StuWilli, Author at Journal of Urgent Care Medicine

Assessment and Management of Common Hand Infections

Urgent message: Common superficial hand infections may be managed easily by the urgent care physician. Left untreated or undertreated, however, simple hand infections may progress to disabling conditions requiring urgent sub-specialty management. Arthur R. Smolensky, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD The hand is an intricate and crucial feature of the human body. Yet, with the exception of superficial cellulitis, common hand infections require relatively simple surgical procedures—many of which can …

Defining Urgent Care

Lee A. Resnick, MD, FAAFP In this issue of JUCM, The Journal of Urgent Care Medicine, we excerpt the landmark report, “No Appointment Needed: The Resurgence of Urgent Care Centers in the United States”. Funded by the California HealthCare Foundation, and authored by Robin M. Weinick, PhD and Renée M. Betancourt, BA, the report represents the first comprehensive look into urgent care practice and the urgent care industry. Everything from business models and staffing to …

Insights In Images: October, 2007 -2

The patient is a 35-year-old Caucasian female who presented with dysphagia and progressively worsening neck pain. No history of injury was reported. Neurovascular exam was normal. 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.

Abstracts in Urgent Care: October, 2007

A Controlled Clinical Trial of Steroids forBronchiolitis Key point: One dose of oral dexamethasone was no different fromplacebo. Citation: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N Engl J Med. 2007;357:331-339. Bronchiolitis is the leading cause of hospitalization of infants in the U.S. Use of steroids for infants with bronchiolitis remains controversial because of the lack of high-quality, sufficiently powered studies. In a multisite, double-blind clinical trial, researchers randomized 600 infants (age range, …

Developing Data: October, 2007

UCA’s Survey Committee has conducted two annual member surveys, to date, designed to establish benchmarks in an industry for which data have been sorely lacking. In Developing Data, we will share one or two tidbits from the second annual survey and other sources in an effort to help readers get a sense of what their peers are doing, and what kind of trends are developing as urgent care evolves. In this issue: Are payors reimbursing …

Proper Coding for Removal of Foreign Bodies

Q.Recently we removed a tampon that was retained for one week. What is the code for removing a foreign body from the vagina? A.Although this procedure involves significant work, and the resultant foul odor can leave an exam room unusable for hours, the procedure is considered to be a part of the E/M. Of course, this is hard to understand, since there is a code for removing a foreign body from the external ear canal …

Insights In Images: October, 2007

The patient pictured presented with two hours of intense pain and redness along the left side of her head and down her left arm. Though this could easily be mistaken for an infectious process, it was actually reflex sympathetic dystrophy (RSD), also referred to as complex regional pain syndrome (CRPS) type I. By any name, however, this is a rare and poorly understood neurological condition. It may manifest by way of sensory, focal autonomic, or …

Effective Occupational Medicine Sales Through Effective Questioning

A productive occupational medicine sales effort is predicated on your ability to identify a prospect’s need and then to match that need with your services. Both require knowing when and how to ask the right questions. Why is Questioning So Important? Invariably, you begin your association with a prospect as“just another salesperson.” You must set yourself apart from the start. Breaking the ice to pique interest is one area in which well-constructed questions can secure …

Hiring an Employee

JOHN SHUFELDT, MD, JD, MBA, FACEP Let’s be honest, we have all done it: hired someone who, in retrospect, had only two brain cells, both of which turned out to be mutually inhibitory. Have I told you about the time (many years ago) when I hired a provider who, on a busy day, locked himself in the bathroom and screamed, “If you don’t get me some more help, I am going to start drinking?” Since …

Supraventricular Tachycardia in a Child with Williams Syndrome after Nebulized Albuterol

Urgent message: Clinicians must be prepared for the possibility of supraventricular tachycardia after administration of nebulized albuterol in patients of any age, especially in the presence of heart disease. Muhammad Waseem, MD, Padma Gadde, MD, and Gerard Devas, MD Asthma is the most common lung disease in children. Five percent of children in the United States have asthma, and status asthmaticus—the leading cause of admission due to asthma exacerbation—accounts for approximately 10% of visits to …

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