Practice Management
A 28-year-old female presents to urgent care complaining of right ankle pain after awkwardly stepping off a high curb, subsequently rolling her ankle while running outside earlier today. She is unable to bear weight on her ankle. She has no past medical history, takes no medications regularly, and has not tried any treatments since the injury. Physical exam reveals she is afebrile with normal vital signs, and she has marked tender edema to the lateral …
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Urgent Message: The placebo effect can produce clinical manifestations of various disease states, particularly for pain. It has practical clinical implications for urgent care clinicians who routinely recommend oral medications for pain. Vinay Sharma, BS; Ariana M. Nelson, MD Keywords: acute pain; chronic pain; placebo effect; expectation; verbal suggestion; endogenous opioid signaling; dopamine signaling; placebo analgesia; medical ethics Abstract The placebo effect—the nonspecific beneficial effect of a medical treatment—involves complex psychological, biological, and physiological interactions. …
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Urgent Message: Necrotizing fasciitis may present without visible soft tissue abnormalities. Therefore, clinical signs and symptoms—including localized pain and tachycardia—are findings that should warrant further clinical investigation. Abstract Introduction: Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection. Early NF may present to urgent care without visible soft tissue abnormalities. As such, clinical signs and symptoms, including localized pain with tachycardia, should warrant further clinical investigation. Case Presentation: A 43-year-old male presented to …
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Urgent Message: Adrenal crisis is uncommon in the urgent care setting, but it can be rapidly fatal if diagnosis is missed. Early administration of hydrocortisone and fluid resuscitation with correction of electrolyte abnormalities are essential to reduce mortality. Clayton R. Halford, PA-C Keywords: adrenal crisis; adrenal insufficiency; Addison disease; hypoglycemia; hyperkalemia; pediatric endocrine emergency Abstract Introduction: Adrenal (Addisonian) crisis is a rare but life-threatening endocrine emergency that can present to urgent care with nonspecific symptoms. …
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Urgent Message: Training urgent care providers to use point-of-care ultrasound resulted in fewer patient transfers to the emergency department for soft tissue/musculoskeletal and first-trimester pregnancy complaints, while also streamlining care in this single-center program. Keywords: point-of-care ultrasound; urgent care; emergency department transfer; soft tissue infection; musculoskeletal complaints; first-trimester pregnancy Lindsey E. Fish, MD, FCUCM; Genie Roosevelt, MD; Amanda G. Toney, MD Abstract Introduction: The use of point-of-care ultrasound (POCUS) is expanding into multiple clinical areas …
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As I continue to meet with operators, clinicians, policymakers, employers, and healthcare leaders, I continue to hear many of the same challenges: reimbursement challenges, rising healthcare costs, workforce shortages, limited access to primary care, and growing pressure on emergency departments. At the same time, I’m hearing something else: growing recognition of the important role Urgent Care plays in addressing these challenges. For years, Urgent Care was often viewed as an alternative, a convenient option when …
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Kim Hardin Urgent care organizations continue to face growing operational pressure as payer requirements become increasingly complex. Among the most significant challenges impacting revenue cycle performance today are provider onboarding and credentialing delays. In an environment where staffing shortages, payer consolidation, and administrative burden continue to rise, efficient credentialing has become critical to financial stability and patient access. Credentialing is the process of verifying a provider’s qualifications, licenses, education, training, malpractice history, and eligibility to …
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While many urgent care operators measure their overall Google ratings—focusing staff on capturing as many “5-stars” as possible—few understand the specific staff behaviors and patient experience that drive positive and negative reviews. To identify the differences, Urgent Care Consultants analyzed the content of 3.1 million Google reviews across 3,665 urgent care centers. The table breaks down the specific themes driving positive and negative experiences. A positive gap indicates a theme more prevalent in 5-star reviews, …
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Urgent Message: Health systems must reframe urgent care from a low-margin cost center to a strategic front door that drives significant returns by utilizing technology to track and maximize “keepage”—the retention of high-value downstream referrals that otherwise leak out of the network. Alan A. Ayers, MBA, MAcc Keywords: urgent care; referral management; downstream revenue; health system strategy; patient retention; return on investment Urgent care is no longer just an access point; it is the strategic …
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A 63-year-old woman visits urgent care with the chief complaint of an asymptomatic scabby growth on her scalp that developed 10 months prior and is gradually getting larger. The patient has no systemic symptoms and is otherwise well. She has a history of working as a welder in a metal fabrication plant for the past 35 years. On dermatological examination, an eroded and crusted plaque is seen on the frontal scalp. A punch biopsy reveals …
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