Journal of Urgent Care Medicine

Are Urgent Cares Liable?

JOHN SHUFELDT, MD, JD, MBA, FACEP Full disclosure: I was not always the smooth, confident provider I hope I am today. No, there was a time when I would say or do things while practicing medicine that would shine a bright light upon my medical inexperience, naiveté, or general ignorance. To wit, the emergency medicine residents where I trained were pressed into servitude twice yearly to go out to the local high schools and perform …

Planning for Meaningful Use? The Clock Is Ticking

Urgent message: CMS offers stimulus funds to providers who “attest” that their EHR use improves patient care: up to $18,000 in 2011 alone. The sooner you do, the more you stand to earn. ERIC McDONALD “Meaningful use” refers to the use of a “certified” electronic health record (EHR) to meet specific objectives established by the Centers for Medicare & Medicaid Services (CMS), which administers the EHR incentive program. An EHR is certified when it demonstrates …

Developing Data: July/August, 2011

In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we offer a look at data from the 2010 Urgent Care Benchmarking Survey Results. These data are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged urgent care centers,” the qualifications for which included accepting walk-ins during all hours of operation, as well as …

Can an Urgent Care Use an ED E/M Code and Three Other Coding Challenges

DAVID STERN, MD (Practice Velocity) Q.Can 99283 and 99214 procedure codes be used for an urgent care visit? The codes were used by an urgent care facility, and I am told that 99283 is categorized as an emergency room code. A.Code 99283 is for an emergency department visit for the evaluation and management of a new or established patient with an expanded problem focused history and examination and medical decision making of moderate complexity. Code 99214 …

How to Get Sued for Malpractice: Four Studies In Self-Destruction

JOHN SHUFELDT, MD, JD, MBA, FACEP In the past, I have written about how to avoid getting named in a medical malpractice action. But it can often be instructive to view things from the opposite perspective. So this time, let’s turn it around and actually try to get named in a malpractice suit. It usually only takes one of the following misadventures: Practice bad medicine and have a bad outcome Practice good medicine, communicate/document poorly, …

Dealing with the Disruptive Doctor

Urgent message: When a physician is dubbed “Tom the Terror,” turning a blind eye can send patients and staff heading for the exit, wreck your reputation, and spark a lawsuit. Here’s what to do instead.LEONARD D. GOODSTEIN, PHD, ABPP, and JOHN SHUFELDT, MD, JD, MBA, FACEP Tom P. is a competent, board-certified emergency physician. He is liked and respected by his patients. But Tom‘s relationships with staffers at the urgent care center where he still …

Every Man His Own Doctor

JOHN SHUFELDT, MD, JD, MBA, FACEP While treating patients in the emergency department, I occasionally marvel at the changes I have witnessed over my 25 years in medicine. Sometimes I think, “Thank God I did not treat you 25 years ago, because if I had, I would have done (fill in the blank), it would not have worked, and you would have probably hated every second of it.” I am as old as Moses, so …

Developing Data: June, 2011

Medical Necessity in E/M Coding, Part 2: ROS and PFSH

DAVID STERN, MD (Practice Velocity) Last month, we presented definitions for medical necessity offered by the AMA and the Centers for Medicare & Medicaid Services (CMS). We looked at the elements appropriate to perform and document in the History of Present Illness (HPI). And we briefly discussed Recovery Audit Contractors (RAC) audits. (If you missed it, the column is archived on the JUCM website [https://www.jucm.com] in the May 2011 issue.) This month, our focus is …