StuWilli, Author at Journal of Urgent Care Medicine

Pediatric Abdominal Pain: Consider Pneumonia in the Differential Diagnosis

Urgent message: Abdominal pain can be a challenging complaint, especially in younger patients. Consider the full range of differential diagnosis in order to initiate prompt, effective management. Curtis Kommer MD, Latha Shankar, MD, MBA and Robert Stuart, MD Introduction Since the time of Hippocrates, the ability of physicians to unravel the mystery of a patient’s abdominal pain has become synonymous with the art and practice of medicine. Pediatric abdominal pain, in particular, with its extensive …

Practice Management: Keys to a Financially Healthy Urgent Care Center: Patient and Payor Mix

Urgent message: The right mix of payors and patients might make the difference between profitability and the poorhouse. Apply the basic principles to your situation, and adjust accordingly. By Stacy Calvaruso Many factors contribute to the ultimate success or failure of an urgent care center. Some are beyond your control, but there are others on which you can exert a good deal of influence — with the right approach. Two such factors that have an …

Assessment and Management of Scrotal Disorders

Urgent message: Males with a scrotal disorder often present to urgent care with pain, swelling, or both. Especially in boys and young men, it is important to quickly assess the acute scrotum, which can be a surgical emergency. Jason Chao, MD, MS Introduction Males with a scrotal disorder often present with pain, swelling, — or both. Because of the location of the problem, patients often choose to seek urgent medical attention. Especially in boys and …

Clinical Challenge 2: November, 2010

The patient is a 77-year-old who presents with pain in the left wrist. She reports injuring it in a fall. 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.

Abstracts in Urgent Care: November, 2010

On ED Visits, Corticosteroids and COPD, Intranasal Steroid in Allergic Rhinitis, Intussusception in Children Under 5, Urinary Antigen Testing, and Emergency Contraception Nahum Kovalski, BSc, MDCM Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Emergency Department Visits on the Rise Key point: ED use in the U.S. is up dramatically; these stats …

Clinical Challenge 2: October, 2010

The patient is a 54-year-old woman who presents with a three-day history of constipation. She denies any vomiting, and you note no abdominal distension. She is passing small amounts of gas. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the page.

23-year-old male has persistent wound after crushing finger

The patient is a 23-year-old healthy male presenting for a “wound check” about four weeks after crushing his left fifth finger in a car door. At that time, x-rays were negative for a fracture. He was placed on cephalexin because of a small avulsion of skin on the distal aspect of the finger. Today, you find that the distal aspect of the dermis of the fifth finger has sloughed off. The underlying tissue is pink, …

In the Beginning: Doc’s In ERgent Care Clermont, Florida

(In the Beginning recounts the real-life experiences of urgent care owners who have taken the initiative to hang out the proverbial shingle and open a new start-up center. It will be an occasionally recurring feature available exclusively in the digital edition of JUCM.) From marketing to urgent care medicine to triathlons, it seems as though Dr. Cheryl Durstein Decker was literally and figuratively born to run, slowing down only occasionally to help others in her …

October 2010

Toxicological Emergencies for the Urgent Care Physician

Urgent message: Several specific toxicological emergencies are most likely to be encountered in the urgent care setting. Prompt recognition of their clinical presentation, understanding the pathophysiology/natural disease progression, and initiation of treatment are critical factors in decreasing morbidity (and potential mortality) in these cases. Michael L. Epter, DO, FAAEM and Alicia Pilarski, DO Introduction Beginning in 2004, poisonings rank second to motor vehicle accidents as the leading cause of accidental death in the U.S., with …

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