Practice Management
Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine Urgent message: As consumers pay closer attention to the ethical behaviors of the companies they do business with, the topic of workplace ethics has garnered renewed interest. Hence, the urgent care operator who makes a concerted effort to build an ethical workplace culture lays the groundwork for patient loyalty, …
Read MoreAntimicrobial stewardship is defined as a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. Stewardship initiatives in the hospital are paving the way for the rest of healthcare through education campaigns, monitoring, and restrictions. Outpatient practice is beginning to catch up as the stories of resistance grow and the lines between nosocomial and community-acquired infections blur. …
Read More
Urgent message: Previously undiagnosed hypertension is common among ambulatory patients, and urgent care providers are often the first to recognize and diagnose this condition. Initiating treatment, testing, and providing patient education and follow-up are well within the scope of urgent care practice and help ensure positive outcomes. Being attentive to the presentation and care of hypertensive emergencies is also paramount. Taylor Fischer MMS, PA-C and Rebecca L. McClough, MPAS PA-C Hypertension (HTN) affects …
Read MoreMax Lebow, MD, MPH, FACEP, FACPM Urgent message: A thorough, occupational medicine-specific history is essential to identifying and resolving work-related injuries and illnesses quickly and safely—for the benefit of the patient and the employer. Like any medical history, the occupational medicine history is meant to guide the clinician to the proper diagnosis and treatment for the patient. However, it is set apart from the “typical” history in that several other goals must be …
Read MoreWHO Announces ICD-11, Coming Next Year Key point: New set will reflect current terminologies and classifications, integrate more smoothly with new technologies. Citation: World Health Organization. WHO Releases New International Classification of Diseases (ICD 11). June 18, 2018. Available at: http://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11). Accessed August 14, 2018. ICD-10 was released in 2015, but according to the World Health Organization (WHO) we can already expect the next revision, ICD-11, sometime early in the next decade. ICD-11 is supposed …
Read More
Case The patient is a 27-year-old male who presents to urgent care with foot pain, for which he says there is no explanation. With probing, he reveals that he is a “fanatic” about running, and that the pain has persisted for close to 7 months. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. Differential Diagnosis Capsulitis Freiberg …
Read More
Case The patient is a 61-year-old man who presents to the urgent care center with lightheaded dizziness, which he says started several hours prior to arrival. He denies chest pain, syncope, and shortness of breath but says he feels “clammy.” He is not taking any medications on a regular basis has no history of myocardial infarction, but he had a stent placed 8 years ago. Upon exam, you find: General: Alert and oriented X 3, …
Read More
Case The patient is a 28-year-old man who presents to urgent care with a fever and complaints of tiredness, myalgia, and sore throat. You note that he has pink, scaly papules on his palms and soles. He also has patchy alopecia developing on his scalp, which he says is a very recent development. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next …
Read MoreOctober 1, 2018 will bring 279 new codes to ICD-10-CM. Combined with 51 deactivated codes (and 143 revised codes), that brings the total number of ICD-10-CM codes to 71,932. We identified a few examples that are especially important for urgent care coders to be aware of; a complete list of ICD-10-CM changes can be found on the CMS website at https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html. Chapter 2: Neoplasms (C00-D49) Melanoma and other malignant neoplasms of the skin The …
Read MoreUrgent care has faced many challenges since its inception—starting with trying to get healthcare consumers and insurers to understand what it has to offer that’s different from a traditional primary care practice or the emergency room. Through true market evolution—we’re talking Darwin, here—that hurdle has helped separate the wannabes from the real innovators. The latter came to grasp that a patient-friendly approach would be one obvious attribute that could keep waiting rooms full and good …
Read More