Practice Management
Joshua Russell, MD, MSc, FCUCM, FACEP Who among us has worked a single urgent care (UC) shift without at least one patient making a humble request for a sick note to take back to work? “Can I have a work note?” It’s a simple ask. In fact, apart from medication refills, work note visits rank among the most welcomed presentations for many overworked clinicians, offering a much-needed mental reprieve and a chance to finally catch up …
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A 75-year-old woman presents to urgent care following a fall in her home that day. An adult daughter explains that her mother has pain on her left side around her ribs. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Urgent Message: The diagnosis of bacterial pharyngitis is often difficult. Rapid polymerase chain reaction testing has potential to improve diagnostic certainty. Despite high accuracy rates, many urgent care providers continue to seek confirmation by throat culture. Justin Bowles, MD, Supreet Ghumman, MS4 Citation: Bowles J, Ghumman S. Real world validation of rapid PCR strep testing in urgent care. J Urgent Care Med. 2023;18(2):15-21 Key Words: bacterial pharyngitis; PCR testing Abstract Introduction: Point-of-care polymerase chain reaction …
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A 66-year-old male presents in the urgent care, saying “it’s hard to breathe.” He’s had weakness and dyspnea for one day. The patient has a medical history of diabetes, hypertension, and heart failure. The patient has a pacemaker. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page
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Urgent care medicine is still trying to find its place in the vast medical care landscape. At the same time, the whole “house of medicine” is going through yet another challenging time. Our journals and the media are reporting that medical providers are feeling demoralized and uncertain of the future. In some clinics, the medical staff shows up focused only on surviving the day. Considering these organizational issues, it can often feel overwhelming when leaders …
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What Should We Do with the Nail? Nailbed Repair in Children Take Home Point: After nail bed repair, discarding the fingernail was associated with similar rates of infection and similar cosmetic outcomes compared to replacement of the fingernail. Citation: Jain A, Grieg A, Jones A, et al. Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. BJS, 2023, 110, 432–438 https://doi.org/10.1093/bjs/znad031 Relevance: Procedures for nail bed …
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Urgent Message: As a rising percentage of jurisdictions require disclosure of salary ranges to current and/or prospective employees, urgent care leaders must achieve compliance with pay transparency laws. Alan A. Ayers, MBA, MAcc California, New York, Washington, and Rhode Island are among the latest states to add salary range transparency laws to their books.[1] As of this writing, eight states have enacted such laws, with at least 15 more considering legislation on this topic, including Illinois, …
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Andrew Alaya MD MSc Urgent Message: Abdominal pain is a common urgent care complaint that may result from a variety of benign to life-threatening etiologies, which can pose diagnostic and therapeutic difficulty for the clinician. Ureteral calculi are able to be diagnosed and managed in the urgent care setting. Citation: Alaya A. Detection and Management of Urinary Calculi in the Urgent Care Setting. J Urgent Care Med. 2023;18(2); 31-38 Introduction/Epidemiology Formation of calculi in the …
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A 52-year-old man presents to urgent care for a new growth on his nose. On examination, a smooth, faint pink papule with overlying scant telangiectasias was seen at the lateral nasal sidewall. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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A new report from the Centers for Disease Control and Prevention (CDC) describes the well-being and working conditions for health workers using self-reported, cross-sectional data. From 2018 to 2022, health workers reported an increase in days where they felt their mental health was poor (from 3.3 days to 4.5 days). Meanwhile, the percentage who reported feeling burnout “very often” increased from 11.6% to 19.0%. Overall, 57.0% reported anxiety symptoms in 2022, and 44.2% reported being …
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