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 the 2 largest age groups of patients using urgent care centers were 21 to 30 years (17.1%) and 31 to 40 years (15.9%); the smallest age group was 51 to 60 years (11.9%). The survey’s methodology and data abstraction forms were initially designed in …
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Recognizing Employee Disengagement and Taking Steps to Re-engage
Urgent message: Employee disengagement is pandemic in the American workplace. At urgent care centers, operators have to work especially hard to keep frontline staff members motivated. Re-engaging employees starts with a strong management culture committed to establishing affinity with employees and ensuring that systems and processes support day-to-day operations. ALAN A. AYERS, MBA, MAcc, Experity For many urgent care operators—clinically adept physician–owners who are likely green as entrepreneurs—it can be sobering to realize just how …
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Aortic Dissection
Urgent message: Although chest pain in young adults is often benign, it is important to realize that emergency cases can sometimes be disguised as normal examination findings in adults. ZANA ALATTAR and JOHN SHUFELDT, MD, JD, MBA, FACEP This case demonstrates the importance of considering and ruling out rare cases of aortic dissection in patients with chest pain. We describe a case illustrating the approach to the management and work-up of chest pain in young …
Read MoreAbstracts in Urgent Care: April, 2015
SEAN M. McNEELEY, MD The Return of Measles Key point: Measles is back, so watch for it among your patients. Citation: Centers for Disease Control and Prevention. Measles (rubeola). Atlanta, GA: Centers for Disease Control and Prevention [updated February 12, 2015; cited February 18, 2015]. Available from: http://www.cdc.gov/measles/hcp/index.html Unfortunately measles is making a comeback. Most likely because of decisions to delay or avoid immunizations, a measles outbreak began in California in December 2014 and has …
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Upper Gastrointestinal Disorders in Urgent Care, Part 1: Gastritis, Peptic Ulcer Disease, and Helicobacter pylori
Urgent message: Gastritis and peptic ulcer disease are a spectrum of diseases that can range from mild to serious; urgent care providers must be on the alert for these conditions. Early diagnosis and treatment, along with recommendations for follow-up care with appropriate specialists, can help prevent long-term sequelae. TRACEY Q. DAVIDOFF, MD Gastritis and peptic ulcer disease (PUD) represent a continuum along a path of inflammation of the gastric mucosa, from superficial irritation of the …
Read MoreClinical Challenge: April, 2015
The Case The patient presented with wrist pain after a fall on an outstretched hand (FOOSH). View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreMedical Malpractice Trial, Part 2: Pretrial
JOHN SHUFELDT, MD, JD, MBA, FACEP Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: Johnny Trey Dalton Attorney …
Read MoreApril 2015
“Why Are You Calling Me?” The Problem with Patient Transfers in Urgent Care
Lee A. Resnick, MD, FAAFP According to the 2012 Benchmarking Survey from the Urgent Care Association of America, about 4% of urgent care patients are referred to an emergency department (ED) for ongoing care. Some get there by personal vehicle, and others are transferred by emergency services, private ambulance, or other critical-care transportation. Given an average patient volume of 40 patients per day for a single urgent care center, that is 1.5 ED transfers per …
Read MoreModifier -X {EPSU}, Pneumococcal Immunizations
Q. Have there been any updates from CMS (Centers for Medicare & Medicaid Services) regarding the new -X modifiers that were introduced in January of this year? A. CMS released MLN Special Edition article SE1503 on January 22, 2015 (see http://www.cms.gov/Outreachand- Education/Medicare-Learning-Network-MLN/MLN MattersArticles/Downloads/SE1503.pdf), stating that there would be forthcoming guidance as to the appropriate use of the new -X {EPSU} modifiers and “that guidance will include additional descriptive information about the new modifiers” before implementing …
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