Practice Management
The patient is a 42-year-old male who presents after referral from a diagnostic testing site with an abnormal ECG, obtained during a preoperative evaluation. He reports a history of hypertension and symptomatic inguinal hernia, and acknowledges chronic right groin pain. He is otherwise asymptomatic, including robust exercise tolerance. View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Tom …
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The patient is a 58-year-old male who presents with a painful mass at the lower aspect of his right knee. He denies any impact to his leg, but reports that the pain started “some time ago,” getting progressively worse. Review the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care and is Practice Management Editor of The Journal of Urgent Care Medicine. Urgent message: The anonymity of social media enables disgruntled patients, former employees, and/or community members to take out vengeance on an urgent care center through negative reviews and postings, typically out-of-proportion to the actual “offense.” Because of the importance of social media as an advertising and marketing channel, urgent care …
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The patient is a 9-year-old girl who is brought to your urgent care center by her parents after falling down the stairs at home. She complains of pain in her left hip, severe enough that she refuses to bear weight. You order imaging of her pelvis, as well as the hip. View the image taken and consider what your diagnosis and next steps would be.
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The patient is a 24-year-old male who presents for a pre-employment physical. While undergoing his exam, he mentions being “curious” about tiny papules he noticed recently in his mouth on the inside of his cheek. They seemed to be a group of slightly yellow lesions, present on both sides of his mouth. He reports that they have been there “for a few months,” but they have not caused discomfort so he hasn’t sought care. …
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The patient is a 67-year-old male with no medical history who presents with severe chest pain radiating to his left arm that started 1 hour prior to arrival. The patient also endorses progressive dyspnea on exertion of six months duration. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case contributed by Gregory J Ducach, MD.) Figure 1. ECG upon urgent …
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Urgent message: The urinalysis is a ubiquitous test in urgent care settings, though there is nuance and complexity in its interpretation. An evidence-based approach is essential to assuring correct interpretation and decision-making. Douglas W. Wallace, MD, Blakeley Hudson, MD, and Matthew Delaney, MD Introduction The urinalysis (UA) is one of the most commonly ordered tests across a variety of practice settings. Despite its ubiquity, interpreting a UA can be complicated and nuanced. Given the variable …
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Urgent message: Though it occurs relatively rarely, mushroom toxicity can result in irreversible organ damage and, in certain cases, death if not recognized quickly. Diagnosis can be difficult due to the facts that toxicity may present at different intervals from time of ingestion, depending on the species of mushroom, and initial symptoms are nonspecific and similar to those of benign gastrointestinal illnesses. Timely consultation with a poison control center may be life-saving. Michele L. Stowe, …
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Shelter at home. Wash your hands. Use a tissue and properly dispose it. See your primary care if you are not feeling well. The advice goes on and on. But what if you are homeless? What if you do not have ready access to soap and water, or hand sanitizer, or tissues, or medical care? Universally, efforts to contain and mitigate pandemic diseases such as COVID-19 leave out a vulnerable population: people experiencing homelessness (PEH). …
Read MoreCost, convenience, and quality are features healthcare consumers cherish. The challenge for healthcare consumers is to find a facility that offers all three. While they can certainly find quality care that’s convenient in their local emergency room, the cost for that care is high. A traditional primary care practice is also a good choice for quality care, but while the cost is going to be much lower than in the ED the patient may have …
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