained of shortness of breath, coughing up blood, and feet turning blue, according to reporting in the Washington Post. He was prescribed an inhaler during the virtual appointment and later died waiting to be seen at a local hospital emergency department in …
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Researchers found that more than 68% of patients in primary care settings with negative chest x-rays were prescribed antibiotics for community-acquired pneumonia (CAP). Two-hundred fifty-nine adults in France with clinically suspected CAP received chest radiography (CR) as part of their evaluations, and 144 (55.6%) had a positive result, according to the study presented in the Annals of Family Medicine. Patients with positive CR had more severe and longer-lasting symptoms—including higher body temperature, faster heart rate, …
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