Practice Management
Urgent message: Even a seemingly minor hand injury can result in lifelong disability if evaluation and treatment are incorrect. TRACEY QUAIL DAVIDOFF, MD Introduction The hand is a vital part of human anatomy allowing us to interact with our environment in nearly infinite ways. The functional aspects of the hand are a direct extension of the brain, allowing us to initially make stone tools, play musical instruments, make intricate crafts, type, communicate, and appreciate our …
Read MoreIn my last column, I addressed the contribution of unrealistic patient expectations to unsustainable healthcare costs. I postulated that the competing societal goals of preserving freedom of choice while providing healthcare for all will produce a futile tug-of-war. I further warned that leaving the solutions to politicians and government administrators will inevitably lead to myopic reforms that threaten the doctor-patient relationship and fail to consistently incentivize good care. In this month’s column, I’d like to …
Read MoreThese data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged urgent care centers” accepting walk-ins during all hours of operation; having a licensed provider and x-ray and lab equipment onsite; the ability to administer IV fluids and perform minor procedures; and having minimal business hours of seven days per week, four hours per day. In this …
Read MoreUSPSTF to Advise Against Routine Prostate Cancer Screening Key point: The US Preventative Services Task Force has concluded that healthy men should not undergo routine prostate-specific antigen testing. Citation: Harris G. US panel says no to prostate screening for healthy men. New York Times website. Available at: www.ny-times.com/2011/10/07/health/07prostate.html. Accessed December 6, 2011. The recommendation was based on an analysis of five trials and applies to men of all ages. The Times quotes the task force’s …
Read MoreJOHN SHUFELDT, MD, JD, MBA, FACEP You’ve researched the industry, have a site picked out, and have a name reserved. Now comes the million dollar question. Wait, that is the question: Where do I get a million dollars to start an urgent care? Do you really need a million? My noncommittal “attorney answer” is: “possibly.” I have had friends lose a lot more than that before being forced to close the doors. That said, you …
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Urgent message: Registration specialists, medical assistants, and techs may be your lowest-paid employees, but the success of your urgent care is in their hands—and their success is in yours. ALAN A. AYERS, MBA, MAcc, Experity Urgent care is a service business whose long-term viability depends on patient loyalty and word of mouth. That’s why urgent care entrepreneurs spend tens of thousands of dollars in selecting the right locations, equipping them with the latest technology, and …
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Urgent message: That back pain is common and typically without serious sequelae may result in misdiagnosis and mistreatment. ERICA MARSHBURN, BS, BA, AND JOHN SHUFELDT, MD, JD, MBA, FACEP Many high-risk conditions can present as back pain, is a very frequent presenting complaint in urgent care medicine. Most back pain is muscular in origin and responds well to conservative intervention. However, because of the frequency of the complaint and infrequency of serious sequelae, providers may …
Read MoreThe patient, an otherwise healthy 64-year-old, fell, suffered a blow to the shoulder, and presents with clinical dislocation. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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The patient, an otherwise healthy 9-year-old, tripped, suffered a blow to the right knee and presented with the knee cap in an abnormal position. View the image taken and consider what your diagnosis and next steps would be
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