StuWilli, Author at Journal of Urgent Care Medicine

Management of Patients Presenting with Constipation

Urgent message: Constipation can be a sign of serious – even life-threatening – etiologies. Once non-benign causes have been ruled out, emphasis should be on evacuation and dietary and lifestyle changes to prevent recurrence. Claire West, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD Introduction Constipation is a common complaint, accounting for approximately 2.5 million doctor visits annually. With increasing difficulty in obtaining a quick appointment with a primary care physician, more and …

Developing Data: February, 2009

In early 2008, UCA revamped its annual survey in conjunction with researchers at Massachusetts General Hospital and Harvard University with the goal of assuring that the UCA Benchmarking Committee’s efforts produced as scientifically valid report. Over the coming months in Developing Data, JUCM will present some of the findings from this landmark survey, to which 436 urgent care centers responded. In this issue: Who owns all those urgent care centers, anyway? Note that the entrepreneurial …

The Only Constant is Change

As I contemplate my own professional transition, from an academic mega-hospital to a private urgent care venture, I have been through the usual rollercoaster of emotions that accompany any major life changes: Stress (physical, mental, and emotional): Change requires simultaneously managing the process you are changing from and the process you are changing to. That’s double the work. In a complex profession like ours, I think everyone will agree there’s enough stress managing just one. …

An Update on New vs. Established Patients

David Stern, MD Q.I read your column about new vs. established patient coding in the January Issue of JUCM. Although the information provided was correct at one time, I believe that Medicare has updated its algorithm to come closer to the algorithm provided by AMA for new vs, established patients. A.You are correct. In a somewhat obscure and rarely referenced information release. (www.cms.hhs.gov/MLNMattersArticles/downloads/MM4032.pdf) CMS did change its position on this issue. “Physicians should not that …

Adjust Your Strategy for a Down Economy

There is a broad consensus that our country’s current recession will advance to become the harshest economic crisis we have faced since the Great Depression. On the surface, spiraling unemployment and broad-based financial pressures portend trouble for most urgent care clinics. Yet, crisis inevitably breeds opportunity if clinic owners avoid being caught like a deer in the headlights and proactively move forward. This month’s column addresses economic realities and what clinics can do now—not just …

How to Say ‘Farewell and Adieu’ to Owning Your Business

John Shufeldt, MD, JD, MBA, FACEP How do you know when it’s time to cut bait? Remember the scene in Jaws when Chief Martin Brody (Roy Scheider) is throwing fish guts into the ocean and comes face to face with the shark? He remarks, somewhat casually. “You’re going to need a bigger boat.” Despite the fact that everyone in the theater is yelling “run for your life,” the trio then decides to continue after the …

Clinical Challenge: February, 2009

10-year-old boy sustains direct blow to elbow

The patient is a 10-year-old boy who experienced a direct blow to the elbow approximately six hours prior to presentation.He had incomplete range of motion with minimal local swelling and considerable pain. View the image and consider what your next steps would be.

26-year-old woman with bleeding lesion

A 26-year-old woman presents to the urgent care center with a bleeding lesion on her finger. The lesion developed in less than a week and was associated with no other symptoms. The patient is on no medications and is otherwise healthy. She reports no prior history of skin disease. View the photo taken and consider what your diagnosis and next steps would be.

The Search for the Urgent Care Center

Urgent message: Efforts to define and accurately count urgent care centers in the U.S.—which may be crucial to the industry’s continued growth—are ongoing, and will require the commitment of trade organizations and individual urgent care owners alike. Our quest to provide accurate, scientifically rigorous benchmarking data for urgent care centers began with the decision to conduct a survey. Before you can administer a survey, though, you need to be able to identify the individuals or organizations …

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