Practice Management
Most urgent care providers loathe when a patient checks in with chest pain because, typically, they are presenting because they’re worried about a heart attack, and we’re worried we don’t have the tools to exclude this diagnosis. It’s no surprise that we’re met with consternation when we suggest they may have come to the wrong place for care. But is unavailability of troponin testing a worthy scapegoat? And is the practice of ED referral for …
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Urgent message: Immobilization following acute knee injury occurs more commonly than the evidence might dictate in urgent care and other acute care settings. Evaluation of data in existing literature suggest that this common practice carries risk for adverse effects when not warranted. Matthew Bruce Baird, MD, CAQ-SM; Mallory Shasteen, MD, CAQ-SM; and Vicki Nelson, MD, CAQ-SM. Citation: Baird MB, Shasteen M, Nelson V. Knee immobilization for acute knee injuries: a review. J Urgent Care Med. …
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Immobilizing Ankle Fractures Treating Septic Olecranon Bursitis EKG Interpretation: Human vs Machine preHEART Score and Prehospital Care Rethinking Otitis Media Management Boosters Limit Risk for COVID—but by How Much? Ivan Koay MBChB, FRNZCUC, MD Casting vs Bracing for Ankle Fractures Take-home point: Plaster casting was not superior to functional ankle bracing for certain ankle fractures. Citation: Kearney R, McKeown R, Parsons H, et al. Use of cast immobilisation versus removable brace in adults with an …
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Urgent message: Previously JUCM-published research revealed that even very low risk for a major adverse cardiac event left clinicians uncomfortable with discharging patients per 2018 ACEP guidelines. What can be learned from a follow-up study reflecting the updated version? Rebekah Samuels, OMS-III; Francesca Cocchiarale; Samidha Dutta, DO, PGY-3; Jarryd Rivera, MD; Amal Mattu, MD; Michael Pallaci, DO; Paul Jhun, MD, FAAEM; Jeff Riddell, MD; Cameron Berg, MD; and Michael Weinstock, MD. Citation: Samuels R, Cocchiarale …
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Urgent message: Previously undiagnosed diabetes in elderly patients is too frequently a precursor to the diagnosis of pancreatic cancer. Incidental and unexpected diagnosis of diabetes in older patients in urgent care, especially in normal or underweight individuals, should prompt a discussion about vigilant monitoring for other symptoms of malignancy and close follow-up with a primary care provider. Joshua Russell, MD, MSc, FCUCM, FACEP CASE PRESENTATION A 72-year-old woman with a history of hypertension presented to …
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The patient is a 10-year-old girl who presents to urgent care with 3 days of fever, headache, muscle aches, nausea, and a skin rash. She has a temperature of 102°F. On examination you find numerous erythematous macules and purpura on her palms and the soles of her feet. The patient is immunocompetent with an unremarkable medical history. Her mother recounts no recent travel from their home in North Carolina, but notes that the patient spent …
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The patient is a 35-year-old woman who presents with a frequent, light cough of several months’ duration. Her medical history is unremarkable, including no history of COVID-19. She is a former “social smoker” who worked out on a treadmill sporadically before the cough began. View the image taken 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: People are unlikely to trust their healthcare to a provider with a sullied reputation, so speaking ill of a provider can cost them in terms of patient revenue or future employment opportunities. Understanding the causes and defenses for defamation can help you protect your reputation and your business. Alan A. Ayers, MBA, MAcc We live in a nation where the First Amendment should protect “free speech,” particularly among public figures. Yet, Google “defamation …
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It won’t be news to you that patient visits dropped—precipitously at times—over the course of the COVID-19 pandemic. And there’s no getting around the fact that business has suffered, though it’s also a plain fact that many patients are returning. What is probably less evident, but certainly interesting, is that between 2019 and 2020 urgent care centers saw less of a decline in utilization than emergency rooms and ambulatory surgery centers, as illustrated in the …
Read MoreWhen it comes to measuring your financial performance, metrics translate the actions of others into insight. They provide visibility into the efficacy of your overall billing process. But while they may shine a light on where you need to improve, they don’t tell you how to do it. For a better understanding of how well your clinic is optimizing the billing process, look at your everyday practices. Our revenue cycle management (RCM) experts compiled 10 …
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