Perichondritis
Urgent message: With the popularity of piercing of the ear cartilage, urgent care providers need to be on the alert for perichondritis and to treat it promptly. SHAILENDRA K. SAXENA, MD, PHD, and MIKAYLA SPANGLER, PHARM D, BCPS Case Presentation A 26-year-old female presented with complaints of a swollen right pinna for 2 weeks. The swelling progressively worsened over time. In addition, she also complained of severe pain of the right pinna, with an intensity …
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Achieving Consistency and Scalability in Urgent Care Service Delivery
Urgent message: Investing time in designing repeatable processes and documentation can pay off in a more efficient, effective, and scalable urgent care operation. ALAN A. AYERS, MBA, MAcc Practice Velocity Introduction Despite management’s best intentions to deliver extraordinary patient experiences, many times employees just don’t know what to do. Front-line staff members are often conflicted between “doing what’s right” for the business, avoiding management scrutiny, exerting extra unrewarded effort, and “doing what’s right” for the …
Read MoreThe New Normal of Medical Malpractice and How We Are Making it Worse
JOHN SHUFELDT, MD, JD, MBA, FACEP I am tangentially involved in a medical malpractice suit in which the physician in question complied completely with the standard of care. Her documentation was great, her care exceptional, there was no discrepancy between her charting and the nurses’ charting, the doctor-to-doctor hand-off went well, and she communicated with the patient and family. Unfortunately, the ultimate patient outcome was horrible. In the aftermath, the physician was named in a …
Read MoreAbstracts in Urgent Care: October, 2013
Clinical Decision Tool Identifies Boys at Low Risk of Testicular Torsion Key point: No child with a normal testicular lie, age <11 years, and absence of nausea or vomiting had torsion. Citation: Shah MI, Chantal CA, Mendez DR. Prospective pi- lot derivation of a decision tool for children at low risk for testicular torsion. Acad Emerg Med. 2013;20(3): 271-278. To develop a clinical decision tool for identifying children at low risk for testicular torsion, investigators …
Read MoreSupervising Physician, Physician Rotation, Critical Care
DAVID STERN, MD (Practice Velocity) Q. Can a Physician Assistant (PA) bill a claim under a supervising physician even when the supervising physician is not physically present during the patient visit? A.A PA can render services when the physician is not on site. Incident-to billing (a specific CMS method for billing midlevel services with the physician as rendering provider) would never apply in this case. Services rendered in this situation should be billed with the …
Read MoreDeveloping Data: October, 2013
These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care). In …
Read MoreRegional Health System Integration: Charting Your Course
Lee A. Resnick, MD, FAAFP These are indeed stormy and transformational times. While no one can seem to agree on the political path to reform, change is nonetheless happening at a rapid pace in health care. Previous efforts to manage health care costs and quality on a national scale sunk at sea (the HMOs and Managed Care Organizations of the 80s and 90s). But the current path to reform appears unstoppable to me, regardless of …
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18-year-old man with a mild blow to his chest
This x-ray was taken on an 18-year-old man with a mild blow to his chest. View the image taken (Figure 1) and consider what your diagnosis would be.
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13-year-old boy who twisted his ankle
This x-ray was taken on a 13-year-old boy who twisted his ankle. View the image taken (Figure 1) and consider what your diagnosis would be.
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