23-year-old woman covered in dark, blistering "bruises"
The patient is a 23-year-old white woman with a medical history significant for asthma as a teenager who presents with “bruising on her legs and belly.” The patient reports that the affected areas became red and started \”stinging\” approximately three weeks ago, accompanied by “some small blisters.” At the time, she attributed the symptoms to sunburn. Gradually, however, the areas evolved into darker \”bruises\” that have now been present for about two weeks. She denies …
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13-year-old male injures hand while bracing fall
The patient is a 13-year-old male who presented to urgent care after taking a fall while running; he landed on his outstretched left hand. Upon examination, you find tenderness in the snuffbox and observe swelling around the wrist. Otherwise, the findings are unremarkable. View the x-ray taken and consider what your next steps would be.
Read MoreToward a Happier World: The Art of Patient Service
Customer service is a trendy theme in virtually every business these days. However, the gap between “woulda, shoulda, coulda” and reality is invariably significant. Simply put, the concept of customer service is given universal lip service, but it is rarely incorporated into the fabric of an urgent care clinic. An effective patient service program requires five core elements: planning, training, execution, evaluation, and reward/recognition. Planning Your program should have a well-designed plan that addresses train- …
Read MoreA 34-Year-Old Male Who Injured His Finger
This patient, a 34-year-old male whose pre and post-reduction x-rays are shown here (Figure 1 and Figure 2), presented to urgent care after sustaining an axial injury to his fourth left finger while playing a weekend game of football. FIGURE 1. PRE-REDUCTION Reduction proved physically chal- lenging to more than one practi- tioner. A physician who happened to be on site tried unsuccessfully to reduce the dislocation at the time it occurred, then recommended the …
Read MoreClinical Challenge 2: July 2008
The patient is a 73-year-old woman who presents with a foreign body (a piece of wood, specifically) sticking out of a scratch on her hand. She reports that she fell in her yard. In addition, you discover that she has local pain and swelling of the left wrist. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge: July 2008
The patient is a 2-year-old girl who experienced a blow to the left foot when she jumped from an unspecified height while playing. The parents were unaware at the time the injury occurred, but toward evening the girl refused to apply weight to her left foot. On exam, the foot is mildly swollen and tender. Otherwise, there are no remarkable findings. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps …
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July/August 2008
Toward a Happier World: The Art of Patient Service
JOHN SHUFELDT, MD, JD, MBA, FACEP Customer service is a trendy theme in virtually every business these days. However, the gap between “woulda, shoulda, coulda” and reality is invariably significant. Simply put, the concept of customer service is given universal lip service, but it is rarely incorporated into the fabric of an urgent care clinic. An effective patient service program requires five core elements: planning, training, execution, evaluation, and reward/recognition.
Read MoreBankruptcy: When BK Doesn’t Mean You Can Have It Your Way
JOHN SHUFELDT, MD, JD, MBA, FACEP My favorite movie—other than Wedding Crashers, of course—is It’s a Wonderful Life. I watch it every Christmas. One of the most memorable scenes is where Uncle Billy misplaces the envelope containing the deposits. Once George realizes the gravity of the situation, he confronts Uncle Billy: “Where’s that money, you stupid old fool? Where’s that money? Do you realize what this means? It means bankruptcy and scandal and prison, that’s …
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