Journal of Urgent Care Medicine

Shortness of Breath in Pregnancy: Differentiating Physiology from Pathology in Urgent Care

Urgent Message: As shortness of breath and edema are common in pregnancy, urgent care clinicians must distinguish patients with normal physiologic changes from those with emergent conditions like venous thromboembolism, hypertension, eclampsia, and cardiomyopathy. John Ramos, MMS, PA-C, CAQ-EM Key Words: Ambulatory Care; Differential Diagnosis; Dyspnea; Pregnancy Complications; Pregnancy Complications, Cardiovascular Abstract Background: Physiologic changes in pregnancy contribute to shortness of breath and edema. However, these symptoms can also be caused by serious etiologies including …

Recent Seasonal Vaccines Demonstrate Effectiveness

A meta-analysis published in the New England Journal of Medicine of 511 studies found peer-reviewed evidence supports the safety and effectiveness of vaccines for COVID-19, respiratory syncytial virus (RSV), and influenza during the 2025–2026 season. The COVID-19 vaccines for the XBB.1.5 variant had a pooled vaccine effectiveness against hospitalization of 46-50% among adults and 37% among adults with weakened immune systems, according to the analysis. For RSV, vaccines had pooled estimates of 68% for maternal …

What Does ‘Standard of Care’ Mean from a Legal Compliance Perspective?

Urgent Message: Urgent care centers are not required to deliver the “best possible care” but rather an “acceptable” level of care, which is legally defined as the “standard of care.” Alan A. Ayers, MBA, MAcc Key Words: Standard of Care, Medical Malpractice, Medical Negligence, Legal Compliance, Disciplinary Action Medical malpractice occurs when a physician’s actions, or failure to act, during patient care don’t meet accepted medical standards and cause harm to the patient. To be …

A Rare Cardiopulmonary Debut of Systemic Lupus Erythematosus: A Pediatric Case Report

Urgent Message: In adolescents presenting with persistent chest pain and systemic symptoms, clinicians should maintain a high index of suspicion for autoimmune etiologies such as systemic lupus erythematosus causing pericardial and pleural effusions. Asra Usmani, MBBS, MD; Ali Baidoun, MD; Aaron Mahoney, DO; Megan Sikkema, DO Key Words: Pericardial Effusion, Pleural Effusion, Systemic Lupus Erythematosus, Chest Pain, Adolescent Abstract Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can affect multiple organ systems. …

United States Sexually Transmitted Infections: A Comprehensive Overview and Relevance To Urgent Care Centers

Urgent Message: Patients frequently utilize urgent care centers for testing and treatment of sexually transmitted infections. All clinicians can be a first line defense to control the spread and combat the current epidemic. Alexandra Faraj, PA-S; Nadesha Muniz, MS Ed, PA-C Key Words: Sexually Transmitted Infections; Chlamydia; Gonorrhea; Syphilis; Expedited Partner Therapy; Urgent Care Abstract The rise in sexually transmitted infections (STIs) in the United States is a major public health concern. Patients frequently utilize …

The Scale of Orthopedic Urgent Care

As of August 12, 2025, there are 726 orthopedic urgent care (OUC) rooftops in the United States, according to National Urgent Care Realty and Urgent Care Consultants. Based on centers added since January 1, 2025, the estimated annual rooftop growth for 2025 is 10.9%. The charts highlight the market’s structure: Most sites operate without hospital affiliation, and OUC is largely a scaled, multisite business rather than single-location clinics. Only 9% of OUC rooftops are single …

Training Our Teams to Meet the Needs of Our Patients

Countless times over the last year I have heard variations on a “we can’t” theme. It’s a specific and focused “we can’t” related to the services we are not able to provide to our urgent care patients. “We can’t do that test.” “We can’t use that medication in clinic.” “We can’t have our medical assistants do that.” Sadly, it is purely a reflection of education and training. However, as opposed to responding with increased training …

One Voice, One Vision

In last month’s column, I wrote about the importance of proving Urgent Care’s value—not just in terms of access and convenience, but also in demonstrating the quality outcomes and systemwide impact that make our care essential to patients, payers, employers, and policymakers alike. Over the past several weeks, I’ve had the privilege of hearing from many of you who share this same commitment and are eager to help strengthen Urgent Care’s position in the healthcare …

Insurers Automatically Reduce Pay For Some E/M Codes

Several large health insurers are drawing provider backlash for relatively new payment policies that reduce certain reimbursements. Cigna is automatically downcoding 6 evaluation and management (E/M) billing codes (99204- 99205, 99214-99215, 99244-99245) for a small percentage of providers starting this month, for example, resulting in lower payments for some routine office visits. The insurers are leveraging algorithms and claims data to automatically downgrade the codes—often relying on third party vendors to do the adjustments. According …

Acupuncture Helps Older Adults With Low Back Pain

In a randomized clinical trial of 800 adults aged 65 years or older with chronic low back pain, both standard acupuncture and enhanced acupuncture with maintenance sessions significantly improved disability related to back pain compared with usual medical care, as published in JAMA Network Open. At 6 months, the adjusted mean disability score (Roland-Morris Disability Questionnaire) improved by −1.0 for standard acupuncture and −1.5 for enhanced acupuncture vs usual care with benefits sustained at 12 …

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