Clinical

Prevailing wisdom is that the current outbreak of measles in the United States began when travelers returned from visiting a country where immunization is not the norm to a community where compliance rates are low. It hasn’t taken long for over a thousand people to be diagnosed, and it’s likely the spread isn’t over. The series of events essentially exposed a loophole in the idea that herd immunity is “enough.” Now that Americans are starting …

Pre-exposure prophylaxis against HIV infection (PrEP) has yet to gain traction in urgent care centers—even among operators who recognize the public health benefit. Some have moral qualms about PrEP, believing that offering an added layer of protection encourages high-risk behavior among those already at the greatest risk (namely, men who have sex with men [MSM], heterosexually active men and women, and people who inject drugs). Others are concerned about reimbursements and the complexities of the …

The United States passed an unfortunate milestone this week when the number of confirmed measles cases reached 1,000 (and surpassed it actually, to 1,001). It’s the worst outbreak since 1992 and comes 19 years after measles was declared “eliminated” in the United States. The Centers for Disease Control and Prevention reports there have been 61 new cases since May 27 alone. Recognizing that public appeals to get vaccinated were falling on deaf ears too often, …

Telemedicine is a hot topic in urgent care circles these days. Some industry leaders herald it as a new way to reach patients and to extend an operation’s reach; skeptics express concern that it’s an obstacle to building a healthy provider–patient relationship and that it facilitates overprescribing. While some of this boils down to a difference of opinion, evidence is mounting that both arguments have merit. A new study out of the University of Pittsburgh …

Weekend hikers will soon be joined on the trail by vacationing families and campers—upping the potential for tick bites and associated disease exponentially as the warm weather weeks wear on. Unfortunately, if recent years are any indication, we can expect to see more cases of tick-borne disease than ever; they’ve risen steadily over the past several years. Notably, the Centers for Disease Control and Prevention has reported a marked increase in spotted fever rickettsiosis, which …

The 2018–2019 flu season is over—according to the calendar, though new cases continue to be reported. As such, it’s a good time to assess the effectiveness of campaigns to drive immunization rates among healthcare workers. According to data from the Children’s Hospital of Philadelphia (CHOP), issuing a requirement for healthcare workers to get a flu shot both increases the proportion of staff who do so and lowers the rate of individuals who get the flu. …

When we last updated you on the measles outbreak in the United States, there were 465 cases spread across 19 states. At the time, that was the highest number of U.S. cases since 2000, when measles was declared “eliminated.” Well, the number of cases now sits at 839—a jump of 374 cases—in 23 states, all diagnosed between January 1 and May 10 of this year. One challenge: The potential to contract measles isn’t limited to …

We told you about a study that asked patients to weigh in on their preferences for how healthcare providers should dress. The choices ranged from office-casual to traditional business attire to the clinical white coat with a tie, or with a dress shirt for women. White-coat-and-tie or dress shirt proved to be the preferred attire because it conveyed both business formality and clinical authority. An article just published in The New York Times has now …

The ongoing (and building) measles outbreak is getting most of the headlines, but simultaneous to that hepatitis A cases have continued to mount well into the thousands. Since the first confirmed case in 2016, more than 15,000 infections have occurred across the country; some 8,500 have required hospitalization. Florida has been hit especially hard, with 883 cases reported so far this year. That’s more than the total for all of 2017 and 2018 combined. Virginia …

As we continue to see success in lowering use of opioid drugs in managing acute pain, the Centers for Disease Control and Prevention offers data suggesting what might be appropriate parameters for their use when they’re truly necessary. Based on 13,440 patients covered by a large U.S. commercial insurer in 2014, and who filled an opioid prescription within 7 days of a primary care clinic visit, an initial prescription for 4–7 days was found to …