Practice Management
Case A 38-year-old female patient presents with acute shoulder pain following a fall on an outstretched arm during a spring skiing vacation. There is a normal appearance to the shoulder, but significant pain even with minimal attempts at range of motion. The clavicle and elbow are nontender. Neurovascular status is intact. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
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Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, …
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Urgent message: The simplest explanation for a mundane symptom may not always reflect the correct diagnosis. Urgent care providers should consider all the possibilities in order to reach the correct conclusion as early as possible, or risk missing a more serious underlying diagnosis. Introduction Sometimes a simple complaint results in a common diagnosis, but other times a rare diagnosis will be discovered. The following case illustrates the importance of considering a wide differential and obtaining …
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Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …
Read MoreTracking Antibiotic Prescriptions for Nonbacterial Acute URI Key point: Patients were more likely to receive prescriptions from mid- or late-career physicians and from those with higher daily patient volumes. Citation: Silverman M, et al. Antibiotic prescribing for nonbacterial acute respiratory infections in elderly persons. Ann Intern Med. [Epub ahead of print May 9, 2017] This retrospective analysis of linked administrative health care data was drawn from 8,990 primary care physicians and 185,014 patients who presented …
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Urgent message: Ideally, paid advertising should show a return on investment based on the revenue it generates. However, revenue-based metrics are difficult to prove using social media, in which “likes” are more valuable in identifying fully engaged patients than generating direct sales. When it comes to social media marketing channels, Facebook remains atop the throne. The fact that 80% of Fortune 500 companies have an active Facebook page more than supports that assertion, and stands …
Read MoreDriven partially by increased use of the powerful synthetic opioid fentanyl, patients continued to flood emergency rooms across the country in increasing numbers over the 10-year period ending in 2014, according to data from the Agency for Healthcare Research and Quality (AHRQ; see graph below). The implications for urgent care are A) that some of those patients surely received their first opioid prescriptions in an urgent care center legitimately for treatment of acute pain, underscoring …
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Pharmaceutical giant Merck and Heritage Valley Health System are the latest healthcare organizations to be struck with a ransomware attack. The same event created havoc across Europe, as well. Electronic security experts point to a version of the Petya virus as the likely “pathogen.” While Merck was largely mum on how it fared, Heritage Valley said its network had “protections” put in place by its antivirus software vendor to ensure patient care was not disrupted. …
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