JOHN SHUFELDT, MD, JD, MBA, FACEP We live and practice medicine in a litigious society. How, evolve into a patient whose ischemic bowel took two or three visits to correctly diagnose. For now, let’s focus on how urgent care providers can protect themselves when the odds are stacked against them. The first and most obvious answer is to not commit malpractice; more about that in a moment. The next most likely answer is for providers …
Read MoreDecember 2006
Urticaria and Angioedema
Urgent message: Patients often present to urgent care with symptoms associated with urticaria and angioedema. Identifying the probable cause can provide relief of symptoms and abate patient concerns. Kent A. Knauer, MD, Director, Allergy and Asthma Center, University Hospitals, Cleveland, OH Urticaria and angioedema are rarely life threatening, but they are extremely disruptive to quality of life and sleep. In addition, hives may be alarming and lead patients to wonder if something serious is afoot. …
Read MoreDeveloping Data: December, 2006
Clinical Challenge: December, 2006
Insights in Images: December, 2006
The Power of Research
Lee A. Resnick, MD, FAAFP Medical progress is driven by research. Opinions must be continuously challenged in order to assure the greatest likelihood of efficacy, quality, and safety. Over the last century, research has focused on examining the innovative diagnostic and therapeutic approaches to disease and prevention that form the backbone of clinical medicine as we know it today.
Read MoreUrticaria and Angioedema
Urgent message: Patients often present to urgent care with symptoms associated with urticaria and angioedema. Identifying the probable cause can provide relief of symptoms and abate patient concerns. Urticaria and angioedema are rarely life threatening, but they are extremely disruptive to quality of life and sleep. In addition, hives may be alarming and lead patients to wonder if something serious is afoot. Swelling of the tongue or throat is particularly likely to be the source …
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Syncope-Evaluation and Management in an Urgent Care Setting
Urgent message: When a patient presents to urgent care after a syncopal event, the clinician’s charge is to determine whether the episode was of benign or potentially life-threatening etiology and whether the patient should be transferred for further evaluation. Introduction Syncope is a sudden, transient loss of consciousness with a loss of postural tone (typically, falling). It results from an abrupt, transient, and diffuse cerebral malfunction and is quickly followed by spontaneous recovery. The term …
Read MoreEvaluation and Management: Coding Details
Q.Why is the (E/M) code important in urgent care? A.Because the majority of urgent care revenue is derived from E/M codes (mostly codes 99210-99215), accurate E/M coding is the most important coding variable in urgent care revenue. Inaccurate E/M coding is, also, the number-one reason that urgent care centers run into compliance issues with payors and regulatory agencies. Q.I see that the Centers for Medicare and Medicaid Services (CMS) lists two sets of guidelines, 1995 …
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