StuWilli, Author at Journal of Urgent Care Medicine

Rocky Mountain Spotted Fever: Dermatologic Manifestation of a Life- Threatening, Systemic Disease

Urgent message: Obtaining a detailed medical history is paramount for the early detection and treatment of Rocky Mountain spotted fever. Failure to acquire adequate patient information can lead to misdiagnosis and delayed treatment of this potentially life-threatening disease. WHITNEY CRAMER, PA-C Many dermatologic conditions such as rashes and eczema are encountered by urgent care providers on a daily basis. Often these conditions are diagnosed as contact dermatitis or are misdiagnosed, or the patient is referred …

Legal Implications of Integration of Hospitals and Urgent Care Centers

Ron Lebow, JD Urgent message: As health systems and payors align their interests in the creation of accountable care organizations, hospitals that acquire or partner with urgent care centers must adopt a legal structure and an operating model that remain compliant with the federal Anti-Kickback Statute and the federal Stark law, and with other federal and state regulations. Introduction With the advent of the Patient Protection and Affordable Care Act (PPACA), the government recognized that …

Abstracts in Urgent Care: December, 2015

SEAN M. McNEELEY, MD Family Members Are Most Frequent Cause of Pertussis in Children Younger Than 1 Year Key point: Be sure to suggest adding a pertussis vaccine to tetanus whenever possible. Citation: Skoff TH, Kenyon C, Cocoros N, et al. Sources of infant pertussis infection in the United States. Pediatrics. 2015;136:636–641. Despite recent efforts to increase the number of U.S. adults whose immunizations are current, pertussis still is a frequent problem for children younger …

Unspecified Diagnosis Codes, Preoperative Examinations, and Tuberculosis Skin Tests

Q. We are afraid of getting denials for using unspecified ICD-10-CM [International Classification of Diseases, 10th Revision, Clinical Modification] codes. In an urgent care center, we sometimes will see a particular patient only one time for minor illnesses and injuries, and follow-up with their primary-care physician is always advised. Do you have any advice on documenting to get claims paid? A. Within ICD-10-CM, you may select codes defined as “Not Otherwise Specified” (NOS). Generally, this should …

Clinical Challenge: December, 2015

Case A 56-year-old woman presents after a fall onto her outstretched hand. She has pain with range of motion of the wrist. She has no associated numbness or weakness and reports no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.

The Most Frequent Disposition of Cases at U.S. Urgent Care Centers in 2014

Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded visits by patients to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, reveal that the most frequent disposition of cases at U.S. urgent care centers in 2014 was provision of follow-up care as needed. The survey’s methodology and data abstraction forms were initially designed in 2008 by researcher Robin M. Weinick, PhD, then an assistant professor at …

Clinical Challenge 2: November, 2015

Case A 67-year-old man presents with constipation and abdominal pain that has been present for the last 2 days. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.

LITERATURE REVIEW: Early Administration of Azithromycin and Prevention of Severe Lower RTI

Citation: Bacharier LB, Guilbert TW, Maugeret DT, al. Early administration of azithromycin and prevention of severe lower respiratory tract illnesses in preschool children with a history of such illnesses. JAMA. 2015;314:2034-2044. Reviewed by: Michael B. Weinstock, MD Background/question: The authors wanted to know if antibiotics administered early in the course of a respiratory tract infection (RTI) in children with recurrent, severe RTIs decreased progression of disease. Study: This is a randomized, double-blind, placebo-controlled trial at …

WellSpan, MedExpress Strike Micro Partnership

WellSpan Health continues to broaden its reach into urgent care, this time striking a partnership with MedExpress—somewhat unusual in that it involves just a single clinic and reflects no change in ownership for either company. WellSpan has been slowly buying up healthcare properties in the area, having acquired Good Samaritan Health System in Lebanon, PA and brought a local orthopedic practice into its fold earlier this year. WellSpan Health is a large integrated healthcare system …

Urgent Care a ‘Disrupter’ of Traditional Primary Care

A new study concludes that the healthcare marketplace is dictating a major renovation of primary care—and urgent care is both one of the causes and a potential beneficiary of the dramatic changes in the landscape. The report from PwC Health Industries’ Health Research Institute says rising costs and increased demand for primary care practitioners are forcing stakeholders to rethink their business models to unlock value. Simon Samaha, MD of PwC says the solution lies in …

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