Practice Management
Our goal with the Bouncebacks series is to maximize patient safety and minimize the urgent care provider’s medico-legal exposure. As Greg Henry wrote in the forward of our Bouncebacks! book, “The smart doctor is not the one who learns from his own mistakes. The smart doctor is the one who learns from the mistakes of others.” Our case this month involves a young man with vomiting and diarrhea and abdominal pain. This typical urgent care …
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Urgent message: Working knowledge of anatomy and familiarity with radiograph reading, injury classification, treatment options, and criteria for referral support positive long-term outcomes in patients with acute ankle injuries. Janet D. Little, MD and William E. Saar, DO Acute ankle injury is one of the most common musculoskeletal injuries in the athlete and sedentary person alike. The yearly incidence of ankle injuries varies between resources, but ranges from 1 million to 5 million per year …
Read MoreLee A. Resnick, MD, FAAFP In a previous column, entitled “Rekindling the Doctor-Patient Relationship”, I focused on methods for developing trust with your patients. The intention of building trust is to enhance patient relationships and ensure positive patient encounters. Judgments can be a significant obstacle to that process, however. In fact, judgments are the surest way to undermine trust, and can potentially lead to delay of appropriate care or to misdiagnosis. Judgments are second only …
Read MoreIt’s not Easy for ED Patients to Get Follow-Up Care Key point: Only 23% of attempts to schedule an outpatient follow-up appointment were successful in this study of callers posing as ED patients without primary care physicians. Citation: Vieth TL, Rhodes KV. Nonprice barriers to ambulatory care after an emergency department visit. Ann Emerg Med. 2008;51(5):607-613. Almost half of emergency department patients are dis- charged with instructions to follow up with an outpatient clinic or …
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The patient is a man who presents to the urgent care center after waking in the morning with a sharp pain and a feeling of \”something grainy\” in his left eye. Upon examination, you find diffuse redness of the sclera and conjunctiva, as well as tearing. Additionally, the patient appears photophobic. You are unable to assess visual acuity because he has left his contact lenses out and does not have glasses. Fluorescein examination reveals no …
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The patient is a 2½ -year-old female who presented after falling, unobserved, from an unknown height with tenderness and swelling around the elbow. Neurovascular exam was normal. View the image taken and consider what your diagnosis would be.
Read MoreAs 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 three commonly prescribed medications are believed responsible for one …
Read MoreDAVID STERN, MD (Practice Velocity) Q.Are you able to bill the following two codes together with a modifier: 17110 (Destruction [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement], of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions) 17111 (15 or more lesions)? – Question submitted by Julie Briggs A.These are mutually exclusive codes. You can use 17110 if the physician destroys 14 or less benign lesions (usually warts). …
Read MorePrevalence of UTI in Children Key point: Prevalence is highest in infants younger than 3 months, girls with fever, and uncircumcised boys. Citation: Shaikh N, Morone NE, Bost JE, et al. Prevalence of uri- nary tract infection in childhood: A meta-analysis. Pediatr Infect Dis J. 2008; 27:302-308. During the past decade, many studies have assessed the preva- lence of urinary tract infection (UTI) in children with fever. In- vestigators conducted a meta-analysis of data from …
Read MoreThe patient is an 80-year-old man who presents to urgent care with low back pain of two weeks duration. He is hemodynamically stable and has a normal neurological exam. His personal medical history reveals hypertension, for which he is being treated. Blood pressure is 140/80, pulse 63. 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.
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