DAVID STERN, MD (Experity) Q.I can’t find any documentation that tells us specifically how we should code when a provider tries to remove a foreign body, but is not successful and decides that the patient should go to the ER. Do we just code for an office visit or do we also code for the removal of the foreign body since the provider did try, albeit unsuccessfully, and decided the patient needed to be seen …
Read MoreAbstracts In Urgent Care: May, 2008
Duration of IV Antibiotic Treatment for Children with Pyelonephritis Key point: Rates of renal scarring were similar in children who received long- or short-course IV antibiotics. Citation: Bouissou F, Munzer C, Decramer S, et al. Prospec- tive, randomized trial comparing short and long intravenous antibiotic treatment of acute pyelonephritis in children: Dimercaptosuccinic acid scintigraphic evaluation at 9 months. Pediatrics. 2008;121:e553-e560. Whether the mode and duration of antibiotic treatment prevent development of renal scars in children …
Read MoreClinical Challenge: May, 2008
This male patient presents to urgent care after, he claims, falling from a ladder. He refuses to give further details, except to say that the distance he fell was “not high.” 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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May 2008
Prescription Drug Abuse and the Drug-Seeking Patient
Urgent message: The urgent care clinic is a prime target for prescription drug abusers seeking possibly inappropriate prescriptions. Clinicians must be vigilant to screen, intervene, and refer such patients. Marcelina Behnam, MD and Mark Rogers, MD Over the past several years, prescription drug abuse has become a problem of epidemic proportions for urgent care centers and emergency departments around the country. There has been an increase both in visits related to the acquisition of these …
Read MoreRekindling the Doctor-Patient Relationship
Lee A Resnick, MD, FAAFP The joy of practice is two-fold: Intellectual and Relational. The intellectual side of us thrives on the challenge of complex medical decision making and computational fact-finding. Understanding and applying pathophysiology is what we trained for, and what most of us consider to be a joyful brain exercise. However, since we do not practice medicine in a vacuum, the relational side of patient care is equally important to job satisfaction. It …
Read MorePerfecting the Clinic Visit as a Closing Technique
Inviting would-be employer clients to visit your urgent care clinic is an increasingly common and effective marketing tool. Yet, most such visits are done with insufficient forethought. The majority of occupational health closes are “soft” commitments—that is, there is no guarantee that the prospect will use your urgent care clinic. Hence, some type of follow-up to most sales calls is advisable. Further, it is best to actually involve the prospect in some manner, as prospect …
Read MoreThere Will be Blood: Key Reasons That Start-ups Fail
JOHN SHUFELDT, MD, JD, MBA, FACEP In the movie There Will be Blood, character Henry Brands says, “That part of me is gone…working and not succeeding—all my failures has [sic] left me….I just don’t… care.” At the end, after the struggles, “I don’t care” is a common aphorism of the wanton entrepreneur. Maybe it is uttered during the futile death throes of the dying business. Or, maybe after leaving the bank president’s office. I suppose …
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The Case of a 71-Year-Old Man with Back Pain
Though it is easy to predict the usual etiology of common complaints, we need to be able to exclude life-threatening causes of symptoms. In law, we are innocent until proven guilty. In medicine, we are required to prove certain diseases are not occurring; we are, in a sense, guilty until proven innocent: A 50-year-old man with chest pain and diaphoresis has an MI until proven otherwise. A 22-year-old woman with lower abdominal pain has an …
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3-year-old female with foot pain after fall
The patient is a 3-year-old female who presented after a fall while running, complaining of pain over the foot. There was minimal local tenderness over the foot and minimal limp, but no other remarkable findings. View the image taken and consider what your diagnosis would be.
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