Practice Management
A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …
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The patient is a 13-year-old boy who presents with knee pain after an awkward fall while playing basketball on an asphalt court. He is unable to walk due to pain and has a swollen knee. View the x-rays taken and consider what your diagnosis and next steps would be.
Read MoreOn March 9, 2021, the American Medical Association updated the new evaluation and management (E/M) coding guidelines with technical corrections. These clarifications apply to the office visit codes 99202–99215 and are retroactive to January 1, 2021. In the past few months there has been industry confusion over whether a test can be counted under the data element for the E/M level when the practice is also billing for the test. The AMA has answered this …
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Urgent message: Establishing respiratory outpatient clinics has been shown to decrease reevaluation rates for patients with bronchiolitis, especially in children aged <12 months and/or those who receive suctioning during their initial urgent care encounter. Prema D. Souza, MD; Aimy Patel, MD; Brian Lee, PhD; and Amanda Nedved, MD Citation: Souza PD, Patel A, Lee B, Nedved A. Do Respiratory Outpatient Clinics Decrease Bronchiolitis Reevaluation Rates? Observational Data for a Quality Improvement Project. J Urgent Care …
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Urgent message: Urgent care operators are spending an increasing amount of their marketing budget on seven digital tactics. Fortunately for those working in healthcare, there will never be a shortage of patients. People will always come down with illnesses, and minor injuries won’t go away anytime soon. That being said, it can still be difficult to get people in the door of your specific urgent care center. Although it often gets neglected, proper marketing is …
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Urgent message: This is the urgent message about a truly urgent case presentation concerning a pediatric patient in an urgent care center. Diana Sofia Villacis Nunez, MD; Amit Thakral, MD, MBA; and Pareen Shah, MD CASE PRESENTATION A 12-year-old previously healthy female presents with a 5-day history of lower extremity rash and low-grade fever (100.6°F). A month earlier, she had a self-resolving viral upper respiratory infection. The rash is described as mildly pruritic, dark red …
Read MoreThe conversation was going nowhere. After 15 minutes of explaining my concerns about the possibility of COVID-19, the lack of indication for antibiotics, the unreliability of rapid testing, I was no closer to satisfying my patient, Mrs. Fletcher, than when I first introduced myself. Joan Fletcher was a 40-something working mother of three who came to urgent care on a mission, as many patients do. The reason for her visit: an antibiotic prescription and a …
Read MoreIt’s not uncommon for the uninitiated to view urgent care as just the first, most convenient stop in what may be a two- or three-stop odyssey to resolve an immediate healthcare need. That could take all day and wind up being very expensive. Those in the know—certainly urgent care providers, operators, and experienced patients—understand that a trip to the urgent care center is often all a patient needs to get the right level of …
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Urgent message: Many performance-enhancing medications not currently approved by the FDA remain undetectable in basic urine specimens collected in the urgent care setting. If there is suspicion of any form of illicit substance use, the inquiry of specific supplements/agents is key, as side effect profiles are often vast and wide. Rachael M. Poff, PA-C and Christina E. Gardner, DHSc, MBA, PA-C INTRODUCTION Selective androgen receptor modulators (SARMs) constitute a class of medication that has become …
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Urgent message: Unmanaged hyperthyroidism can cause any number of acute conditions that would drive a patient to visit an urgent care center. Further, thyroid storm can mimic several life-threatening events. Early recognition of the correct diagnosis is essential to raising the likelihood of a positive outcome—and protecting the patient from self-harm. Amrita Mahajan, BA and Lindsey Fish, MD INTRODUCTION Thyroid storm is a rare, life-threatening complication of thyrotoxicosis, a condition caused by excess thyroid hormone. …
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