Practice Management
The patient is a 57-year-old man who reports to urgent care complaining of right-sided pain in his ribs when taking deep breaths. He reports that he worked out at his health club that morning before work, but denies any pain at the time or potential cause of injury related to that. Rather, he said the pain began suddenly a couple of hours later while he was at work. View the images taken and consider what …
Read MoreMore Advice on Inquiring About—and Assessing—Vaping and EVALI Key points: Citation: Siegel DA, Jatlaoui TC, Koumans EH, et al. Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury—United States, October 2019. MMWR Morb Mortal Wkly Rep. 2019;68:919–927. Key point: Physicians should inquire about e-cig or vaping use in a nonjudgemental but thorough manner. Ask about specific products, frequency, and associated drug use. …
Read MoreWhat’s New in Flu Vaccine Information New First-In-Class Pleuromutilin Antibiotic for CAP Abdominal Pain in Patients with IUDs—Watch Out for Ectopic Pregnancy Cancer-Causing Chemical Found in Ranitidine Measles Cases and Outbreaks Cooling Pediatric Burns Occ Med: Severe Silicosis in Stone Fabrication Workers An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate …
Read MoreUrgent message: Just as what is predicted to be a brutal flu season picks up steam, the Infectious Diseases Society of America has released new guidelines stressing the need for timely, dual treatment in adults with community-acquired pneumonia who also test positive for influenza. Cornelius O’Leary, Jr., MD After more than a decade, the Infectious Diseases Society of American has published new guidelines on community-acquired-pneumonia—noteworthy for both its switch from narratives to a Grading of …
Read MoreThe year was 2006: Saddam Hussein was executed for crimes against humanity. The Wii gaming console debuted. Pluto lost its planetary status. High School Musical and Borat were the talk of the town in entertainment. And JUCM, The Journal of Urgent Care Medicine was born—the first and only peer-reviewed journal in the industry (which it remains to this day). Well, let’s just say that JUCM was the undisputed highlight of 2006! The whole idea for …
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Tracey Q. Davidoff, MD, FACP, FCUCM Urgent message: Underlying medical and psychiatric conditions can cloud judgment and lead to cognitive errors, which may result in potentially serious medical errors.1 Case Presentation A 31-year-old woman with a medical history significant for fibromyalgia, migraines, bipolar disorder, and anxiety presents with 2 hours of severe bilateral neck spasms, left shoulder and arm pain, and chest pain which began soon after taking a new prescription for olanzapine. She also …
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Urgent message: Though ear pain is often due to otitis media or externa, it is important to include other diagnoses, some of which could be life-threatening, “can’t miss” causes. Introduction Patient complaints of ear pain (otalgia) are seen frequently in the urgent care setting. It can be frustrating for patients and providers when a patient’s ear pain has no obvious cause. Differential diagnoses include several primary and secondary causes of otalgia. (See Table 1.) Lab …
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The Case The patient is a 65-year-old woman who presents with pain in her left hip after stumbling down the last step of her front stoop. Her daughter, who witnessed the incident, reports that her mother did not fall and insists she “didn’t even land that hard” on her left leg. Review the image taken and consider what our diagnosis and next steps would be.
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The patient is a 13-year-old boy who complains of pain in his right hip and groin after playing soccer. His mother says she didn’t see what happened, but reports that she looked up from a magazine she was reading to see him limping suddenly. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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David Mathison, MD, MBA Thirty years ago, there was widespread concern that specialty medicine was “a problem.” Consumers were self-selecting specialty (vs primary) care for routine ailments, thus driving up the cost of healthcare. Without restrictions, consumers could choose neurologists for headaches, orthopedists for ankle sprains, and dermatologists for acne—all very appropriate with complexity, but unnecessary and costly for routine problems. Hence came the dawn of managed care armed with gatekeepers, referral requirements, and …
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