There are a few things from residency training that resonated so profoundly for me that they permeate everything I have done since. I will never forget my first delivery, not because I thought I would ever deliver babies in my practice, but because of the emotional and enduring collision of medicine and nature it represented for me. And who can forget the 36-hour shifts (now extinct) that I am quick to recount for young clinicians …
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Get the Most Out of Providing Medicare Wellness Exams
Q: Are there specific requirements for Medicare wellness exams and who can perform them? A: Medicare offers an initial preventive physical examination (IPPE), which is also known as the “Welcome to Medicare” preventive visit or the annual wellness visit (AWV). Either a physician (a doctor of medicine or osteopathy) or a qualified nonphysician practitioner (a physician assistant, nurse practitioner, or certified clinical nurse specialist) can provide the services. The IPPE is a one-time initial examination …
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Neck Rash on a 21-year-old Male
Urgent message: Acanthosis nigricans has a strong association with obesity and insulin resistance. Assessment involves a thorough physical exam to differentiate from other dermatosis, as well as full workup for insulin resistance. Early diagnosis in the urgent care setting, and treatment, will improve the appearance of acanthosis nigricans, but also the patient’s overall morbidity. Shailendra Saxena, MD, PhD and Bao Chau Nguyen, BS Introduction A 21-year-old Caucasian male presented for a circumferential hyperpigmented rash around …
Read MoreA 20-Year-Old Woman with Acute Chest Pain
The patient is a 20-year-old female who presents with sudden onset of left sided chest pain. A collegiate cross-country runner, she reports that she also felt lightheaded when lacing up her running shoes earlier in the day. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreAbstracts in Urgent Care – February 2018
Revisiting Parameters for Treating Hypertension Key point: New guidelines have lower thresholds for diagnosis and treatment of hypertension. Citation: Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/ AGS/APhA/ASH/ASPC/ NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. [Epub ahead of print November 13, 2017] The 2017 American College of Cardiology/American …
Read MoreA 51-Year-Old Man with Shortness of Breath and ‘Burning’ in His Chest
The patient is a 51-year-old man with shortness of breath and an intermittent burning sensation in his chest. His symptoms began 2 days ago. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Drug Screening Market Expected to See Healthy Growth Through 2022
New data show the market for companies that provide drug screen services—which would include urgent care operators who offer occupational medicine services—should grow at a 10.2% clip annually through 2022. By that time, the total market value would be $8.63 billion (up from $5.32 billion in 2017). The Drug Screening Market Report from ReportsnReports reasons that demand will continue to be driven by growing drug and alcohol consumption among workers, combined with increased enforcement of …
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Prepare Yourself and Your Staff: CDC Extends Projected Flu Season
The 2017–2018 influenza season doesn’t just seem long, thanks to the high volume of cases—and deaths—this year; it’s actually going to last longer than usual, according to the Centers for Disease Control and Prevention. In fact, the CDC says flu season hasn’t even peaked yet; flu activity continues to be widespread in every state except Hawaii and has remained unchanged for 3 weeks—and indicator that the natural wane is still ahead of us. Nearly 12,000 …
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Mercy Stresses the Urgent Care Option as ED Volume Swells
Like many facilities across the country, Mercy Hospital in Fort Smith, AR wrestles with overcrowding in the emergency room, especially during flu season. In addition to higher patient volume, resources are further stretched due to staff calling in sick in greater numbers. The administration is dealing with the crisis by employing all available resources, including making the most of the flexibility of the urgent care model. Mercy has dedicated one location specifically to patients presenting …
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Government Report: U.S. Needs Better Occupational Health and Safety Surveillance
The timing couldn’t be better for urgent care operators who offer occupational medicine services, as a new government report challenges various stakeholders to establish more robust health surveillance practices in the workplace. A Smarter National Surveillance System for Occupational Safety and Health in the 21st Center, published by the National Academies of Sciences, Engineering, and Medicine, calls for greater coordination among federal agencies and the states, as well as the creation of regional occupational safety …
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