Clinical Challenge 2: April 2011

The patient is a 49-year-old woman who presents with a two-day history of chest pain and vomiting. The exam reveals no cause for alarm, and other than the primary complaint the patient is in no remarkable distress. However, you discover that she has had intestinal volvulus twice in the past. 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 …

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Abstracts in Urgent Care: April, 2011

Randomized Controlled Trial of Cephalexin Versus Clindamycin for Uncomplicated Pediatric Skin Infections Key point: When it comes to curing skin infected with MRSA (methicillin-resistant Staphylococcus aureus), timely and proper wound cleaning and draining may be more important than the choice of antibiotic. Citation: Chen AE, Carroll KC, Diener-West M, et al. Pediatrics. 2011;127(3):e573-e580. Researchers originally set out to compare the efficacy of two antibiotics commonly used to treat Staph skin infections, ran- domly giving 191 …

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Medical Histories in the Digital Age

Lee A. Resnick, MD, FAAFP “Single?” “Married”? Or, “It’s complicated?” In an era of revealing your relationship status to millions of strangers, we have grown accustomed to people sharing “TMI” about themselves. How might this affect the doctor-patient relationship of a new generation? Are younger patients more likely to share important information with their physicians, where older generations are less forthcoming? Is there a silver lining to this comfort with exposing one’s personal information for …

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The Missing Key: Enhancing Care by Understanding Patients’ Emotions

Urgent message: Even with the utmost attention to proper protocols, current data, and vast clinical experience, patient emotions are the unforeseeable x factor in a positive encounter (and, sometimes, even positive outcomes). Author: Bob Stuart, MD and Bob Bichler, RN As providers, we have been trying to understand how we can be more helpful and effective with the patients to which we provide care. How can I best provide care which will feel most satisfying …

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A New Era for Urgent Care

Lee A. Resnick, MD, FAAFP Spring is here. It’s time to shake off the cobwebs of winter and take a fresh look toward the future. With clear eyes, and a little more daylight, our focus is more acute, and our visionary juices start flowing. The Urgent Care Association has always been a forward-thinking organization, trying to be a step ahead in a dynamic healthcare arena. Over the last seven years, UCA membership has grown sharply, …

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Developing Data: April, 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 first look at data from the 2010 Urgent Care Benchmarking Survey Results. The data are based on the responses of 209 U.S. urgent care centers, 78.8% of which were UCA members. The survey was limited to “full-fledged urgent care centers,” the qualifications of which included accepting walk-ins during all hours of …

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S9088 Coding for Medicare or Medicaid, Coding for SVT, and Coding 99211

DAVID STERN, MD (Practice Velocity) Q.In one of your articles concerning the S9088 code (services provided in an urgent care center), you  indicate this code cannot be billed to Medicare or Medicaid. However, I read in another source that S9088 and S9083 (global fee for urgent care centers) had been approved by the Centers for Medicare and Medicaid Services (CMS) for billing these services. What is the current status of these codes as they relate …

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Using Workplace-based Education as a Marketing Tool

Offering a key decision-maker a tour of your facility is often helpful in signing a new client. But what about the scores of individuals who work for that company? They’re not likely to come traipsing through your clinic en masse, hungry to learn about your services. Remember what the infamous criminal Willie Sutton said when a reporter asked him why he robbed banks: “That’s where the money is.” Similarly, if you want to reach the …

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The Unsociable Network

JOHN SHUFELDT, MD, JD, MBA, FACEP I work with a non-physician professional in the emergency department. She is very intelligent, practical, and always helpful. There is only one small issue: many of her posts on her Facebook page are overtly anti-patient. She frequently rants about the stupid patients, how “bad” the clientele we treat act and how, ultimately, they get what they deserve. Despite her obvious intelligence, she has not realized that what she posts …

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