Urgent message: Government financial enticements for whistleblowing have resulted in a sharp rise in employee reports against their health-care employers. Urgent care centers can protect themselves by identifying potentially litigious employees, having a wellpublicized compliance program, and by establishing internal reporting procedures. Introduction In recent years, there has been a dramatic rise in the number of whistle-blower lawsuits in the health-care industry. Because these lawsuits reap huge payouts for the federal government, whistle-blowers are monetarily enticed to report their employers to government agencies rather …
Read MoreAbstracts in Urgent Care: April, 2016
SEAN M. McNEELEY, MD Copeptin and Troponin Together Are Useful in Diagnosing Acute Coronary Syndromes Key point: There is a new tool for ruling out myocardial infarction. Citation: Ricci F, Di Scala R, Massacesi C, et al. Ultra-sensitive copeptin and cardiac troponin in diagnosing non-ST-segment elevation acute coronary syndromes—the COPACS Study. Am J Med. 2016;129:105–114. Concern about patients with non-ST-segment elevation myocardial infarction with chest pain and normal electrocardiogram (ECG) findings frequently causes a transfer …
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Ocular Arteriovenous Malformation Manifesting as Proptosis
Urgent message: Proptosis may be caused by a variety of vascular, infectious, endocrine, and neoplastic diseases that may threaten vision or cause serious systemic complications or death. Providers should be familiar with causes and work-up, including which findings suggest a need for immediate imaging and consultation. ARMIN GOLLOGLY, MD, BRIAN ZIPSER, MD, WENDY HUANG, MD, FAAO, FAAP, CHRISTOPHER M. FECAROTTA, MD, FAAO, FAAP, FCPP, AND MARK RICHMAN, MD, MPH Introduction This report describes a case of unilateral proptosis due to …
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Roundtable: Expert Perspectives on X-Ray Over- Read Strategies in Urgent Care
Urgent message: To ensure a high quality of patient care and reduce the risk of medical errors while also controlling administrative overhead, every urgent care center should have a clear policy and process for radiologist interpretation of x-ray images, image over-read, or both. IntroductionAs health-care costs continue to multiply, it is important to consider money-saving measures across the board. Radiography is an essential service in differentiating urgent care centers from primary care and other providers, …
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Evaluation of Scrotal Pain in the Urgent Care Setting
Urgent message: Evaluating patients with acute scrotal pain can be a challenge for clinicians in the outpatient setting because several conditions indicated by it can cause significant morbidity. Performing a thorough but focused medical history and physical examination and considering certain diagnoses, including testicular torsion, epididymitis, and prostatitis, are imperative when assessing these patients. JEREMY HAWKINS, MD, BRIT LONG, MD, and ALEX KOYFMAN, MD, FAAEM Introduction Evaluation of acute scrotal pain is often challenging for clinicians …
Read MoreApril 2016
In New York, No More ‘Writing’ Prescriptions
Use a prescription pad in New York, go to jail—potentially, anyway, as the state becomes only the second state to require electronic prescribing and the first to establish penalties, which include fines, loss of license, and even jail time, for noncompliance. Paper and telephone prescriptions will be exempted for emergency situations, however. Proponents reason that e-prescribing is a big step toward eliminating prescribing errors and long wait times at the pharmacy, and that it reduces …
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FDA Wants Some Gloves to Take a Powder
The Food and Drug Administration wants to ban most powdered gloves from exam rooms, as well as operating rooms. The ban would apply to powdered surgeon’s gloves, powdered patient examination gloves, and absorbable powder for lubricating a surgeon’s glove. The FDA says the risk that synthetic proteins in the gloves can cause airway inflammation, wound inflammation, and postprocedure adhesions is too great to allow their continued use. If finalized, the ban would force withdrawal of …
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Data Show More Institutions Getting into the Urgent Care Market
Hospital chains and insurance companies continue to invest in urgent care centers at an ever-increasing pace, while also forging partnerships with independently owned clinics, according to a report from Merchant Medicine. The perception is that as Americans live to an older age—and stay active longer while doing it—they want more convenient care for nonemergent injuries while maintaining a relationship with institutions they’ve come to trust. Current data from the Urgent Care Association (UCA) show that …
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Difficult Patients May Be More Difficult to Diagnose
As the difficulty in dealing with a patient goes up, diagnostic accuracy goes down, according to a new report published in BMJ Quality and Safety. The complexity of the ultimate diagnosis and the amount of time spent with the patient appear to have no bearing on the probability of making a correct diagnosis. The article is based on two studies in the Netherlands that showed physicians were more likely to misdiagnose patients who exhibited “disruptive …
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