Journal of Urgent Care Medicine

The Role of Urgent Care in an Integrated Care System: Insights from Intermountain Healthcare

Urgent message: This exclusive interview with Intermountain Medical Group Chief Executive Officer Linda Leckman, MD, illustrates how urgent care can improve access and clinical outcomes while reducing costs for patients in a system that integrates providers, hospitals, and health insurance using a shared electronic medical record and capitated payment. ALAN A. AYERS, MBA, MAcc, Experity Introduction In the evolving U.S. health-care system, individual providers, ancillary facilities, hospitals, and payors are joining together in connected systems …

Medical Malpractice Trial, Part 3: The Trial

JOHN SHUFELDT, MD, JD, MBA, FACEP Recap of the Facts Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: …

Presenting Conditions Documented in Patient Charts at U.S. Urgent Care Centers in 2014

Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded patient visits to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, show that the top 3 conditions that patients reported at presentation were cough (10.9% of visits), sore throat (10.4% of visits), and pain of some kind (7.7% of visits). The survey’s methodology and data abstraction forms were initially designed in 2008 by researcher Robin M. Weinick, …

Rib Fractures, Joint Injections and Aspirations, Sports Physicals, and Tuberculosis Skin Tests

Q. What code do we use now to bill for closed treatment of a rib fracture? A. In 2015, Current Procedural Terminology (CPT) deleted codes 21800, “Closed treatment of rib fracture, uncomplicated, each,” and 21810, “Treatment of rib fracture requiring external fixation (flail chest),” because of lack of use. You are now to report closed treatment of an uncomplicated rib fracture using an appropriate evaluation and management (E/M) code. Q. We perform many joint injections …

Six Elements of a Winning Patient Experience

Urgent message: Successful urgent care centers depend on repeat visits from loyal patients, but if patients do not like the experience provided, do not value it, or do not think it meets their needs, they will not come back. Cultivating a loyal following entails understanding and building a service offering around the factors that attract patients and keep them coming back. ALAN A. AYERS, MBA, MAcc, Experity Urgent care is differentiated from other medical practices …

Patient Age Breakout for the U.S. Urgent Care Market in 2014

Data from the 2014 Urgent Care Chart Survey of 1,778,075 blinded patient visits to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, show that the 2 largest age groups of patients using urgent care centers were 21 to 30 years (17.1%) and 31 to 40 years (15.9%); the smallest age group was 51 to 60 years (11.9%). The survey’s methodology and data abstraction forms were initially designed in …

Recognizing Employee Disengagement and Taking Steps to Re-engage

Urgent message: Employee disengagement is pandemic in the American workplace. At urgent care centers, operators have to work especially hard to keep frontline staff members motivated. Re-engaging employees starts with a strong management culture committed to establishing affinity with employees and ensuring that systems and processes support day-to-day operations. ALAN A. AYERS, MBA, MAcc, Experity For many urgent care operators—clinically adept physician–owners who are likely green as entrepreneurs—it can be sobering to realize just how …

Medical Malpractice Trial, Part 2: Pretrial

JOHN SHUFELDT, MD, JD, MBA, FACEP Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: Johnny Trey Dalton Attorney …

Modifier -X {EPSU}, Pneumococcal Immunizations

Q. Have there been any updates from CMS (Centers for Medicare & Medicaid Services) regarding the new -X modifiers that were introduced in January of this year? A. CMS released MLN Special Edition article SE1503 on January 22, 2015 (see http://www.cms.gov/Outreachand- Education/Medicare-Learning-Network-MLN/MLN MattersArticles/Downloads/SE1503.pdf), stating that there would be forthcoming guidance as to the appropriate use of the new -X {EPSU} modifiers and “that guidance will include additional descriptive information about the new modifiers” before implementing …

Medical Malpractice Trial, Part 1: The Events

John Shufeldt, MD, JD, MBA, FACEP I recently spent 3 amazing weeks in a medical malpractice trial. Over the next few months, I would like to share the experience with you. Despite the fact that I practice law and have been an expert witness for more than 20 years, the experience opened my eyes and has definitely changed how I practice medicine in the urgent care setting. I took copious notes during the trial and …

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