bnapolitano, Author at Journal of Urgent Care Medicine

WHO Recognizes Workplace Burnout—Do You Recognize the Signs in Your Urgent Care Team?

The latest version of the International Classification of Diseases from the World Health Organization has a startling new entry: for the first time, it officially classifies burnout as an occupational phenomenon. Previous editions have referred to burnout as a “state of vital exhaustion” but stopped short of linking it to the workplace. Now the WHO describes burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed,” including the …

Warning: Fallout from the Latest Healthcare Data Breaches Is Still Unfolding

A pair of data breaches at two lab test companies exposed information relating to more than 19 million consumers this week. First, Quest Diagnostics admitted it experienced a breach that exposed 12 million patients’ information; a day later, LabCorp revealed a breach affecting 7.7 million people. In the latter case, the company said the breach occurred at a third-party collections firm called American Medical Collections Agency (AMCA) between August 1, 2018 and March 30, 2019. …

Establishing a Need—and Helping to Fulfill It—Can Bring New Patients Your Way

JUCM readers know urgent care is a frequent destination for patients who’ve experienced a blow to the head that could have caused mild traumatic brain injury—with children being brought in by parents of particular concern. The operators of Westex Urgent Care in Texas not only recognized that, as well, but have mobilized their resources to get on the prevention side. Westex recently took part in a Texas Medical Association initiative to provide bicycle helmets, free …

UnitedHealth Sets $100 Billion Expectation for Medical Business

Some “experts” in both the insurance and healthcare industries may have been skeptical when UnitedHealth Group’s Optima division bought MedExpress a few years ago. Others predicted that the insurance giant would likely look for ways to deliver deeper healthcare services to their own plan members. They were right. MedExpress is now the largest urgent care chain in the country. UHG expects even bigger things to come, however—projecting that MedExpress will help push its OptumCare medical …

Rural Hospitals Are Dying; Can Urgent Care Pick Up the Slack for Patients’ Immediate Needs?

More than a quarter (26%) of Americans who live in rural areas have not been able to get healthcare when they needed it at some point in recent years, according to new research National Public Radio conducted with the Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation. This in spite of the fact that 87% have one form of health insurance or another. The reason? Rural hospitals, which many rural …

Telemedicine in Urgent Care—Yay, Nay, or Too Soon to Say?

If you read this month’s Urgent Perspectives column (page 1), you were treated to a dynamic conversation between two urgent care leaders about the relative merits—and potential drawbacks—of utilizing telemedicine in the urgent care setting. The disparate opinions presented there are reflected in the larger urgent care marketplace, as well. The Urgent Care Association’s 2018 Benchmarking Report notes an interesting dichotomy: Only 1.58% of the sampling reflected in the report say they provide telemedicine—a drop …

A 27-Year-Old Marathon Runner with Epigastric Pain

A 27-year-old woman who has been training for a marathon presents to the urgent care center with epigastric pain. She states the pain is worse after she consumes tomato sauce or orange juice, and wonders if she may have reflux. She denies shortness of breath, exertional component, pleuritic pain, leg swelling, use of hormonal therapy, or sweating. No right upper quadrant pain. Improves with antacids. No FH or heart disease or other risk factors. Upon …

A Construction Worker with Sudden Foot Pain After Stepping Into a Hole

Case The patient is a 45-year-old male construction worker who felt pain immediately after stepping down from a truck into a pothole. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1.

Get Ready for the Next Round of Changes to E/M Guidelines

The American Medical Association has announced it is taking the first steps towards revising the new Evaluation and Management (E/M) guidelines that the Centers for Medicare and Medicaid Services (CMS) introduced last year to reduce the administrative burden on clinicians with the Patients over Paperwork initiative.1 Effective as early as January 1, 2021, office visit Level 1 E/M code 99201 will be deleted. Additionally, while the history and exam will be required to be reviewed …

A 9-Year-Old Girl with Sudden-Onset Sore Throat After a Meal

Urgent message: Sore throat and throat pain are common complaints in the urgent care setting. While infectious causes are the most common and the likely cause of the patient’s complaint, it is important to consider other causes. Linu Samuel, MD Introduction Sore throat and throat pain are common chief complaints across all ages in the urgent care setting. As clinicians who likely see these complaints multiple times a day, our differential diagnosis when walking into …