Practice Management
A 61-year-old female presents to urgent care with chest pain for 2 days. She describes it as “mild right now” but that it varies in intensity; it was so severe the previous night that it kept her from sleeping. Today the pain has been stuttering, lasting a couple of minutes at a time. Pain is substernal, nonradiating, and is associated with vomiting and diaphoresis. Vital signs are normal. View the ECG and consider what your …
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The patient is a 28-year-old female who presents with pain in her left foot after a fall of roughly 10 feet while rock-climbing. She reports that she “landed hard” with the left foot taking the full force of the impact. On exam, she had left midfoot dorsal and plantar tenderness and bruising across top of foot. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is …
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The patient is a 10-year-old boy who presents after twisting his right knee while playing a backyard game of badminton. The pain is such that he is unable to bear weight on the leg. 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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Urgent message: Nondisclosure agreements that are commonly required of management and providers to protect a company’s business strategies, intellectual property and human capital generally cannot prohibit employees from sharing their own pay, benefits, working conditions, or conditions of employment even on social media. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Practice Management Editor of The Journal of Urgent Care Medicine Many companies expect and even demand confidentiality of proprietary information. …
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Urgent message: Lingering warm weather and postpandemic euphoria continue to have patients eager to pursue outdoor activities, including swimming in pools, freshwater lakes, and oceans. Those who have suffered a drowning episode and whose symptoms have resolved may seek care or reassurance at the local urgent care center. Citation: Davidoff TQ. Evaluation of nonfatal drowning in urgent care. J Urgent Care Med. 2021;15(11):11-14. Case Presentation A 4-year-old Hispanic male without significant past medical history is …
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Taylor wore her embroidered sorority sweatshirt and a mask below her nose when she came to see me. She was 19 and had just finished her freshman year at the local university. Her story was cliché, as well: cough, runny nose, and sore throat “that wouldn’t go away.” She’d been sick for 8 days and she’d come in to get antibiotics. This isn’t a story about antibiotic stewardship, though. “Have you been tested or vaccinated …
Read MoreBack in the day, you probably would have been right to assume that the closest urgent care center was founded, owned, and run by a physician. Many other practices (primary care, pediatric…) would have been the same. Well, times have changed in a big way. The mavericks who simply wanted to find a better, more sensible way of practicing medicine and wound up creating a new industry are now employees of national and regional health …
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Urgent message: Pulmonary eosinophilia is a generic term for a heterogeneous group of disorders that result in increased eosinophils within the pulmonary parenchyma. Ultimately, the patient here was treated with an extended course of glucocorticoids to treat his chronic eosinophilic pneumonia until he could follow up with his hematologist/pulmonologist. CASE PRESENTATION The patient is a 29-year-old male with history of pulmonary eosinophilia, degenerative disc disease, and asthma who presents to an urgent care center with …
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Urgent message: LGBTQ individuals are subject to implicit and explicit bias in our society, ranging from microaggressions and antagonistic legislation to overt discrimination and harassment. This can inhibit willingness to seek medical care—and, subsequently, lead to worse health outcomes. Given the more accessible, episodic nature of urgent care, understanding how word choice and other subtle cues communicate our competency in working with LGBTQ patients can help us engender trust more quickly. INTRODUCTION The goals for …
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The patient is a 71-year-old female with type 2 diabetes who calls attention to a rash on her shins during an annual physical. The rash appears to be pink, atrophic scars surrounded by hyperpigmented patches. They have developed since her last physical. She denies discomfort but is concerned as to what could have caused them. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described …
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