36-year-old woman experiencing postnatal back pain

36-year-old woman experiencing postnatal back pain

The patient is a 36-year-old obese woman who presented with upper right back pain 10 days after a normal child birth. Pain is worse on coughing. Otherwise, she is fit and well. Upon examination, you find: No shortness of breath Normal oxygen saturation Patient is afebrile Auscultation: Reduced breathing sounds in right base, fine crackles on right View the image taken and consider what your diagnosis would be.

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Developing Data: April, 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 trend is emerging in how participating urgent care practices …

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The Finer Points in Determining New vs. Established Patients

DAVID STERN, MD (Practice Velocity) Q.Our urgent care practice serves a 70-physician primary care group. The UC uses the three-year rule; if the patient has been seen by any physician in the medical group within the last three years, he/she is an established patient even if the patient has never been previously seen in the urgent care. A comparable UC center in a nearby city applies the three-year rule differently; if the patient has been …

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Clinical Challenge: April, 2008

The patient is an 82-year-old man who presented after having fallen backwards and landing on his back. He did not lose consciousness; nor did he vomit. The patient entered the clinic using a walk- er, which he reported using on a regular basis. Examination revealed an abrasion over his forehead and over the anterior right tibia. The neurological exam showed no acute changes. The patient was specifically tender over the shoulder, but there was no …

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Abstracts in Urgent Care: April, 2008

Non-Steroidal Anti-Inflammatory Drugs for Low-Back Pain (Review) Key point: NSAIDS are more effective than placebo, are all similar in efficacy, and do have significant side effects. COX- 2 seems to have fewer side effects; however, the recent data on CV side effects is a concern. Citation: Roelofs PDDM, Deyo RA, Koes BW, et al. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD000396.  DOI: 10.1002/14651858.CD000396.pub3. The authors searched the MEDLINE and EMBASE databases …

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Hiring the Best Occupational Health Sales Professionals

Do you hire an experienced salesperson and train him or her in occupational health, or hire an occupational health professional and train that person in sales? The former brings sales experience but needs to learn the “product;” the latter brings product knowledge but needs to learn fundamental sales skills. Given this choice, my answer is the former. It is easier to train an experienced salesperson in product knowledge than vice versa. However, there are numerous …

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The “O-Ring” in Medical Malpractice Cases

JOHN SHUFELDT, MD, JD, MBA, FACEP The moment is forever etched in my mind. It occurred while I was in my fourth year of medical school during a radiology rotation in Scottsdale, AZ. I was doing everything I could not to fall asleep while sitting in the dark film-reading room, listening to a tonally flat radiologist dictate plain film reports. I got up to splash some cold water on my face and as I was …

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Playing to Win: Maximizing Profits in Urgent Care

Playing to Win: Maximizing Profits in Urgent Care

Urgent message: The financial health of your practice depends on a balanced approach that takes into account both increasing income and reducing expenses. Alan A. Ayers, MBA, MAcc, Experity From an economic perspective, the independent urgent care owner/operator has a dual goal: to build the long-term value of the medical practice while maximizing cash that can be taken out of the business in the form of income. To achieve both of these goals—to expand revenues …

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Creating a Health Surveillance Product Line

Creating a Health Surveillance Product Line

Urgent message: Keeping patients able to perform their jobs is critical to the success of an urgent care occupational medicine program. Donna Lee Gardner, RN, MS, MBA To best meet the needs of employers, an urgent care occupational medicine (UCOM) clinic should feature five basic product lines: • health surveillance • injury/loss management • rehabilitation • prevention services • on-site services This article will address the first of these product lines, health surveillance; the other …

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