Ashley Blachford, Author at Journal of Urgent Care Medicine

Yes, Disparities in Prescribing Exist in Urgent Care—but Which Disparities?

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 …

Approach to the Transgender Adolescent and Specific Health Considerations

Urgent message: It is common for transgender patients to have a history of poor experiences with healthcare providers. As such, they may be less likely to have an ongoing clinical relationship with a primary care provider, making urgent care a likely destination when a need arises. Familiarity with issues facing adolescent transgender patients, in particular, can benefit both the provider and the patient. Timothy McGinnis and Emily Montgomery, MD THE CASE A 15-year-old transgender male …

A 36-Year-Old Male with Sudden-Onset Substernal Chest Pain

The patient is a 36-year-old male with a history of tobacco and alcohol use who presents to urgent care with sudden-onset substernal chest pain and shortness of breath that began 1 hour prior to arrival. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 43-Year-Old Man with a Painful, Purulent Finger

The patient is a 43-year-old male who presents with a painful collection of pus near his fingernail. He reported that it had developed over the past day. On examination, a large, yellow-green superficial pus collection was seen at the proximal nail fold with surrounding erythema and edema. The patient mentioned that he had a home renovation business and that it was common for him to experience mild injuries such as splinters on his hands. The …

A 47-Year-Old with Pain After Twisting His Ankle

The patient is a 47-year-old male who presents with a primary complaint of right ankle pain after a pick-up game of basketball. He reports he twisted his ankle when he landed on another player’s foot. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Reoccurring Metatarsophalangeal Joint Pain

Urgent message: Acute or chronic hallux pain is a common complaint in urgent care. Due to the structure, several diagnoses can have similar presentation on history and exam. With this discussion, we examine a sesamoid stress injury. Sergio P. Ramoa, MD, MS INTRODUCTION The tibial (medial) and fibular (lateral) sesamoids are contained within the flexor hallucis brevis tendons along the metatarsal head.1 They have several roles such as absorbing weight, helping glide and reducing friction …

COVID-19 Testing Pattern in a Suburban Pediatric Urgent Care Center

Urgent message: Though not considered as at “at risk” for severe disease with COVID-19, children have suffered significant disruptions to educational and personal activities throughout the pandemic. Recognizing urgent care’s role in testing for the virus could show benefit for families and urgent care centers alike. Rita P. Nunag, MD; Francesca M. Darquea, MD; Claire Loiselle; and Magdy W. Attia, MD Citation: Nunag RP, Darquea FM, Loiselle C, Attia MW. COVID-19 testing pattern in a …

Thinking About Buying or Selling an Urgent Care Center?

Urgent message: While market conditions for mergers and acquisitions are currently “hot,” variability in urgent care volume attributable to COVID-19 has led to changes in how deals are evaluated and structured. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Senior Editor of the Journal of Urgent Care Medicine Nationally, merger-and-acquisition activity has set a record pace across all industries since the start of the pandemic. Corporations, private equity funds, and buyout …

More People Really Are Trying Telehealth These Days—but That Doesn’t Mean They Prefer It

There’s been a lot of discussion (including in JUCM and JUCM News) as to whether the COVID-19 pandemic would usher in a Golden Age of telehealth, whether within urgent care or in possible competition with urgent care. Now that we’re approaching 2 years in, actual data on the subject are starting to emerge. First, some background: Household Experiences in American During the Delta Variant Outbreak, a survey conducted this year for NPR, the Robert …

Atypical Skin Abscess Caused by Nontuberculous Mycobacterium

Urgent message: Cutaneous abscesses are common presentations in urgent care. While either methicillin-sensitive or methicillin-resistant Staphylococcus aureus accounts for up to 75% of skin abscesses, atypical organisms such as nontuberculous mycobacteria (NTMB) can also lead to abscess formation. Urgent care providers should be aware that the clinical presentation may be atypical and require specialized treatment. Rachel Hughes, MD and Erik Butler, DO CASE PRESENTATION A 26-year-old female with no known past medical history other than …