UCAOA’S Survey Committee drew two important conclusions from its first industry-wide survey: urgent care is a growing industry nationwide, and those within the industry are hungry for benchmarking data. In each issue of JUCM, Developing Data will seek to fulfill that need. In this issue: Typically, urgent care providers are physicians/entrepreneurs. But they come from a wide variety of practice environments—family practice, emergency medicine, etc.—so what’s the breakdown of how urgent care practices are structured, …
Read MoreCode Compliantly But Differently, Based on the Payor
DAVID STERN, MD (Practice Velocity) Q.I have been told that I can get credit for a complete review of systems (at least 10 systems) by simply noting positive findings in certain systems and then noting “all other systems negative.” A.This is, indeed, a general CMS “guideline,” but two Medicare carriers have issued contradictory guidelines. TrailBlazer Health Enterprises (Medicare carrier for Delaware, the District of Columbia, Maryland, Virginia, and Texas) and Wisconsin Physicians Services (Medicare carrier …
Read MoreClinical Challenge: March, 2007
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 x-rays taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.
Read MoreAbstracts In Urgent Care: March, 2007
Single-Dose Oral Dexamethasone in the Emergency Management of Children with Exacerbations of Mild-to-Moderate Asthma Citation: Altamimi S, Robertson G, Jastaniah W, et al. Pediatr Emerg Care. 2006;22(12):786-793. URL: http://www.pec-online.com/pt/re/pec/home.htm Key point: Singe-dose dexamethasone is equivalent to five days of oral prednisone for kids with mild/moderate asthma. The purpose of this study was to compare the efficacy of a sin- gle dose of oral dexamethasone (dex) versus five days of twice-daily prednisolone (pred) in the management …
Read MoreFilling Your Emotional Tank
Lee A. Resnick, MD, FAAFP Nothing like a frigid winter day to inspire a discussion on emotional well-being; the final reserves of endorphins and serotonin that I stored away for the winter are almost depleted, flu season is upon us, wait-times are long, and everyone is cranky. Times like these remind me of the importance of refueling the emotional tank. This is not just a matter of feeling good, though that’s important, too. But physical …
Read MoreHow to ‘De-Commoditize’ Your Urgent Care Practice
If your practice is in its first year or two of operations, it is easy to stay on top of what your patients want, the quality of their care, and the customer service they are receiving. But as your practice grows, patient counts increase, and you add more corporate clients to your occupational medicine business, you also add links to the customer service and quality care chain. Increasing the number of care providers, nurses, office …
Read MoreClinical Challenge 2 : February, 2007
A 78-year-old woman presents to your urgent care clinic with new onset palpitations that began a few hours before presentation. Upon examination, you find: Pulse is 123 Blood pressure is 152/83 The only existing issue she admits is hypertension, for which she is taking thiazides as Consider Figure 1, above, and what your possible diagnosis might be, based on the evidence available. Resolution of the case is on the next page. >!–nextpage–> Resolution The patient …
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Management of Acute Orofacial Pain Syndromes
Urgent message: The differential diagnosis of acute orofacial pain is wide ranging; prompt recognition of these syndromes is vital for ensuring the best possible outcome. John A. Vaughn, MD, Immediate Health Associates, Westerville, OH A cute orofacial pain—pain arising from the teeth or soft tissues of the mouth—is extremely common, affecting 22% of people in the United States. Since it is more likely to affect younger adults and those without adequate access to primary care, …
Read MoreLeveraging Existing Relationships to Generate More Business
FRANK H. LEONE, MBA, MPH Urgent care clinic operators tend to think of increasing employer-generated volume primarily in terms of new prospects; that is, they tend to believe that growth is attained primarily by expanding their client base. But in many cases, there is as much—if not more—opportunity inherent in selling additional services to existing clients. And “cross selling” to existing clients is just one of many potential advantages that your clinic can accrue by …
Read MoreHow to Define a Type B ED—and Other Vexing Questions
DAVID STERN, MD (Practice Velocity) The urgent care practitioner may not live by coding alone, but proper reimbursement depends on it. To that end, Dr. David Stern, who is in great demand as a speaker and consultant on coding in urgent care, will offer answers to commonly asked questions in every issue of JUCM. In this issue, he addresses a potpourri of issues raised by urgent care practitioners. Q.A consultant tells us that we have …
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