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From Don’t Be Evil to Do the Right Thing: The Code of Conduct Evolution
In the year 2000, Google famously adopted the corporate code of conduct motto, Don’t Be Evil to represent its approach to both business and workplace behavior. At the time, the approach seemed sensible, but today it feels strikingly out of touch. It’s a low bar that misses the mark on one of the most pressing issues of our time: respect and freedom from harassment, at work, at home, and at play. Don’t be evil is …
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Implications of HIPAA and Employee Confidentiality Rules on Positive Drug Test Results
Urgent message: In addition to drug testing their own employees, many urgent care centers offer drug testing as a service to other employers. Therefore, it’s important to understand the laws affecting the privacy of drug screen results. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine Introduction It’s standard procedure throughout the country for employers to require …
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A 5-Month-Old with Symptoms Beyond the Presenting Complaint
Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, …
Read MoreUrgent Care Evaluation of Arrhythmias
Urgent message: Initial evaluation of a patient with an arrhythmia in the urgent care setting can be as difficult as it is critical to the patient’s survival—one key concern being sudden cardiac death, which occurs in roughly 328,000 cases annually. Riaz Fabian, DO Introduction Cardiac arrhythmias are a group of conditions in which a patient has an abnormal heart rate or rhythm. They are caused by any disruption of the electrical conduction system of the …
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A 3-Year-Old with Lesions on His Thumb
A mother brings her 3-year-old son to urgent care with multiple skin lesions on his thumb, which he frequently sucked for comfort. The grouped configuration of lesions was painful and had developed over the last 5 days to become vesicles. Upon exam, you note that the boy has a nearly healed cold sore on his lip, pain in his wrist, and an elevated temperature. View the photo and consider what your diagnosis and next steps …
Read MoreA 21-Year-Old Male with Persistent Ankle Pain Following Trauma
The patient is a 21-year-old male who presents with persistent ankle pain 4 weeks after suffering a trauma. He fell while scaling the exterior of his dormitory, trying to gain entry into a second-floor window because he’d locked his keys inside. 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 MoreA 44-Year-Old Man with Intermittent Dizziness
Case A 44-year-old man presents to your urgent care center complaining of intermittent dizziness. He denies shortness of breath, fever, chest pain, and syncope. 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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2018 Current Procedural Terminology (CPT) Code Changes
There are 314 code changes in the CPT manual for 2018, with 172 new codes, 60 revised codes, and 82 deleted codes. Most of the changes affect surgery procedures, but the updates include several changes that are relevant to urgent care. For your convenience, we have listed these changes in expected relevance to urgent care: Radiology Codes for x-rays of the chest and abdomen have been deleted and replaced with codes based on the number …
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Nurse-Only Visits in Urgent Care: An Analysis of Outcomes and Patient Satisfaction Relative to Traditional Care
Urgent message: As shown in an in-house study by one urgent care operator, protocol-driven, nurse-only care of specific presenting complaints may be one way to help curb healthcare spending while not compromising on quality of care or threatening patient-satisfaction scores. Kyle Coon and Brett Whyte, MD Abstract Basic healthcare costs are rising at a staggering and, it’s widely considered, unsustainable rate. As a result, lower-cost alternatives that maintain quality and satisfaction are being explored across …
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