The patient is a 15-year-old boy who presents with pain in the wrist 40 minutes after stopping a soccer ball with his hand. There is no snuffbox tenderness. View the x-rays taken and consider what your diagnosis and next steps would be.
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Bankruptcy Part Two: Honesty is the Only Policy
JOHN SHUFELDT, MD, JD, MBA, FACEP In this challenging financial market, in this space (urgent care medicine), should bankruptcy be something with which you are overly concerned? The answer is an unequivocal, “yes!” Urgent care ownership is not for the faint of heart or the short of capital. As a friend of mine said, “This business has a lot of moving parts and misfiring on any one of them can cause your business to be …
Read MoreDeveloping Data: September, 2008
As an emerging distinct practice environment, urgent care is in the early stages of building a data set specific to its norms and practices. In Developing Data, JUCM will offer results not only from UCA’s annual benchmarking surveys, but also from research conducted elsewhere to present an expansive view of the healthcare marketplace in which urgent care seeks to strengthen its presence. In this issue: What effect does the presence of a retail clinic have …
Read MoreOf Discounts, Surgical Wound Dressing, and the S9088 Code
DAVID STERN, MD (Practice Velocity) Q.For uninsured patients, how much discount should be given—70% off charges? Particularly in California. A.It would be extremely rare to offer such a big discount to self-pay patients. It would be unadvisable for the following reasons: Unless your fee schedule is ridiculously high, you could not operate profitably at these Discounts should be given not for being self-pay, specif- ically, but for paying in full at time of You will …
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September 2008
Abstracts in Urgent Care: September, 2008
Vasopressin Not Helpful for Out-of-Hospital Cardiac Arrest Key point: For now, epinephrine remains the only evidence- based drug option in CPR. Citation: Gueugniaud P-Y, David J-S, Chanzy E, et al. Vasopressin and epinephrine vs. epinephrine alone in cardiopulmonary re- suscitation. N Engl J Med. 2008;359:21-30. The ideal drug regimen for use in CPR is a subject of controversy. Epinephrine is the recommended vasopressor agent, but results of some studies suggest that combining epinephrine with vasopressin …
Read MoreFear as a Factor in Occupational Health Sales
Avoidance, sometimes even more than appeal, appears to be a very real part of decision making at every level. Given sufficient probing, most sales prospects harbor inner fears that can be successfully addressed. Buyers of occupational health services have two basic motivations: helping their parent company save money, and making their own life easier. Most occupational health sales presentations emphasize the former: reduce injury/illness incidence and associated lost work time, save the employer money, and …
Read MorePharyngitis: Diagnosis and Treatment in the Urgent Care Setting
Urgent message: Sore throat is a complaint commonly encountered in urgent care. Proper evaluation and understanding and use of appropriate antibiotics will foster better patient care and understanding while limiting antibiotic resistance. William Gluckman, DO, MBA, FACEP and Jessica Kay, PharmD Pharyngitis refers to the inflammation or irritation of the pharynx, including the tonsils, and can have many etiologies, including a variety of infections, cancer, allergic reactions, gastroesophageal reflux, or toxic inhalations and ingestions. This …
Read MoreUCA in the News
Lee A. Resnick, MD, FAAFP UCA has been a busy organization of late. The announcement of an alliance with the Joint Commission is big news, indeed. We recognize that this news may not be welcomed by all, but are confident that most of your preconceptions will not be validated by the process. I think we all can agree on the goals of an urgent care accreditation program: First and foremost, it should be “urgent care …
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76-year-old woman with sudden ulcers on roof of mouth
The patient is a 76-year-old woman with a one-day history of multiple painful ulcers, with general erythema on the mucosa of the left side of the hard palate of her mouth. On examination, you find that they stop at the midline of the palate. There are no other remarkable findings, but upon questioning the patient reveals a three-day history of fevers and general aches. View the photo and consider what your next steps would be.
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