StuWilli, Author at Journal of Urgent Care Medicine

Antibiotic Management of Acute Uncomplicated Cystitis and Pyelonephritis in Women

Urgent message: Proper empiric antibiotic treatment in women with acute uncomplicated cystitis and pyelonephritis can prevent unnecessary morbidity and provide urgent relief from these common genitourinary infections. MOZELLA WILLIAMS, MD Genitourinary infections in women are encountered frequently in the urgent care setting. Timely diagnosis and proper empiric antibiotic treatment will usually forestall serious complications and provide speedy relief. Over a lifetime, 50% of women will experience an acute uncomplicated cystitis, also known as a lower …

Man with bruised hand

These x-rays were taken on a 47-year-old male who presented to an urgent care clinic 3 days after punching a wall. He had pain, massive swelling, and bruising at the base of the 3rd, 4th and 5th metacarpals of the right hand. View the images taken (Figure 1) and consider what your diagnosis would be.

Clinical Challenge 2: October 2014

The Case This x-ray was taken on a young basketball player with foot pain and no specific injury. View the image taken (Figure 1) and consider what your diagnosis would be.

The Power of Innocence in Medicine

Lee A. Resnick, MD, FAAFP Medicine, from time to time, calls for reflection. The hangover from arduous shifts, the mind-numbing regulatory “whack-a-mole,” the technology treadmill and the career second-guessing, all contribute to an epidemic of lost perspective in our profession. In an effort to manage an avalanche of competing interests, physicians often sacrifice themselves to the point of burnout and self-destructive behavior. Without perspective, these burdens soon overwhelm even the hardiest among us. We become …

An Urgent Care Approach to Joint and Soft-Tissue Injection/ Aspiration: Part 2

Urgent message: Injection/aspiration therapy for selected musculoskeletal complaints is becoming more common in urgent care practice. Part 2 of this series offers step-by-step guidance on treatment of conditions from “tennis elbow” to bursitis and cysts. THOMAS V. GOCKE, III, MS, ATC, PA-C, DFAAPA The focus of Part 1 of this series, in the September issue of JUCM, was on understanding the inflammatory response, use of corticosteroids and anesthetic agents (Table 1), pre- and post-aspiration/injection considerations, …

New CMS Modifiers, Urgent Care Codes, Supply Codes

Q. What will be the impact of use of the new HCPCS modifiers related to modifier -59 beginning January 1, 2015? A. CMS recently announced the creation of four new HCPCS modifiers that will further refine modifier -59, “Distinct procedural service.” According to CMS, modifier -59 is the most widely used modifier, and it is being used inappropriately in most cases. Adding modifier -59 indicates that a code represents a service that is separate and …

ST Elevation Myocardial Infarction

Urgent message: Chest pain in young adults is often benign but it’s important to always consider conditions that increase risk of cardiovascular disease when evaluating these patients. RAFAEL ILYAYEV, MD, FACP, MOHAMED A. MOHAMED, MD, AND HASSAN FARHAT, MD Overview This case illustrates the importance of considering and ruling out rare causes of coronary artery disease (CAD) in young patients who present with chest pain. One of these rare causes is a hypercoagulable state secondary …

Head in the Game: Cultivating the Mindset of a Successful Urgent Care Operator

Urgent message: Just because you build it, patients won’t necessarily come. As entrepreneurs, successful urgent care center owners must market their services to the community, innovate with new services to fill excess capacity, and create positive patient experiences that spur repeat visits and positive word-of-mouth. ALAN A. AYERS, MBA, MAcc Practice Velocity One needn’t look further than the 20,000+ physicians already practicing in urgent care centers nationwide to grasp just how attractive this business model …

October 2014

Abstracts in Urgent Care: October, 2014

Timing of concussion symptoms Key point: Symptoms of concussion such as sleep disturbance, forgetfulness, and fatigue are late in onset. Citation: Eisenberg MA, Meehan WP 3rd, Mannix R. Duration and course of post-concussive symptoms. Pediatrics. 2014;133(6):999-1006. Estimates of the duration of concussion symptoms in children vary from 1 week to months. This study looks at previous cohorts where the median time to recovery was 13 days and considers symptoms, their duration, and clinical course. The …

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