Practice Management
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, …
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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 …
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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 …
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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 …
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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 …
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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 …
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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’ …
Read MoreWe all know urgent care has been growing steadily, nearly since its inception. Hard data on the size of the marketplace can be hard to come by, though, as different sources apply varying definitions of what exactly constitutes an urgent care center. Similarly, we know proper utilization of urgent care services has tremendous potential to lower healthcare costs compared with visits to the emergency room. Again, though, the details can be hard to put a …
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An urgent care nurse practitioner at NextCare in Albuquerque, NM has just been named to the Board of Nurses of the American Health Council. Gilberto Alvarado, MSN, CNP, FNP-BC, BSN, RN has been in healthcare for 45 years, starting as a hospital corpsman in the United States Navy and advancing through a number of clinical positions—with the requisite additional training—culminating in his current position at NextCare. AHC describes its mission through the mnemonic ABCDE: advocacy, …
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An urgent care operator in Ohio is one of the 14 sites in a phase 3 clinical trial for a prospective Allergan product to treat patients with diabetic gastroparesis (DG), a condition that slows or stops the movement of food from the stomach to the small intestine. The trial, officially titled A 46-week, Double-blind, Placebo-controlled, Phase 3 Study With a 6-week Randomized-withdrawal Period to Evaluate the Safety and Efficacy of Relamorelin in Patients with Diabetic …
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