Journal of Urgent Care Medicine

Are Insurance Plans Still Waiving Cost-Sharing?

A common question that I receive is whether COVID-19 testing is still being covered by insurance plans. The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES) require insurance plans to cover diagnostic testing without cost-sharing (cost-sharing being the amount assigned to patient responsibility; it includes deductibles, copays, and co-insurance). The word “diagnostic” is significant. COVID-19 testing falls into two categories: Diagnostic – used for treatment. Patients are …

Time to Presentation for Acute Otitis Media During the COVID-19 Pandemic

Urgent message: Concern over the potential spread of COVID-19 may (or may not) have affected the timeliness with which parents chose to present with children who had symptoms concerning for acute otitis media, thereby throwing the concept of “delayed” antibiotic prescribing into question. Emily J. Montgomery, MD; Brian R. Lee, PhD, MPH; Amanda Montalbano, MD, MPH; Amanda Nedved, MD Citation: Montgomery RJ, Lee BR, Montalbano A, Nedved A. Time to presentation for acute otitis media …

A 27-Year-Old Male with Chest Pain and No Reported Medical History

Chamber Abnormalities: Pathologic or Not? A 27-year-old male with no reported medical history presents with chest pain. He relays several weeks of intermittent symptoms which started after lifting heavy boxes. The pain is sharp, located in the mid-chest and is otherwise non-tearing, non-pleuritic, non-positional and not associated with exertion. On examination, the patient is in no acute distress, and appears lean without cachexia or wasting. The pain is reproduced with shoulder extension. It resolves with …

A Legal Quandary: Poor Care…or Malpractice?

Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and, therefore, mis- or missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. Michael Weinstock, MD and Charles Pilcher, MD Back pain is usually back pain, whether it’s from a muscular strain or another self-limiting, non-serious cause. But there is potential danger lurking below the surface, …

A 68-Year-Old Woman with a Rash of Several Weeks’ Duration

The patient is a 68-year-old woman who presents with a rash she says developed on her trunk over a span of several weeks. On examination, there were multiple confluent, orange-red plaques on the trunk and arms with “islands of sparing” within them. The rash had a primarily truncal distribution and was pruritic. She was feeling well otherwise. View the image and consider what your next steps and diagnosis would be. Resolution of the case is …

Considerations for Urgent Care Operators on Equal Pay Legislation and Enforcement

Urgent message: As we see a shift to an overwhelming female workforce in urgent care, it is essential that urgent care operators understand the conditions of, and develop policies to be compliant with, employment laws requiring equal pay among genders. Alan A. Ayers, MBA, MAcc, is President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine. INTRODUCTION Many urgent care centers already pay the same hourly rate for all …

An Underrecognized Epidemic: Toxic Positivity in Medicine

Joshua Russell, MD, MSc, FCUCM, FACEP A colleague, Dr. Mitchell we’ll call him, told me about a PA that he was supervising recently who made a great catch in a patient with a swollen, blue finger: Achenbach syndrome. When the PA presented the presumptive diagnosis, Dr. Mitchell, unfamiliar with the condition, had to Google it before seeing the patient. Our PA was right, though. The patient walked out of clinic, happy to have a benign …

Yes, Disparities in Prescribing Exist in Urgent Care—but Which Disparities?

If you read Evaluation of Healthcare Disparities in Urgent Care: A Case Example for Bacterial Pneumonia—see page 23 of this issue—you know that the proportion of appropriate prescriptions written for an on-label medication (in this case, doxycycline for bacterial pneumonia) may differ among various demographic groups. While the conclusions of that study do not necessarily make a cause-and-effect connection, the data should inspire some analysis as to possible rationale for differences for care of various …

FastMed Pools Data to Highlight Differences Between Urgent Care and the ED

To the average consumer, the key similarity between the urgent care center and the emergency room is plain to see: you get to see a doctor without an appointment. That’s deceptively simple, however, and doesn’t take into account relative wait times, cost to the patient and the insurer, whether the complaint is truly emergent, and the overall implications of going to the ED when it’s not necessary. FastMed Urgent Care, which owns and operates 109 …

Article Highlights Migration from Traditional Primary Care to Urgent Care

The ongoing growth of urgent care, among other trends, is at least partially responsible for an increasing scarcity of traditional primary care physicians, according to analysis of new data posted to Advisory Board. Citing research by the Health Care Cost Institute and an article just published in The New York Times, the piece notes that “the emergence of urgent care centers and retail clinics, as well as proliferating mergers between healthcare providers” is lowering patients’ …

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