We all think we are great listeners. We “listen” to chief complaints, we listen to histories of present illness, we listen to heart and lung sounds. We spend the better part of the day “listening.” But are we really listening? Or are we just “hearing?” Hearing is the perception of sounds by the auditory nerves in the ear. Listening involves an attentiveness to hear with a purpose of understanding. hearing is a temporal lobe function, …
Read MoreCase Report: Gout vs. Cellulitis
Urgent message: Sometimes, cellulitis can be confused with gout – especially when it involves the area around a joint. A detailed history and physical exam, along with diagnostic testing, will help you reach definite diagnosis. Introduction Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. It is a type of monoarticular arthritis caused by deposition of monosodium urate crystals in and around the joint. Hyperuricemia (serum uric acid level >6.5 mg/dL) seems …
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2-year-old boy with sudden pain in left leg
The patient is a boy, age 2 years 8 months, who presents with the complaint of pain in the left leg that started five hours ago. There is no history of trauma. On exam, the child looks well and has a temp of 98.96 degrees (axillary) and a pulse of 114. In addition, he has a WBC of 17.7, with 73.7 percent granulocytes. The child\’s leg has no external findings. There is clear pain on …
Read MoreDeveloping Data: February, 2010
In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we share insight into the most common reasons patients choose to visit an urgent care center. These data reflect the results of a cross sectional survey of 1,006 patients who visited an urgent care clinic.1 Reasons named by less than 40% of patient included: transportation available at that time told to come by outside …
Read MoreCoding for Two Visits in One Day, Billing for Atypical Urgent Care Services, and Billing on the UB-04
Q. The patient in question is a new patient to the urgent care. At 10 a.m., she visited the urgent care with chief complaint of cough, headache, and myalgias. She was discharged home with a final diagnosis of cough and prescription for ibuprofen and cough syrup. At 3 p.m., she retuned with a complaint of headache and was treated with IM headache medications and sent home with a diagnosis of headache with pain meds. How …
Read More‘Sorry’ Shouldn’t Be the Hardest Word
The following movies, in my opinion, are non-starters on first dates. In no particular order: Sophie’s Choice (tragic) Schindler’s List (depressing) The Exorcist (freaky) The English Patient (mind-numbing boredom) Terms of Endearment (heart-wrenching) and finally, Love Story (sappy). You may, if you were born before 1960, remember the tagline and memorable quote in Love Story. “Love means never having to say you’re sorry.” Oh please, even in 1970, when I was 10-years-old, I knew that …
Read MoreMake Connectivity Part of Your Marketing Strategy
We live in an entirely new business world these days: a world in the midst of rapid change and new rules. Three words seem to embody this new reality: • leverage • integration • alliances These three words apply well to urgent care clinic sales and marketing. They can also be viewed as essential to the concept of connectivity. Here, we will review how connectivity can be used to enhance an urgent care clinic’s occupational …
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Building Urgent Care Referral Relationships Part 2: EDs, PCPs, and Specialists
Urgent message: Forging solid relationships with other clinicians in emergency, primary care, or specialty settings can help facilitate two-way referrals and prove beneficial to all parties involved – including patients. The second of two parts. Alan A. Ayers, MBA, MAcc Overbooked primary care officers and time-consuming (not to mention costly) trips to the emergency room leave many patients frustrated and feeling they have no place left to turn when a medical condition requires immediate attention …
Read MoreAbstracts in Urgent Care: February, 2010
Management of Forearm Fractures in Adults Key point: Primary care evaluation and management of forearm fracture in adults is presented. Citation: Black WS, Becker JA. Common forearm fractures in adults. Am Fam Physician. 2009; 15: 80(10): 1096-1102. Upper extremity fractures are often evaluated by primary care physicians at the patient’s initial presentation or at follow-up after the initial presentation to urgent care or the emergency department. These fractures account for approximately 2 million visits to …
Read MoreClinical Challenge: February, 2010
In 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 patient is a 17-year-old male who fell and experienced a blow to the right knee. On examination, you not local swelling. The patient complains of pain …
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