In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we offer a look at data from the 2010 Urgent Care Benchmarking Survey Results. These data 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,” the qualifications for which included accepting walk-ins during all hours of operation, as well as …
Read MoreMedical Necessity in E/M Coding, Part 3: Correctly Coding the Physical Exam
DAVID STERN, MD (Practice Velocity) Some coding auditors do not understand the urgent care setting. As a result, they have been inappropriately downcoding evaluation and management (E/M) levels— not based on levels of documentation, but rather on whether the documentation is supported by their “view” of medical necessity, even though these auditors have usually never been providers and lack clinical experience. In this situation, the best defense is a strong offense. This column reviews medical …
Read MoreTo Board or Not to Board…That Is the Question!
Lee A. Resnick, MD, FAAFP With the announcement of the Board of Certification in Urgent Care Medicine (BCUCM), an American Board of Physician Specialists (ABPS) member board, the urgent care community is abuzz about its meaning, value, and importance for specialty recognition of the discipline and professional identity for its physician practitioners. Some believe the American Board of Medical Specialties (ABMS) is the only body with the authority to anoint specialty certification and provide board …
Read MoreClinical Challenge: September, 2011
The patient, an otherwise healthy 18-yearold, presented with pain in the upper arm. There was no history of trauma. 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 MoreMarketing to Local Schools
Offering preparticipation physicals to student athletes is a win-win-win proposition. It can be lucrative. It renders an important service. And because of the exalted place of school sports in American society, ensuring that young athletes are healthy enough to participate spotlights your urgent care in your community and makes people aware of the many other services you offer. The key to profitability is effective marketing. Area school children who participate in sports are required to …
Read MoreAre Urgent Cares Liable?
JOHN SHUFELDT, MD, JD, MBA, FACEP Full disclosure: I was not always the smooth, confident provider I hope I am today. No, there was a time when I would say or do things while practicing medicine that would shine a bright light upon my medical inexperience, naiveté, or general ignorance. To wit, the emergency medicine residents where I trained were pressed into servitude twice yearly to go out to the local high schools and perform …
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A Surprising Cause for Constipation?
Urgent message: Prescribing Miralax and an enema would likely have killed this patient. He nearly died in the hospital. Can you figure out why? WILLIAM A. GLUCKMAN, DO, MBA, FACEP, CPE, CPC Constipation, a common urgent care complaint, can be a symptom of many things, not all of them obvious, and some life-threatening. In this tricky case, the underlying problem is one that many urgent care physicians would not consider in a differential diagnosis, yet …
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Planning for Meaningful Use? The Clock Is Ticking
Urgent message: CMS offers stimulus funds to providers who “attest” that their EHR use improves patient care: up to $18,000 in 2011 alone. The sooner you do, the more you stand to earn. Eric McDonald, CEO of DocuTAP “Meaningful use” refers to the use of a “certified” electronic health record (EHR) to meet specific objectives established by the Centers for Medicare & Medicaid Services (CMS), which administers the EHR incentive program. An EHR is certified …
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Sudden Cardiac Death
Identifying Risk Factors in Preparticipation Physicals for Young Athletes Urgent message: Doctors in the US and Europe are divided over what the cardiovascular component of a proper sports physical should include. Here is a reasonable approach. NATHAN P. NEWMAN, MD, FAAFP Sudden death in young athletes is not new. In 490 BC, when the Greeks improbably defeated the invading Persians at Marathon, a young herald, Phidippides, ran 25 miles back to Athens to announce the …
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70-year-old experiencing shoulder pain
This 70-year-old patient presented with pain in the left shoulder. There was no history of trauma. View the image taken and consider what your diagnosis and next steps would be.
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