Practice Management
A 28-year-old female presents to urgent care complaining of right ankle pain after awkwardly stepping off a high curb, subsequently rolling her ankle while running outside earlier today. She is unable to bear weight on her ankle. She has no past medical history, takes no medications regularly, and has not tried any treatments since the injury. Physical exam reveals she is afebrile with normal vital signs, and she has marked tender edema to the lateral …
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Urgent Message: The placebo effect can produce clinical manifestations of various disease states, particularly for pain. It has practical clinical implications for urgent care clinicians who routinely recommend oral medications for pain. Vinay Sharma, BS; Ariana M. Nelson, MD Keywords: acute pain; chronic pain; placebo effect; expectation; verbal suggestion; endogenous opioid signaling; dopamine signaling; placebo analgesia; medical ethics Abstract The placebo effect—the nonspecific beneficial effect of a medical treatment—involves complex psychological, biological, and physiological interactions. …
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Urgent Message: Necrotizing fasciitis may present without visible soft tissue abnormalities. Therefore, clinical signs and symptoms—including localized pain and tachycardia—are findings that should warrant further clinical investigation. Abstract Introduction: Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection. Early NF may present to urgent care without visible soft tissue abnormalities. As such, clinical signs and symptoms, including localized pain with tachycardia, should warrant further clinical investigation. Case Presentation: A 43-year-old male presented to …
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Urgent Message: Adrenal crisis is uncommon in the urgent care setting, but it can be rapidly fatal if diagnosis is missed. Early administration of hydrocortisone and fluid resuscitation with correction of electrolyte abnormalities are essential to reduce mortality. Clayton R. Halford, PA-C Keywords: adrenal crisis; adrenal insufficiency; Addison disease; hypoglycemia; hyperkalemia; pediatric endocrine emergency Abstract Introduction: Adrenal (Addisonian) crisis is a rare but life-threatening endocrine emergency that can present to urgent care with nonspecific symptoms. …
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Urgent Message: Training urgent care providers to use point-of-care ultrasound resulted in fewer patient transfers to the emergency department for soft tissue/musculoskeletal and first-trimester pregnancy complaints, while also streamlining care in this single-center program. Keywords: point-of-care ultrasound; urgent care; emergency department transfer; soft tissue infection; musculoskeletal complaints; first-trimester pregnancy Lindsey E. Fish, MD, FCUCM; Genie Roosevelt, MD; Amanda G. Toney, MD Abstract Introduction: The use of point-of-care ultrasound (POCUS) is expanding into multiple clinical areas …
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A 63-year-old woman visits urgent care with the chief complaint of an asymptomatic scabby growth on her scalp that developed 10 months prior and is gradually getting larger. The patient has no systemic symptoms and is otherwise well. She has a history of working as a welder in a metal fabrication plant for the past 35 years. On dermatological examination, an eroded and crusted plaque is seen on the frontal scalp. A punch biopsy reveals …
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With great excitement—and in full disclosure—I am writing this as the newly elected President of the College of Urgent Care Medicine (CUCM) and Urgent Care College of Physicians (UCCOP). It is truly a pleasure to have been elected during the most recent Urgent Care Conference this past April in Chicago, and I look forward to leading these organizations for the next 2 years. Now I am calling all urgent care clinicians—nurse practitioners (NPs), physician assistants/associates …
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Pediatric Antibiotic Prescribing: In-Person Vs Telemedicine Take Home Point: Telemedicine integrated within primary care was associated with more judicious antibiotic prescribing without increased follow-up visits or inappropriate antibiotic use. Primary care telemedicine may improve access to care while supporting antibiotic stewardship efforts. Citation: Ray K, Wittman S, Kelly M, et al. Primary Care Telemedicine vs In-Person Antibiotic Prescribing for Pediatric Respiratory Tract Infections. JAMA Netw Open. 2026;9(5):e2610062. doi:10.1001/jamanetworkopen.2026.10062. Relevance: Acute respiratory illness (ARI) is a …
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An 86-year-old male presents to urgent care with intermittent palpitations for the past several days. He says he has a history of Wolff-Parkinson-White syndrome.An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 28-year-old male with history of left shoulder dislocations presents to urgent care with severe left shoulder pain. He reports an inability to move the arm after injuring his shoulder while taking off his shirt. He reports feeling the shoulder “shift out of place” during the movement. On examination, the patient is in significant discomfort. He is holding the left arm in slight abduction with left shoulder external rotation. His elbow is flexed and his …
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