StuWilli, Author at Journal of Urgent Care Medicine

Your Antibiotic Stewardship Efforts Are Paying Off

A new study by the Blue Cross Blue Shield Association indicates that efforts to curb inappropriate antibiotics prescribing are working. The project considered 173 million claims reflecting the care of subscribers <65 years of age who filled antibiotic prescriptions between 2010 and 2016, finding that prescriptions for antibiotics fell 22% for infants, 16% for children, and 6% for adults during that time frame. Patients in the South and Appalachia were more likely to fill prescriptions …

Intermountain Quantifies Goal to Cut Opioid Prescriptions

The need to reduce access to opioid pain medications is pretty well accepted at this point, though much of the outcry is vague and often geared toward echoing statistics about the very real epidemic of addiction and death. However, Intermountain Health, which operates InstaCare urgent care centers in Utah and Idaho, has gone a step further by crunching its own numbers and devising a plan to cut opioid prescriptions across its systems by 40% by …

Urgent Care Data Would Feed NJ ‘Master Person Index’ to Help Prevent Mistaken Identity

Lax record keeping, the transient nature of online identities, and continually changing mobile phone numbers make it hard enough to keep tab on “who’s who” in your patient records. Add common names to the mix and it’s easy to see how patient identity could be hard to keep straight—the consequences of which could be severe in terms of patient safety and your adherence to confidentiality laws. New Jersey thinks one solution would be Master Person …

Connecticut Tries (Again) to Regulate Urgent Care Centers

Connecticut lawmakers apparently think “If at first you don’t succeed…” is the perfect approach to slapping licensing fees on the urgent care industry. Democrats in the state House of Representatives have inserted a provision in the current proposed budget that would require all urgent care centers there to carry a distinct license. The problem (for them) is, they don’t have an abiding definition of what constitutes an urgent care center. Currently, the law views urgent …

Independence Blue Cross Slashes Reimbursements on Modifier 25

Independence Blue Cross has implemented a new policy that cuts reimbursements on procedures billed with modifier 25 (“Significant, separately identifiable E/M service”) by half for care given to Medicare Advantage members and patients covered by private insurance plans. The lower rate does not apply to traditional Medicare claims. Independence covers patients under its own name, but also through QCC Insurance Company, Keystone Health Plan Eastand AmeriHealth. The move sets Independence apart from other payers, including …

September 2017

A 30-Year-Old Woman with a ‘Burning’ Tongue

Case A 30-year-old woman visited urgent care complaining of a burning sensation on her tongue. At first, she had blamed it on a spicy meal, but the feeling didn’t go away and now she feels as though she isn’t able to taste food as usual. Looking back, she recalls that over a month ago she noticed a white plaque on her tongue. However, that had had disappeared within a day so she hadn’t thought much …

A 73-Year-Old Man with a 2-Week History of Palpitations

Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …

A 21-Year-Old Male with Foot Pain

Case A 21-year-old male presents with pain after dropping a piece of furniture on his right foot. He is physically able to bear weight during the assessment, though his pain is evident and he is unsteady when shifting his weight to the injured foot. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Come October, Come the Flu

On paper, flu season starts next month, meaning it’s an ideal time to start reminding patients they’ll need flu shots (and that you’ll be happy to provide one). While the majority of children tend to get their shots toward the end of the season according to the Centers for Disease Control and Prevention, the distribution has been more evenly distributed for adults over the past few flu seasons, as seen in Figure 1, below. The …

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