The Case A patient presents after a backward fall off a ladder. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreMaintenance of Certification: A Punch in the Gut
In an era of plummeting leverage and influence over health care and the well-being of our practices and patients, physicians desperately need representation. Our collective voice has been muzzled and utterly dismissed when it comes to health-care delivery and economics. We have essentially been relegated to serving as the voice of public health and clinical best practice, nothing more. How did we get here, and what are our representatives in our professional organizations doing to …
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Implications of Patients Recording Urgent Care Provider Encounters
Urgent message: The ubiquity of smartphones increases the risk that patients will openly or covertly record interactions with their physicians. Urgent care operators should understand the legal and privacy implications and protect themselves with appropriate policies and training. ALAN A. AYERS, MBA, MAcc Practice Velocity Smartphones with cameras and audio and video recorders that can be easily concealed in a pocket, purse, or backpack are now used by roughly 71% of Americans, including 86% of …
Read MoreFractures in ICD-10-CM
Q. We treat a lot of fractures in our urgent care clinic, and I understand there are changes for coding these in ICD-10-CM [International Classification of Diseases, 10th Revision, Clinical Modification]. What will we need to be aware of? A.Most of the changes made in ICD-10-CM were to chapter 19, “Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88),” because of the need to identify laterality and 7th-character extensions that indicate the type of …
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A 34-Year-Old Man with Left Side Pain
In Bouncebacks, which appears periodically in JUCM, we provide the documentation of an actual patient encounter, discuss patient safety and risk-management principles, and then reveal the patient’s bounceback diagnosis. This month’s case reflects the actual documentation from an urgent care visit, and the patient’s bounceback the next day to the emergency department. Can you spot the red flags without knowing the outcome? MICHAEL B. WEINSTOCK, MD, and MIZUHO SPANGLER, DO Introduction Apicture tells a thousand …
Read MoreTop Classes of Prescriptions Written at U.S. Urgent Care Centers in 2014
Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded patient visits to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, show that for almost half of visits (48.6%) to U.S. urgent care centers, the prescriptions written by health-care providers are for oral antibiotics. The next 4 classes of prescriptions written are as follows, in descending order by percentage of visits: corticosteroids (13.7%), narcotic analgesics (9.9%), cough …
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July/August 2015
Hyperbilirubinemia: An Urgent Care Approach
Urgent message: Although frequently overlooked, routine urinalysis results can serve as an important diagnostic indicator of underlying and potentially life-threatening systemic disease states. NATALIE SMITH, MS, PA-C Urinalysis is one of the most common diagnostic tests used in and urgent care medicine. Urinalysis results yield routine clinical information necessary for everyday diagnoses localized to the renal and urologic systems; findings such as pyuria indicative of cystitis or hematuria related to renal calculi are some commonplace …
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Acute Severe Thigh Pain While Running
Urgent message: Summer brings increased participation in outdoor activities and sports in which patients are likely to sustain injury. Patients with thigh injuries, such as injury to the quadriceps and patellar tendon, may present to the urgent care center. Timely diagnosis is essential in preserving strength and function of the quadriceps complex. TRACEY QUAIL DAVIDOFF, MD Patients who run and jump are at risk for injuring their quadriceps complex. These activities are common in the …
Read MoreAbstracts in Urgent Care: July/August, 2015
SEAN M. McNEELEY, MD Sumatriptan Less Effective in Migraine with Aura Key point: Migraine with aura might require additional treatment measures. Citation: Hansen JM, Goadsby PJ, Charles A. Reduced efficacy of sumatriptan in migraine with aura vs without aura. Neurology. 2015;84:1880–1885. This study used pooled data to compare the response of patients with migraines with aura and the response of those with migraines without aura. A total of 3714 patients were compared; 1199 had an …
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