Practice Management
Roger Hicks, MD I live in the foothills of the Sierra Nevada in Northern California, where, like numerous other parts of the world, extreme weather events are becoming increasingly routine occurrences. The “hot days” are hotter and more abundant, and the droughts are more severe. In turn, this has precipitated more wildfires, which lead to problematic smoke and hazardous air quality. When I opened my urgent care (UC) clinic 24 years ago, I never thought …
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International Classification of Disease (ICD) codes—maintained by the World Health Organization and published in the United States by the Centers for Medicare and Medicaid Services—standardize the categorization and reporting of patient diagnoses. Currently, U.S. healthcare operators use the ICD-10 edition. The analysis below examines 2023 urgent care visits logged by users of Experity’s electronic medical record, revealing that 28,686 diagnosis codes were documented in urgent care patient medical records. While it’s logical to conclude …
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Urgent Message: Patients commonly present with respiratory symptoms in the urgent care setting and not infrequently complain of some degree of shortness of breath—or dyspnea. It is critical for clinicians to have comfort with the clinical assessment and appropriate use of diagnostic resources for the dyspneic patient. Identifying patients requiring immediate emergency department referral is an important skill. Evan Price, DO; Eric Patten, MD; Shakil Hossain, DO; Michael Weinstock, MD Citation: Price E, Patten E, …
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Using AI to Detect Myocardial Infarction Take Home Point: The use of an occlusive myocardial infarction (OMI) artificial intelligence (AI) electrocardiogram (ECG) model has the potential to improve identification of acute coronary syndrome (ACS) by enabling timely and accurate detection of OMI regardless of the presence ST-segment elevation. Citation: Herman R, Meyers H, Smith S, et. al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit …
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A 60-year-old man presents to urgent care complaining of an annoying cough for several months. He states that he frequently has sputum production with his cough. He denies any fever, chills, or other symptoms. Review 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: With hyperabduction and hyperextension of the thumb, the ulnar collateral ligament may be stretched or torn, or may avulse a segment of bone from its insertion point. Radiographic imaging of suspected “gamekeeper’s thumb” must be obtained to evaluate for an associated fracture, which may change the decision for conservative vs surgical management. Omar Jafry, MS-3; W. Bradley Strauch, MD Citation: Jafry O, Strauch WB. Urgent Care Evaluation and Management Of Injury to the …
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A 15-year-old male with no significant past medical history presents after he was noted to be gasping for air and difficult to arouse after taking a nap. At the urgent care, 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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A 29-year-old woman presents to urgent care for a painful rash that developed on her arm. It started 1 day after working on a landscaping project that involved pulling weeds under intense sunlight. On examination, an edematous, pink, scaly plaque and nearby erosions are seen on her right arm. The patient appears well and has no systemic symptoms. View the image below and consider what your diagnosis and next steps would be. Resolution of the …
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Urgent Message: Patients may present to an urgent care facility with intraoral angioedema, a life-threatening emergency that requires referral to an emergency department in any case with rapid progression or concerns for airway involvement. This case report describes angioedema from olanzapine, an antipsychotic prescription drug. Chantelle Petterson, BDS, Benjamin Fu, MD, BDSc (HONS), MPhil, FRACDS (OMS) Citation: Petterson C, Fu B. Intraoral Angioedema After Olanzapine Overdose: A Case Report. J Urgent Care Med. 2024; 18(9):34-36 …
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I like to think that I usually have a pretty good read on Urgent Care, but I am currently mystified by something and need your help. For as long as I can remember, everyone in Urgent Care has chanted a common refrain: “We need a seat at the table!” In the beginning, we were too small to make enough noise to be heard and way, way too tight on funds to even think about hiring …
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