Practice Management
Urgent message: Patients with minor traumatic brain injury can be difficult to assess. Identifying those at risk for poor outcomes is critically important in the urgent care setting. Joseph Toscano, MD The term traumatic brain injury (TBI) describes various injury patterns that result from force being absorbed by the brain after a rapid acceleration or deceleration or head impact. TBIs can span a spectrum from minor changes to fatal catastrophes and can affect patients in …
Read MoreLee A. Resnick, MD, FAAFP It’s springtime again, and for us Northerners, that is a welcome sign. It’s time to end months of hibernation holed up in our overly heated homes. It’s time to break out of our winter routine of work, eat, and sleep and welcome in several months of energizing warmth and rejuvenated spirit. At UCA, we use this time of year to re-energize the membership, welcome in new members, and set the …
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The patient is a healthy 30-year-old male who presents with pain shortly after “twisting” his ankle while playing soccer. Pain is severe enough to prevent him from putting weight on the ankle. There are no other remarkable findings from exam or patient history. View the image taken and consider what your diagnosis would be.
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The patient is a 3-year-old girl who presented to the urgent care center with right hip pain. She has no fever, and the parents report there was no trauma. The child has a limp and reproducible pain on external rotation of the right hip. White blood count is 11,900 with 40.7 lymphs. The erythrocyte sedimentation rate (ESR) is 3 mm/hour. The x-ray shows fluid around the right hip joint; this finding was confirmed by ultrasound. …
Read MoreThe patient is a 3 ½-year-old girl who fell from a bicycle, receiving a blow to the elbow a short time before presentation. She had marked swelling and local tenderness over the elbow. The only other remarkable finding was a pulse of 132. 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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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 did the corporate structure/organizational models among participants in UCA’s …
Read MoreDAVID STERN, MD (Practice Velocity) Q.Many procedures, such as injections and fracture care, are reported to patients as “surgery.” Patients sometimes accuse us of false billing, as they don’t consider these procedures to be a “surgery.” How can we fix this problem? A.All third-party payors have installed computer software programs that have code descriptions loaded for each CPT code. Many of these code descriptions are hard to understand, and sometimes they are not truly accurate. CPT …
Read MoreOver the Counter but No Longer Under the Radar—Pediatric Cough and Cold Medications Key point: Since 1985, all six controlled studies of cough/cold preparations in children have not shown a positive effect. Over the last 7 years, poison-control centers have reported more than 750,000 calls Citation: Sharfstein JM, North M, Serwint JR. N Engl J Med. 2007;357(23):2321-2324. In recent weeks, over-the-counter cough and cold medications for children have received unprecedented attention from reg- ulators, physicians, …
Read MoreThe patient is a 9-year-old girl who fell and received a blow to her right chest. A few hours later, she presented to urgent care complaining of pain on deep breathing. On exam, you find a pulse of 103, and SAT of 96. She is not in respiratory distress; her chest exam was clear and she has an abrasion over her right chest. She is generally healthy, is on no medica- tions, and has no …
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