A 70-Year-Old Man with Hand Numbness and Pain

A 70-Year-Old Man with Hand Numbness and Pain

The patient is a 70-year-old male who presents to urgent care with numbness, pain, and difficulty opening his hands. His son, who drove his father to the appointment, notes that the skin also looks “bunched up in places.” The physician also observes what look like raised scars. The thumb and index finger seem unaffected. Upon questioning, the patient says he started noticing smooth nodules “a couple years ago.” He attributed that to his many years …

Read More

Not Like Old Times

The first time I wrote this column was for the inaugural issue of JUCM in October 2006. Today I could reflect on how much has changed around us, yet how much has stayed the same, but you know…no one really cares about what’s happened since 2006. What we really care about is today, and tomorrow. What’s happening right NOW, and what’s going to happen NEXT. And that’s the inspiration for the 2020 Convention. Yep, I’m …

Read More
Urgent Identification and Management of Postsplenectomy Sepsis

Urgent Identification and Management of Postsplenectomy Sepsis

Urgent message: Asplenic individuals have a rate of severe infections 2-3 times higher than the general population. Postsplenectomy sepsis should be considered in patients with impaired splenic function who present with a fever. Megan L. Lawson, PA-C and Christina Gardner, DHSc, MBA, PA-C CASE PRESENTATION A 45-year-old male presented to the urgent care with 18 days of sinus pain and congestion unresponsive to two courses of antibiotics, cefdinir and levofloxacin. Past surgical history revealed a …

Read More

Ringing in 2020 with CPT Changes

It’s that time of year again. The American Medical Association has implemented the 2020 Current Procedural Terminology (CPT) code set. This year we have 394 changes: 248 additions, 71 deletions, and 75 revisions. All changes took effect on January 1. While the impact to urgent care is minor, several items bear highlighting Health Behavior Assessment and Intervention The codes in the Health Behavior Assessment and Intervention section are used to report services provided to improve …

Read More
A Blistering Rash in an Otherwise Healthy 9-Year-Old Boy

A Blistering Rash in an Otherwise Healthy 9-Year-Old Boy

Urgent message: Impetigo is one of the most common skin infections in children, and can have a variable presentation. As such, it is essential that the urgent care provider be able to recognize this common skin infection, and to know the treatment options. Aimy T. Patel, MD, FAAP, Allison Burris, MD FAAP, and Nirav Shastri, MD, FAAP, FAMIA, ABMS-CI CASE PRESENTATION History A 9-year-old otherwise healthy boy presents with a 1-week history of an itchy …

Read More

Keep Your Differential Broad, Especially During Flu Season

I’m phenomenally bad at gambling for a multitude of reasons. I bet small when I should bet large. I bet large when I shouldn’t even be playing the game. I’m especially terrible at roulette because when I pick a number, usually 22, I stick with it—much longer than I should. Each time the wheel stops, on any other number, I’m disappointed, sure. But that disappointment is quickly replaced with hope that the odds of lucky …

Read More
Smoothing Ebb-and-Flow for Greater Staff Efficiency and Shorter Wait Times in Urgent Care

Smoothing Ebb-and-Flow for Greater Staff Efficiency and Shorter Wait Times in Urgent Care

Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Urgent message: Integration of healthcare delivery with mobile technology is leading more urgent care operators to embrace digital queuing systems that, given their ability to positively impact patient wait times, offer the promise of elevating the patient experience—and a distinct competitive advantage. In a perfect world, every patient who showed …

Read More
A 69-Year-Old Man with a 2-Month History of Shortness of Breath and Mild Chest Pain

A 69-Year-Old Man with a 2-Month History of Shortness of Breath and Mild Chest Pain

The patients is a 69-year-old man with shortness of breath and mild chest pain of 2 months duration. He has felt it unnecessary to see his “regular doctor” because his complaints haven’t gotten worse, but conceded to visit urgent care today at the insistence of his family. When asked, he acknowledges a history of congestive heart failure and hypertension. View the ECG and consider what your diagnosis and next steps would be. Resolution of the …

Read More

Evaluation and Diagnosis of Trigger Finger with Current Management Strategies

Urgent message: Appropriate treatment of “trigger finger” in the urgent care setting starts with differentiating that diagnoses from other disorders of the hand. This is relatively straightforward if one finger is involved, but can become more complex with multiple digits. Shailendra K. Saxena, MD, PhD and Alexander M. Stock, BS INTRODUCTION Trigger finger, also known as stenosing flexor tenosynovitis, is a common hand disorder that affects approximately 2.6% of the general population during their lifetime.1 …

Read More
What Urgent Care Operators Need to Know About OSHA

What Urgent Care Operators Need to Know About OSHA

Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Urgent message: Though the topic of OSHA doesn’t often come up in the context of urgent care facilities themselves, operators are nevertheless required to have a thorough understanding of its standards and guidelines towards ensuring their facilities are in compliance, and that the health and safety of employees, patients, and …

Read More