StuWilli, Author at Journal of Urgent Care Medicine

Acute MI After a Normal Stress Test

Urgent message: Evaluation of chest pain in the low-risk patient can be daunting. This case, in which the patient had no known history of cardiovascular disease, exemplifies the challenge. MARREN J. WEBER, DO The standard treadmill exercise tolerance test (ETT) and echocardiography are widely used as the initial tests of choice for prediction of cardiovascular disease. Historically stress echocardiography has been recognized to perform well in predicting mortality in conjunction with clinical data and other …

In Appreciation…

Lee A. Resnick, MD, FAAFP JUCM, The Journal of Urgent Care Medicine, is approaching its fifth year of publication (a feat not without reason for celebration). In an environment of tremendous financial pressures, increasing scrutiny, and decreasing ad revenues, medical publishing is confronting significant challenges. JUCMis not immune. Most casual readers remain unaware of the challenges behind the scenes. It is, perhaps, no concern of theirs. But that does not mean the efforts should go …

Anaphylaxis: Clinical Guidelines for Diagnosis and Management

Urgent message: Anaphylaxis is a true medical emergency that requires rapid and aggressive treatment. When a patient with a Type 1 hyper – sensitivity reaction is brought to your urgent care, here is how to proceed. DAVID WEIN, MD, MBA, FACEP, and DENNIS DIXON, MD Introduction Anaphylaxis is a severe, whole-body, allergic reaction to a chemical that has become an allergen. Anaphylaxis is a true medical emergency, often with a rapid and unpredictable onset. It …

Developing Data: June, 2011

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 …

Medical Necessity in E/M Coding, Part 2: ROS and PFSH

DAVID STERN, MD (Practice Velocity) Last month, we presented definitions for medical necessity offered by the AMA and the Centers for Medicare & Medicaid Services (CMS). We looked at the elements appropriate to perform and document in the History of Present Illness (HPI). And we briefly discussed Recovery Audit Contractors (RAC) audits. (If you missed it, the column is archived on the JUCM website [https://www.jucm.com] in the May 2011 issue.) This month, our focus is …

Abstracts in Urgent Care: June, 2011

When Should Diagnostic Imaging Be Used for Patients With Low-back Pain? Key point: With low-back pain, the risks associated with X-rays and MRIs often outweigh the benefits. Citation: Daily POEM: imaging for low-back pain: rarely indicated, often harmful. Available at: www.essentialevidience- plus.com. These guidelines are based on a systematic review and meta- analysis of research investigating the usefulness of various im- aging studies in patients with low-back pain. Based on a meta- analysis of six …

Clinical Challenge: June, 2011

The patient is an otherwise healthy child, age 11, who presents with acute pain to the wrist following a blow. 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.

Author: StuWilli

Acute MI After a Normal Stress Test

In Appreciation…

Anaphylaxis: Clinical Guidelines for Diagnosis and Management

Developing Data: June, 2011

Medical Necessity in E/M Coding, Part 2: ROS and PFSH

Abstracts in Urgent Care: June, 2011

Clinical Challenge: June, 2011

57-year old patient bothered by a troublesome cough

42-year-old man unable to bear weight on his ankle

Clinical Challenge 2: May, 2011

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