StuWilli, Author at Journal of Urgent Care Medicine

Minor Traumatic Brain Injury: Applying the Evidence to Urgent Care

Urgent message: While few data specific to the urgent care setting exist, applying the medical evidence gleaned from other acute care settings can enable the clinician to effect positive outcomes in patients presenting with symptoms indicative of minor TBI. Joseph Toscano, MD Head trauma is among the most important problems evaluated in acute-care medicine. Estimates from the Centers for Disease Control and Prevention indicate that each year in the Unites States, approximately 1.4 million individuals …

Notes From the Field

Lee A. Resnick, MD, FAAFP I write to you from the beautiful landscapes of New Zealand, where I just participated in the first-ever international conference for urgent care. Representatives from all over the world joined to share ideas and experiences of their journeys into the development of urgent care as a discipline and an industry. This international dialogue broadens our understanding of the clinical and market forces driving this global phenomenon, and strengthens our individual …

53-year-old woman with limited motion and pain in knee

The patient is was a 53-year-old female who experienced a fall, landing on her knee, several hours before presenting. Her knee is stable and she is able to bear weight on the affected leg, though there is mildly decreased range of motion due to generalized pain in the area. You note that the pain is not over the patella, however. There is no fluid in the knee. View the image taken and consider what your …

38-year-old with progressive abdominal pain

The patient is a healthy 38-year-old who presents with progressive abdominal pain. There is no fever, vomiting, or diarrhea. There are no peritoneal signs. Pulse is 55, and blood pressure is 118/50. The only remarkable finding when the history is taken is that the patient had corrective heart surgery as a child. View the image taken and consider what your diagnosis would be.

March 2008

Developing Data: March, 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: How do patients view the importance of “emotional support” from …

Readers’ Coding Inquiries

DAVID STERN, MD (Practice Velocity) Q.How would you define the difference between an expanded problem-focused exam and the detailed exam in the 1995 evaluation and management coding guidelines? – Question submitted by Eddie Stahl, Medical Staff Director, Tennessee Urgent Care Associates A.For both the expanded problem-focused exam (EPF) and the detailed exam, the provider must document between two and seven body systems. The difference is that the EPF exam requires a “limited” exam of a …

Learning to be Direct in Sales Negotiations

In 2008, we live in a vastly different world in which we feel information-saturated, overburdened, and pressed for time. It is a world in which long dialogue is generally a nuisance and short, to-the-point interchange is embraced. It is a world that values Headline News, USA Today, and Internet blogs more than traditional news shows or in-depth books. In short, we live in a world in which people want things short, simple, and digestible. That …

What the Gray Haired Never Shared

JOHN SHUFELDT, MD, JD, MBA, FACEP For some reason, it is likely that no one with gray hair ever sat you down and shared with you some secrets to longevity, productivity, and career success in medicine. Why we in medicine tend to “eat our young” remains a mystery to me. If you have seen the movie 300 or read the book Gates of Fire, you understand that we tend to act very “Spartan-like.” I am …

The Case of a 10-Year-Old Male with Eye Pain

Other than these medical errors, dyspnea and advanced age were the two most common factors associated with an unscheduled return visit. What is the incidence of bouncebacks? What is the incidence of bounceback admissions? What is the inci- dence of death in patients recently discharged from the ED? What percent of bouncebacks occur because of medical errors? How can we use this information to improve patient safety? This month, we will discuss Question IV: What …

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