Case A 78-year-old man presents to an urgent care center with bilateral knee pain that he has had for 1 week. The pain is worse in his right knee and is worse with ambulation. He says that he has not experienced any recent trauma, but he does note that he has been helping his son move into an apartment. He reports no fever, dizziness, chest pain, or shortness of breath. He has hypertension, for which …
Read MoreYoung Football Player with Sudden Chest Pain
Case A 20-year-old previously healthy man presents with sudden onset of substernal chest pressure after completing football practice. His chest pain is nonradiating, nonreproducible, and nonpositional. He does not have associated palpitations, dyspnea, or diaphoresis. He reports that he has not had recent upper respiratory tract infections or contact with ill people. He does not have a history of using alcohol, tobacco, or illicit drugs. He has no family history of sudden cardiac death or …
Read MoreImaging: X-Rays and Computed Tomography
Q. I understand that there will be reductions for x-ray reimbursements from Medicare in 2017. Is this true? A. To give imaging providers an additional incentive to adopt more advanced x-ray technology, Medicare will reduce reimbursement, beginning in 2017, for the technical component (and the technical component of the global fee) in claims submitted for x-rays performed with analog equipment. The cuts will continue in future years for those using computed radiography equipment (Table 1). …
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Painful Nose Crusting in a Child
Urgent message: Common nasal infections can have serious health consequences if not quickly diagnosed and treated. Introduction Both children and adults present to urgent care centers with nasal pain. Infectious causes of such pain include impetigo, furuncles, and nasal vestibulitis (NV). Noninfectious causes include squamous cell cancer and lupus vulgaris. A careful physical examination and a thorough medical history can allow the health-care provider to rule out more serious conditions or to transfer the patient …
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Understanding the Impacts of Health-Care Reform on Urgent Care
Urgent message: Urgent care plays a vital role in reducing medical expenses and improving population health by enabling the right care, at the right place, by the right provider, at the right price. Introduction Health-care reform, quality of care, and costs are center stage topics for politicians and the general public. As medical providers and administrators in the United States, we share in the challenge of understanding this complex system. Whereas traditional approaches in the …
Read MoreAbstracts In Urgent Care – November 2016
Sean M. McNeely, MD
Read MoreIncome Tax Liability from Phantom Income
Urgent message: How physician and entrepreneur investors structure their urgent care center may expose them to an income tax liability from phantom income, but there are steps they can take to ensure there are sufficient funds to cover it. Introduction Income taxes are one of life’s certainties for most working Americans. Typically, however, income taxes are paid only on cash received during the course of a year. For example, a Form W-2 received by an …
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Pediatric Oral Lesions in the Urgent Care Setting
Urgent message: Being able to recognize the distinct oral lesions of common illnesses in children is essential, but it can be difficult to conduct an oral examination in frightened young children. Introduction Inspecting intraoral lesions in children will often confirm a diagnosis, but getting uncooperative patients to let the clinician visualize such lesions is challenging. Here we provide helpful examination tips and review common pediatric infectious and allergic oral lesions and their treatment. Techniques for …
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High Cost of Care Elsewhere May Be Nudging ACA Patients to Urgent Care
Patients whose health is insured under marketplaces created via the Affordable Care Act (ACA, aka “Obamacare”) have become acutely cost conscious when it comes to their own care—to the extent that they may not be getting the care they need, according to a new survey. While that paints a picture of a dysfunctional system, urgent care may be reaping some rewards as patients seek out quality care that won’t cost them as much as a …
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Disclosure and Billing Practices Are Central to Suit Against Adeptus
“Surprise” bills are a common complaint among patients who’ve visited freestanding emergency departments (FSEDs). While that hasn’t stopped their growth, billing practices have become the subject of pending legislation around the country—and, now, one basis of a suit against Adeptus Health, the nation’s largest operator of FSEDs. The Oklahoma Law Enforcement Pension (OLEP) has initiated a class action lawsuit against Adeptus, its private equity firm, and its officers related to its secondary stock offering, claiming …
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