In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. And few things are more relevant to urgent care’s role in the greater healthcare marketplace than wait times in various settings. This may be especially true to the emergency department, as one of the more often heard take-home messages in urgent care promotion is shorter wait times versus a trip to the Ed. This begs the …
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A 12-year-old Girl with Back Pain
Urgent message: Back pain in a pediatric patient requires a high index of suspicion. Ominous causes (e.g. cancer, infection), are far more common in the pediatric population. Conversely, mechanical low back pain is far less common, and is a diagnosis of exclusion. Forrest Nguyen, DO Introduction As urgent care physicians, we are responsible for anything that comes through the door. Often, the diagnosis proves to be routine – a viral infection, a sore throat, or …
Read MoreSplint Applications by Staff, and Proper Use ofModifiers -25, -26, and -59
Q. At the UCA Fall Urgent Care conference, you welcomed all questions, so here goes: Can you please let me know if it is appropriate to charge for Ortho-Glass and fiberglass splints in the urgent care setting? In some cases, the splints are applied by a tech under the direct supervision of the physician. In other cases, can the charge for the application of the splint be coded in addition to the Q code? Question …
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December 2009
Clinical Challenge: December, 2009
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 93-year-old female who lost her balance and twisted her ankle. She presents with significant pain in the ankle and swelling over her lateral …
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23-year-old male complains of heel pain since slipping down steps
The patient is a 23-year-old male who presents with a complaint of pain in the heel area after slipping down four steps. He is limping but able to bear weight. On exam, you note local tenderness and swelling over the area of the Achilles tendon. Other findings are unremarkable. View the x-ray taken and consider what your diagnosis and next steps would be.
Read MoreAbstracts – November 2009
Cost and Quality of Care at Retail Clinics Key point: Quality scores at retail clinics rivaled those at urgent care centers, physician offices, and EDs. Citation: Mehrotra A, Liu H, Adams JL, et al. Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. Ann Intern Med. 2009; 151(5): 321-328. Professional organizations have raised concerns about the quality of care that is delivered at store-based retail …
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55-year-old female experienced blow to back from fall
The patient is a 55-year-old female who experienced a blow to the back when she fell while riding a bus. She complains of pain in her neck, shoulder, and back. On examination, you find that her vitals are stable and she has no significant past medical history. View the x-ray taken and consider what your diagnosis and next steps would be.
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Treatment of Pediatric Community-acquired Pneumonia in an Urgent Care Center
Urgent message: Although diagnosis of pediatric community-acquired pneumonia is not always straightforward, most cases can be diagnosed adequately by non-pediatricians and treated in the urgent care center, thereby reducing hospitalization for this condition. By Deena R. Zimmerman, MD, MPH, IBCLC, Scott Fields, MD, Nahum Kovalski, BSc, MDCM Introduction Pediatric community-acquired pneumonia (CAP) is a common illness. Estimates are that the annual incidence of pneumonia per 1,000 children in North America ranges from 30 to 45 cases …
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