Practice Management
A 13-year-old boy presents to urgent care after “rolling” his left foot. He explains that he tripped on a cement curb while riding his skateboard. He has foot and ankle pain that is worse with weight. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Urgent Message: While patients with asthma will frequently experience exacerbations following viral respiratory infections, the urgent care clinician must be cautious when assuming dyspnea is due to asthma. As dyspnea can be caused by a wide variety of conditions, it is important to maintain a broad differential diagnoses, even in patients with underlying asthma. Tracey Quail Davidoff, MD, FCUCM Key words: Influenza, Dyspnea, Asthma, Congestive Heart Failure, Myocarditis, Diagnosis Momentum Abstract Introduction: Patients commonly present …
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The following table summarizes the 100 largest urgent care operators by number of locations as of April 1, 2025, based on data provided by National Urgent Care Realty and Urgent Care Consultants. Because of the significant number of private operators that also operate facilities with hospital partners, the list delineates health-system-affiliated locations. Duplication is avoided by placing joint venture centers under the operating partner. Data is reported by the parent entity as opposed to regional …
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Can Doctors Predict Patient Outcome from a First Impression? Take Home Point: In this systematic review, the first impressions of “sick versus not sick” and appropriate patient disposition had reasonable predictive value for patient outcomes but was not sufficiently accurate to supplant thorough clinical assessment. Citation: Treloar E, Abraham A, Smith E, et. al. Can first impressions predict patient outcomes? Acad Emerg Med. 2025 Mar;32(3):351-354. doi: 10.1111/acem.15053. Relevance: In busy environments such as urgent care …
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A 33-year-old female presents to urgent care with pleuritic chest pain that is gradual in onset over the preceding several days and worse when lying flat. She denies fever, cough, and shortness of breath. She is well appearing with normal vital signs. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 63-year-old man presents to urgent care with sudden-onset floaters and blurred vision in his right eye for one day. He denies trauma, headache, or flashes of light. He has no history of similar symptoms. His past medical history includes hypertension and type 2 diabetes. Vital signs are normal. Visual acuity measures 20/40 OD and 20/25 OS. No facial asymmetry or eyelid swelling is noted. Visual fields are intact bilaterally. A non-dilated fundoscopic exam is …
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A 55-year-old woman presents to urgent care because of skin dryness and scaling on her legs that developed 2 weeks prior. The patient was recently diagnosed with psoriasis by a different provider and was treated with a combination therapy of tazarotene and a topical steroid for over 4 weeks. Diffuse dryness and white scales were seen on her legs. View the image below and consider what your diagnosis and next steps would be. Resolution of …
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Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC Urgent care operators face increasing challenges from payer reviews—a situation exacerbated by ongoing confusion around coding guidelines and proper documentation of medical decision-making (MDM). As more urgent care providers grapple with administrative burdens and financial pressures, understanding how to document and code accurately has never been more important. The Rise of Payer Reviews Pre-payment reviews have become commonplace, initiated when a provider’s billing patterns—such as a higher frequency …
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During flu season, many people go out of their way to wash down high-touch surfaces at home, at work, and in schools, hoping to avoid the spread of germs. An experimental laboratory study published in Microbiology and Immunology that evaluated the risk of influenza transmission through contact with contaminated surfaces, however, found the risk of picking up the flu from touching door handles and other objects is actually quite low. Researchers in Japan simulated “artificial …
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Urgent Message: Compartment syndrome is a limb-threatening emergency that can present with variable clinical signs and symptoms. When the diagnosis is missed or delayed, poor functional outcomes and subsequent malpractice claims are common. Prevention of negative outcomes relies on early detection and a low-threshold for emergency department referrals. Josie L. Bunstine, DO; Ariel Cohen, DO Key words: Compartment Syndrome, Medical Malpractice Questions for the Clinician at the Bedside Abstract Acute compartment syndrome is a limb-threatening …
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