A 67-year-old man presents, reporting constipation that has lasted 3 days. He has a constant, generalized dull abdominal pain that is intermittently worse, occurring in what he describes as waves. He has nausea and reports that he has vomited once. He reports no blood in the urine or stool, and no weight loss, dysuria or urinary frequency, or dizziness. View the image taken (Figure 1) and consider what your diagnosis would be. Differential Diagnoses Small …
Read MoreAnkle Injury Sustained During an Amateur Football Game
A 25-year-old man presents to the urgent care center after a backyard game of football in which he twisted his ankle. Because of alcohol intoxication, he cannot remember the mechanism of injury. He reports isolated right ankle pain and is unable to bear weight. On physical examination, he has pain with palpation of the ankle, but there are no gross signs of deformity. An ankle x-ray has already been done by the time you see …
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Thoracic Pain After a Fall
A 51-year-old man presents to an urgent care center with sharp left thoracic pain that began suddenly after he fell after tripping on a banana peel that had been left on his kitchen floor. He has pain with breathing as well as with range of motion of the chest wall. He reports no head trauma, head or neck pain, fever, vomiting, or dizziness. View the image taken (Figure 1) and consider what your diagnosis would …
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‘Balance Billing’ Complaints Keep Rising
Texas is the latest state to report a dramatic jump in patients complaining about “surprise” medical bills after a trip to the hospital—on the order of a 1,000% increase between 2012 and 2015, according to the Texas Department of Insurance. The Centers for Public Policy Priorities in Austin notes that while there is no state law against “balance billing” in place, federal lawmakers are working on a bill that would make the practice illegal. Several …
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Occ Med Providers Need Clarity on Legal Marijuana in Workers
Legal use of marijuana could mean high times for urgent care centers that offer robust occupational medicine services—such as workplace drug testing—provided the operators are up on applicable state laws. Twenty-three states and the District of Columbia have enacted medical marijuana laws, though the laws in just eight of those states (Arizona, Connecticut, Delaware, Illinois, Maine, Nevada, New York, and Minnesota) include antidiscrimination or reasonable accommodation provisions for employers. Arizona, Delaware, and Minnesota have laws …
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Asthma Presentation? Be Wary of Abdominal Aneurysm Rupture
A new study found a significant link between asthma, the use of bronchodilators, and rupture of abdominal aneurysms (AAA). The news underscores the importance of getting a thorough medical and medication history for patients presenting to urgent care with asthma-like symptoms. Researchers noted that asthma patients over age 50, in particular, appear to have an increased risk for AAA and sudden death from its rupture, with the risk going up with recent asthma activity. Further, …
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CDC: Public Exchange Coverage Up, Off-exchange Coverage Down
As public exchange coverage climbed in the third quarter of 2015, use of off-exchange private coverage dropped, according to new data from the Centers for Disease Control and Prevention. This see-saw effect seems to indicate that U.S. health carriers had more trouble holding on to enrollees in group plans and off-exchange individual policies than they did holding on to enrollees in public exchange plans. Critics of the Affordable Care Act exchange system have noted that …
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GoHealth Partners with Dignity Health in San Francisco Bay Area Expansion
GoHealth Urgent Care is broadening its horizons by partnering with Dignity Health to open 12 urgent care centers in the San Francisco Bay area within the next 12 to 15 months. The venture will be owned equally by the two companies, but Dignity physicians will staff the new facilities. Each center will have basic lab and x-ray capabilities. Presently, GoHealth’s operations are limited to the New York and Portland, OR metropolitan areas. Dignity Health is …
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Pediatric Emergency Care Finds Most Urgent Care Sites Well Prepared
A new article published in the journal Pediatric Emergency Care adds valuable data that should further distinguish urgent care centers from retail health outlets commonly seen in community drugstores. Lead author Robert Wilkinson, DO and colleagues set out to quantify how prepared urgent care centers are for emergencies involving younger patients per guidelines issued by the American Academy of Pediatrics. They found it is typical for urgent care centers to have what it deems “essential …
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Follow-up Text Messages Raise Medication Compliance by 18%
As some insurers explore the wisdom of encouraging web chats and email for physician–patient communication, a new study published in JAMA Internal Medicine supports the idea that text messages may bolster patient compliance with a physician’s directions. This particular metaanalysis considered 16 studies involving nearly 3,000 patients and showed an 18% increase in patient follow-through with appropriate medication use (from 50% to 68%). Increased adherence with medication regimens not only leads to better outcomes, but …
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