(In the Beginning recounts the real-life experiences of urgent care owners who have taken the initiative to hang out the proverbial shingle and open a new start-up center. It will be an occasionally recurring feature available exclusively in the digital edition of JUCM.) From marketing to urgent care medicine to triathlons, it seems as though Dr. Cheryl Durstein Decker was literally and figuratively born to run, slowing down only occasionally to help others in her …
Read MoreInvesting in Expansion: Do It Yourself, or Take on Investors?
Urgent message: Sound finances and proven business management skills may be the most valuable assets for the urgent care operator looking to capitalize on past successes by expanding. by Michael Gotlieb Introduction Urgent care owners, like many other entrepreneurial businesspeople, have great opportunities in front of them, yet need assistance at times. Sometimes, that “assistance” is purely financial. Most often in inflection point cases like expansion; however, it is a combination of financial and business acumen …
Read MoreIn the Beginning: Medical Express Care, Dunmore, Pennsylvania
(In the Beginning recounts the real-life experiences of urgent care operators who have taken the initiative to hang out the proverbial shingle and open a new start-up center. It will be an occasionally recurring feature available exclusively in the digital edition of JUCM.) Ask Dr. Donna Eget about the greatest benefit to owning an urgent care center and she doesn’t miss a beat; to her, it is time—time with family and time with patients. The …
Read MoreCase Report: Upper Extremity Deep Venous Thrombosis – Paget-Schroetter Syndrome
Urgent message: Vigilance for risk factors and diagnostic methods related to Paget-Schroetter syndrome in patients presenting to urgent care with relevant risk factors is essential to initiating therapy on site and timely referral to a hospital and/or vascular surgeon. Darshan Shah, MD, Shikhar Saxena, MD and Shailendra Saxena, MD, PhD Introduction Upper extremity deep venous thrombosis (UEDVT) is estimated to constitute 1% to 4% of all cases of deep venous thrombosis (DVT).1 The incidence may …
Read MoreClinical Challenge 2: April 2010
The patient is a 26-year-old who presents to urgent care after “twisting” the right foot, complaining of local pain but able to bear weight. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreEvaluating Febrile Patients with Rash
Urgent message: The broad differential diagnoses in patients presenting with rash and fever range from minor conditions to life threatening illnesses, requiring the urgent care provider to make prompt but valid assessment with minimal diagnostic tools. Kosta G. Skandamis, MD The combination of fever and rash is so common that it may sometimes seem to be a daily occurrence in the urgent care setting. Nonetheless, the extensive differential diagnosis requires the provider to be vigilant …
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Beyond Vital Signs: Managing by Metrics for Optimal Health of Your Practice
Urgent message: Establishing a system of metrics and ‘dashboards’ allows the urgent care operator to quantify key success factors and company values that may otherwise be impossible to measure. Laurel Stoimenoff Metric – Function: noun \’me-trik\ Def: A standard of measurement – Merriam Webster Online Dictionary. “What gets measured gets managed.” This pearl applies not only to the behemoths like General Electric, but also to a single-site urgent care center. A 2008 survey by the …
Read MoreA 9-year-old Boy with Respiratory Symptoms
Urgent message: ‘Fresh eyes’ may be needed to reconsider an initial diagnosis or re-evaluate treatment in patients who present with unresolved symptoms. Joseph Toscano, MD The Case A 9-year-old boy presented to an urgent care clinic with a several-day history of dry cough and intermittently noisy and difficult breathing, especially at night. He had no fever or chest pain, no nasal discharge or headache, and no rash or pruritis. His past medical history included no …
Read MoreCase Report: Gout vs. Cellulitis
Urgent message: Sometimes, cellulitis can be confused with gout – especially when it involves the area around a joint. A detailed history and physical exam, along with diagnostic testing, will help you reach definite diagnosis. Introduction Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. It is a type of monoarticular arthritis caused by deposition of monosodium urate crystals in and around the joint. Hyperuricemia (serum uric acid level >6.5 mg/dL) seems …
Read MoreClinical Challenge 2: January 2010
The patient is a 20- year- old female who presents with pain one day after experiencing a blow to the knee during a fall. On exam, you reveal no significant findings beyond mild local tenderness. She is able to bear weight fully on both legs. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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