Practice Management
The patient is a 22-year-old male who presents for a pre-employment physical. During the exam, he mentions foot pain of several years’ duration, the origin of which he has no explanation. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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“Do you know what the first question anyone gets asked at these things nowadays?” asked a member at a recent industry event. I didn’t know the answer, and when I heard it, I was speechless. He said, “They ask you how many urgent cares you have.” Who are we becoming when this is our measurement of worthiness? When did size become the first thing that matters in our getting to know one another? Can we …
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Urgent message: Many urgent care operators took full advantage of opportunities to serve their communities during the pandemic, accumulating cash in the process. While many question what comes next, there’s no better time to grow your own urgent care business. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Senior Editor of The Journal of Urgent Care Medicine. On March 11, 2020, the World Health Organization declared COVID-19 a pandemic, and within …
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A 6-year-old girl presents to urgent care for vaccinations at the start of the school year. Her father asks the pediatric provider to look at bumps that developed on her abdomen about 4 weeks ago. They consist of tiny papules, some scattered and some in linear configurations. The patient is asymptomatic without pain or itching. Her father is concerned because they have not resolved. View the image in this context and consider what your diagnosis …
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The patient is a 36-year-old male who presents with left hip pain for “years.” The pain is motion- or position-related and over time there has been occasional pain in his buttock, back, and thigh. Additionally, he has stiffness, clicking, locking, and catching. View the image taken 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 message: Musculoskeletal pain is a common urgent care complaint, with x-rays very commonly ordered. However, a “normal” image does not necessarily support eliminating what could be a serious injury from the differential diagnosis. Arun Sayal, MD, CCFP(EM) Citation: Sayal A. When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging. J Urgent Care Med. 2022;16(7):13-16. Medical tests lie. Not intentionally, of course, but their result may not align with reality. A test may …
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KEY QUESTIONS What phenomenon explains the ST elevations in this ECG? What are the features of this condition? What is the clinical significance of this phenomenon?
Read MoreThe Protecting Medicare and American Farmers from Sequester Cuts Act was signed into law on December 10, 2021. This law addresses the reduction in the 2022 Conversion Factor set by the Physician Final Rule, as reported in my December column, increasing the 2022 Conversion Factor by 3%. The new conversion factor becomes $34.61 compared to $34.89 in 2021. With the increase in Relative Value Units on most E/M codes, the impact to 2022 rates becomes …
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Sal D’Allura, DO, FAAFP “It’s lonely being the defendant in a medical malpractice case.” Truer words were never spoken. At some point in our careers, the majority of us will be named in a medical negligence case. The unfortunate reality is that medicolegal issues will arise as a part of our professional lives along with a multitude of negative emotions (which inevitably spill over into our personal lives) when we stand accused. These negative feelings, …
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The patient is a 46-year-old male with a history of hypertension and congestive heart failure who presents complaining of his defibrillator firing—twice yesterday and once today. He denies chest pain, shortness of breath, fever, nausea or vomiting. He ran out of his carvedilol about 1 month ago. View the initial ECG and consider what your diagnosis and next steps would be.
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