Practice Management
Urgent message: Each case—and patient presentation—in urgent care must be evaluated on its own merits. Rare diagnoses are possible and “benign” back pain complaints sometimes are not. HEATHER VARLEY, PA-C, and WILLIAM GLUCKMAN, DO, MBA, FACEP Introduction Each day in the urgent care setting, we are presented with a range of various pain complaints, from headaches, to back pain, to extremity pain. These complaints may be the result of injury, overuse, infection, arthropathy, or have …
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Urgent message: Whether benign or vision-threatening, acute eye conditions seen in the urgent care setting require careful evaluation and triage, based on access to the right tools and knowledge of key clues to diagnosis. SARVOTHAM KINI, MD In Part 1 of this article in January, we discussed urgent care management of foreign bodies in the eye, corneal abrasion, red eye, scleritis, and conjunctivitis. In Part 2, we will review subconjunctival hemorrhage, uveitis, iritis, keratitis, acute …
Read MoreLee A. Resnick, MD, FAAFP It is well known, and exhaustively preached, that a satisfied customer will tell 2-3 people while a dissatisfied one will tell 8-10 (with some estimates as high as 20). Measuring and tracking patient satisfaction has become a focus of most every practice owner, much to the chagrin of their employees, who often view this as a way to publicly embarrass and unfairly harass the staff. And yet, whether we are …
Read MoreMetabolic Consequences of Insufficient Sleep Key point: A small, randomized, controlled crossover study demonstrates changes in a critical insulin-signaling pathway in peripheral tissue. Citations: Broussard JL, Ehrmann DA, Van Cauter E, Tasali E, Brady MJ. Impaired insulin signaling in human adipocytes after experimental sleep restriction: A randomized, crossover study. Ann Intern Med 2012;157(8):549-557. and Cappuccio FP, Miller MA. A new challenge to widely held views on the role of sleep. Ann Intern Med 2012;157(8):593-594. Small …
Read MoreTHE CASE The patient, a 53-year-old man, presented with acute back pain after a fall. View the image taken (Figure 1) and consider what your diagnosis would be.
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Urgent message: The use of dilute proparacaine appears to be a safe and cost-effective way to treat the pain associated with many acute corneal injuries. JACQUALINE DANCY, PA-C, MPAS Editor’s Note: This article deviates from our typical case report format to underscore one of the key points for management of eye conditions discussed in this month’s cover story. Introduction Ocular injuries are often painful and can cause significant suffering. Many medical practitioners provide immediate, but …
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Urgent message: Triage of eye conditions in urgent care to ensure the best patient outcome requires knowing what equipment to use and understanding when to refer to an ophthalmologist. Always remember to document acuity of vision in all patients presenting with an eye complaint. SARVOTHAM KINI, MD Introduction Ocular complaints are extremely common in the urgent care setting. Yet the capacity of individual urgent care centers to provide high quality eye care is variable. The …
Read MoreLee A. Resnick, MD, FAAFP As I was writing this column about visioning for the new year in urgent care, I couldn’t help but think of the Alan Parsons Project tune, “Where Do We Go From Here?” Opportunity abounds but risk remains, and there are gaps, so we must not pursue opportunity blindly. Consider the following: Urgent Care Achievements Strong organized medicine representative (UCA and its branches) Proven, stable trade association (UCA) Conferences Education Vendor …
Read MoreThe patient, a 12-year-old female, presented after twisting her right ankle. She could not bear weight on her right leg. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreLong-term survival following pneumococcal pneumonia Key point: Pneumococcal pneumonia foretold considerably higher 10-year mortality than the expected rate. Citation: Sandvall B, Rueda AM, Musher DM. Long-term sur- vival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145-1146. Before antibiotics, pneumonia was called “the old man’s friend” for carrying the old and infirm to a swift and relatively painless death. Now that short-term survival after pneumonia is the rule, does the disease provide any long-term prognostic information? Veterans …
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