Practice Management
Urgent message: Sexual harassment claims can be costly for an urgent care operator, not tomention ruinous to a center’s reputation. An urgent care center should protect itself by having firm policies and procedures in place to prevent and resolve sexual harassment issues. Alan Ayers, MA, MAcc, Experity Sexual harassment emerged as a major human resources issue in the 1990s. Victims of alleged sexual harassment – who can be men or women – sometimes find sympathetic …
Read MoreIn each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected] The Case The patient is a 22-year-old male who fell and landed directly on his shoulder. On examination, you note marked local swelling and decreased range of …
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The patient is 2-year-old boy with Williams syndrome who presents two days after a trip to the emergency room for a three-day history of fever, cough, and wheezing. In the ED, the parents report, he received three doses of nebulized albuterol and was diagnosed with reactive airway disease and bilateral otitis media. He was discharged on oral amoxicillin and albuterol MDI. Today, you find he has similar symptoms, plus vomiting. His parents say he vomited …
Read MoreDiagnostic Medical Errors: What Goes Wrong and Why Key point: Errors often occur because clinicians don’t consider the diagnosis, test for it, or follow up on abnormal test results. Citation: Schiff GD, Hasan O, Kim S, et al. Diagnostic error in medicine: Analysis of 583 physician-reported errors. Arch Intern Med. 2009; 169: 1881-1887. Autopsy data from the past few decades reveal diagnostic error rates of 10% to 15%, but do not inform us about the …
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Urgent message: Vaginal bleeding is a common presentation in the urgent care setting. An assessment of hemodynamic status, as well as an understanding of potential causes, is necessary to initiate treatment and triage the patient correctly. Thomas Sunshine, MD Introduction Patients presenting with what they perceive to be vaginal bleeding will not know whether that bleeding is specifically uterine, cervical, or (rarely) vaginal in origin. It is incumbent upon the urgent care provider to have …
Read MoreTexting, chatting, networking, blogging, and posting. The evolution of communication into characters on a screen…digitized snippets, factoids, and acronyms used to express display, inform, and explain. Even emotions have been whittled down into emoticons…a semicolon “wink” and a parenthetic “frown.” E-mail? That is soooo last decade! Electronic communication technology has practically replaced more traditional forms. So what does this mean? What is the impact on socialization, relation, and emotional connection? Are there any negative effects? …
Read MoreJohn Shufeldt, MD, JD, MBA, FACEP In his book, How the Mighty Fall: And Why Some Companies Never Give In, Jim Collins discusses the five markers or stages of decline and how a company can identify these stages and reverse itself even after large-scale defeats along the way. (Or, as Bluto (John Belushi) said in Animal House, “Was it over when the Germans bombed Peral Harbor?”) Applying those stages to the rough patch of road …
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Urgent message: Understanding the body’s natural ability to heal itself – and factors that diminish that ability – is of great clinical value and can help you determine whether a wound is acute or chronic, and inform the decision to clean and dress or refer to a wound specialist. Michael S. Miller, DO, FACOS, FAPWCA, CWS and Eric Newgent, DO, MS Introduction The skin is the largest organ in the human body. In simplest terms, …
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