A 45-Year-Old with Chest Deformity

A 45-Year-Old with Chest Deformity

Click Here to download the article PDF. A 45-year-old man presents with “asthma-like symptoms” that he says have “come and gone” for several years. He denies chest pain or a sense of racing heartbeat. A chest deformity is clear from observation. View 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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There’s No Casual Approach to Improving Antibiotic Stewardship—but When You Make the Effort, It Works

There’s No Casual Approach to Improving Antibiotic Stewardship—but When You Make the Effort, It Works

Improving antibiotic stewardship was an industry-wide mandate even before a 2018 study indicated that urgent care appeared to be more likely than other settings to overprescribe for common infections. While the methodologies could be questioned, especially in their take on the nature of urgent care visits, the point was well taken. Since then, urgent care as a whole has sought to improve providers’ prescribing habits more aggressively than ever. The initial awareness campaigns did a …

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Management of Patients on Low-Dose Naltrexone: A Clinical Review for Urgent Care Providers

Management of Patients on Low-Dose Naltrexone: A Clinical Review for Urgent Care Providers

Urgent message: Low-dose naltrexone (LDN) is becoming more common as a treatment option for pain and thus will be increasingly prevalent in patients presenting to the urgent care setting. A thorough medication history, prioritization of non-opioid treatment options, and timely referral or transfer for severe uncontrolled pain are important considerations in the management of patients using low-dose naltrexone. Ting-Hsuan Chiang, MD; Kenneth Schmitt, BS; Ariana Nelson, MD INTRODUCTION Naltrexone is an opioid receptor antagonist approved …

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Abstracts in Urgent Care – July/August 2023

Abstracts in Urgent Care – July/August 2023

Click Here to download the article PDF. Lyme Disease Diagnosis in Children of Different Racial Groups Take-home point: Black children with Lyme disease were more likely to have arthritis rather than cutaneous findings at the time of diagnosis. Citation: Hunt K, Michelson K, Balamuth M, et al. Racial differences in the diagnosis of Lyme disease in children. Clin Infect Dis. 2023;76(6):1129-1131. Relevance: Erythema migrans (EM) is commonly felt to represent the first clinical finding in …

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COVID-19 and RSV: Coinfection Requiring Hospitalization

COVID-19 and RSV: Coinfection Requiring Hospitalization

Click Here to download the article PDF. Urgent message: Coinfection with COVID-19 and other respiratory pathogens can lead to a worsening clinical picture and requires careful assessment in the urgent care center. Marcia Taylor, MD, MSCR, FAAFP Citation: Taylor M. COVID-19 and RSV: coinfection requiring hospitalization. J Urgent Care Med. 2023;17(10):28-29. Key words: COVID-19, SARS-CoV-2, RSV, coinfection, pandemic ABSTRACT Patients who present with symptoms suspicious for COVID-19 and other respiratory conditions, regardless of vaccination status, …

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Modifier 25: What You Need to Know

Modifier 25: What You Need to Know

Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC Modifier 25 is used to indicate a significant, separately identifiable evaluation and management (E/M) service was required on the day of a minor surgical procedure. The procedure performed must have a global period of 0 or 10 days. An example of this is a laceration repair. Modifier 25 is overused in the industry and has been under scrutiny from payers for decades. Now private payers are implementing policies …

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Dig a little deeper

Dig a little deeper

Tracey Quail Davidoff, MD, FCUCM I was scanning the tracking board during an urgent care shift the other day and, as usual, my brain was five steps ahead. I read the chief complaints and had already determined the questions I’d ask to guide the history based on the differential diagnoses I’d predicted. This is a regular occurrence in the UC and ED, whether we admit it or not. It’s part of how we move things …

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Urgent Care’s Top Hospital-Affiliated Urgent Care Operators—by Number of Locations

Urgent Care’s Top Hospital-Affiliated Urgent Care Operators—by Number of Locations

The makeup of the urgent care industry has changed considerably since its inception in the 1970s. At the time, it was a radical idea to see patients with nonemergent complaints on a walk-in basis. Certainly hospitals wanted no part of it; that’s what they had emergency rooms for. Rather, the UC industry’s founders tended to be in private or small group practices, but unsatisfied with how they were practicing. Over the decades that followed, it …

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“Big Retail” Pivots Are a Retreat from “On Demand” Care

“Big Retail” Pivots Are a Retreat from “On Demand” Care

Click Here to download the article PDF Urgent message: Food, drug, and mass retailers continue to explore the healthcare space and seek profitable ways to leverage their massive footprints. As they shift their strategies in favor of primary care, especially for Medicare populations, they are relinquishing control of the transactional health market to urgent care. Alan A. Ayers, MBA, MAcc is President of Experity Consulting and is Senior Editor of The Journal of Urgent Care …

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Downtime

Downtime

It’s a weird time right now, isn’t it? On one hand, visit volumes seem to be back to our pre-COVID “norms.” This should be business-as-usual to us, but it feels scary because everyone got used to volumes being so high for so long. On the other hand, everyone is short-staffed, so it’s a good thing we aren’t busier, but being short-staffed is also scary because we feel unprepared for the coming months when volumes go …

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