Lee A. Resnick, MD, FAAFP No one has more eloquently stated the case for carving out the so-called “unnecessaries” from the capitalist code of taxation than Adam Smith. Yet, more than 230 years after the publication of arguably the most authoritative text in defense of capitalism, we continue to struggle with the concept of taxation as a socialist plot. Last month, I examined the so-called “success tax.” I suggested that a tax on earned income …
Read MoreAbstracts in Urgent Care: January, 2011
Position Statement on Sports Concussions Key point: Sports are second only to motor vehicle accidents as the leading cause of traumatic brain injury among 15- to 24- year-olds. Citation: AAN Sports Neurology Section, Practice Committee, and Board of Directors. Position statement on sports concus- sion. October 2010 (AAN Policy 2010-36). Concussion is a common consequence of trauma to the head in contact sports, estimated by the Centers for Disease Control and Prevention to occur 3 …
Read MoreClinical Challenge 2: December, 2010
The patient is a 54-year-old woman who presents with a one-day history of abdominal pain and nausea. On exam, you note distended abdomen with diffuse tenderness and rebound. 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.
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Cold Weather-related Injuries
Urgent message: Inadequate protection from the cold can put a patient’s life and limb at risk. The urgent care clinician must be able to identify symptoms of specific conditions, using the history and awareness of weather conditions to distinguish among the most common. Introduction Winter months provide ample opportunities for recreation such as skiing, sledding, or snowmobiling – and for an array of injuries related to varying degrees of exposure to lower temperatures. Generally, the …
Read MoreFunding Healthcare Reform: Tax Sugar, Not Success
Lee A. Resnick, MD, FAAFP Healthcare is the ultimate paradox for democratic and capitalist ideas, an epic clash between inalienable rights and free market forces. Most everyone agrees that basic healthcare should be attainable, affordable, and non-discriminatory for all citizens. But how can we achieve this somewhat socialist-sounding goal within a free market system? Well, the free market has proven incapable of making healthcare affordable, and government coffers have proven too empty to subsidize it. …
Read MoreAbstracts in Urgent Care: December, 2010
Nahum Kovalski, BSc, MDCM Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. New Guidelines for Prevention of Stroke in Patients with Stoke or TIA Key point: New, evidence-based recommendations aim at reducing risk of ischemic stroke in patients who have had a stroke or transient ischemic attack. Citation: Furie KL, Kasner SE, …
Read MoreClinical Challenge: December, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient is a 16-year-old boy who presents with local swelling of both eyelids. There is no limitation in the range of motion of either eye, however. …
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A 23-year-old Woman with a Scapular Fracture
Urgent message: Mechanism of injury – in case being thrown from a slow-moving vehicle – provides essential clues to the extent of injuries, even if the patient initially thought them to be relatively minor. Proper evaluation requires a thorough history. Shannon Dowler, MD The Case The patient is a 23-year-old female who presented to urgent care with an approximately 36-hour history of “shoulder pain.” She is otherwise well-appearing. Discussion with the patient reveals that she …
Read MoreClinical Challenge: November, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient is a 15-year-old boy who complains of pain over the right hip after falling while playing soccer. He is able to bear weight on his …
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Pediatric Abdominal Pain: Consider Pneumonia in the Differential Diagnosis
Urgent message: Abdominal pain can be a challenging complaint, especially in younger patients. Consider the full range of differential diagnosis in order to initiate prompt, effective management. Curtis Kommer MD, Latha Shankar, MD, MBA and Robert Stuart, MD Introduction Since the time of Hippocrates, the ability of physicians to unravel the mystery of a patient’s abdominal pain has become synonymous with the art and practice of medicine. Pediatric abdominal pain, in particular, with its extensive …
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