StuWilli, Author at Journal of Urgent Care Medicine

The Case of an 18-Year-Old Male with Hand Pain

Urgent message: A thorough history and physical exam are essential to positive outcomes and risk reduction when managing patients with hand injuries. Michael B. Weinstock, MD and Ryan Longstreth, MD, FACEP Bouncebacks, in which we recount scenarios of actual patients who were evaluated in and discharged from an emergency department or urgent care facility and then “bounced back” for further treatment, appears semi-monthly in JUCM. Case presentations on each patient, along with case-by-case risk management …

UCA: A Vision for the Future

Lee A. Resnick, MD, FAAFP The UCA National Conference, held last month in Daytona Beach, FL, was an important milestone in the organizational evolution of UCA: The elections conducted at the meeting marked the second rotation of board seats since our founding in 2004, and the first board election of a new president. It is critical to the success of our organization to have a rotating leadership at the board and officer levels. Our bylaws …

Management of Patients Presenting with symptoms of Vulvovaginitis

Urgent message: As the cause of approximately 10 million office visits in the United States annually, vulvovaginitis remains a common but important complaint seen in the urgent care setting. Jansen Tiongson, MD, Samuel Keim, MD, and Peter Rosen, MD Although numerous etiologies account for vulvovaginitis, the vast majority of cases are due to bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV causes 40% to 50% of all cases, while candidiasis and trichomoniasis account for …

Occupational Medicine- June, 2007

Injection Procedures and E/M Codes

DAVID STERN, MD (Practice Velocity) Q.Can we bill an evaluation and management code along with the code for administration of an intravenous injection? A.Although it may seem obvious to expect reimbursement in these situations, Medicare waited until 2006 to begin reimbursing physicians for a separate E/M (99201- 99205, 99212-99215) when performed at the same time as IV drug administration. The Medicare Claims Processing Manual states, “Medicare will pay for medically necessary office/outpatient visits billed on …

Addressing the Data Drought

Urgent message: The second UCA Benchmarking Survey takes one small step toward filling the information gap in urgent care medicine. Introduction: Although the practice of urgent care medicine is not a new phenomenon, there is a significant absence of reliable information about the industry. One first step toward filling that void was initiated last year when the Urgent Care Association’s Benchmarking Committee released the results of its first-ever benchmarking survey of UCA members and others …

Abstracts in Urgent Care: June, 2007

Evaluation of the Utility of Radiography in Acute Bronchiolitis Key point: Infants with typical bronchiolitis (clinically O2sat>92% and mild/moderate distress) do not need imaging. Citation: Schuh S, Lalani A, Allen U, et al. J Pediatr. 2007;150: 429-433. URL: http://sitemaker.umich.edu/emjournalclub/article_database/ da.data/1619753/PDF/bronchiolitis_xray_j_pediatrics.pdf The purpose of this study was to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given …

Using Education as an Occupational Health Marketing Tool

As marketing initiatives become increasingly self-serving, it behooves an urgent care clinic to differentiate itself by “playing the education card.” Why Education? Many employer decision-makers are still strikingly naïve about the value of a well-integrated, proactive approach to their company’s health and safety activities. Educational information does not come off as self-serving and is perceived as a “kinder and gentler” form of marketing. In our information-saturated world, it is imperative to find a way to …

Vicarious Liability

JOHN SHUFELDT, MD, JD, MBA, FACEP It’s 8:15 on Sunday morning. This is the first morning you have actually been able to sleep in since you opened the urgent care center five months ago. Truth be told, you drank a glass (or two) of wine too many last night and are still feeling the effects this morning. However, you don’t care; you have the day off and you can slouch around till noon and no …

Author: StuWilli