bnapolitano, Author at Journal of Urgent Care Medicine

For Auld Lange Syne, Many Great Years

The year was 2006: Saddam Hussein was executed for crimes against humanity. The Wii gaming console debuted. Pluto lost its planetary status. High School Musical and Borat were the talk of the town in entertainment. And JUCM, The Journal of Urgent Care Medicine was born—the first and only peer-reviewed journal in the industry (which it remains to this day). Well, let’s just say that JUCM was the undisputed highlight of 2006! The whole idea for …

Three Tips to Optimizing Patient Collections

Over the last decade, perhaps the most staggering shift in consumer-based healthcare has been the increase in patient responsibility. Due to the rise in high-deductible health plans (HDHPs), providers are now faced with the challenge of collecting an average of 35% of their revenue from patients, without a downward swing in the insured population. Consider the following: In 2018, 85% of covered workers had a deductible, up from 59% in 2008. The average deductible in …

Atypical Chest Pain in a Fibromyalgia Patient Presenting to Urgent Care

Tracey Q. Davidoff, MD, FACP, FCUCM Urgent message: Underlying medical and psychiatric conditions can cloud judgment and lead to cognitive errors, which may result in potentially serious medical errors.1 Case Presentation A 31-year-old woman with a medical history significant for fibromyalgia, migraines, bipolar disorder, and anxiety presents with 2 hours of severe bilateral neck spasms, left shoulder and arm pain, and chest pain which began soon after taking a new prescription for olanzapine. She also …

Rural and Tertiary Markets: The Next Urgent Care Frontier

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: Given the oversaturation and resulting fierce competition among urgent care chains in the affluent suburbs of major cities, the underserved rural healthcare market offers tremendous growth opportunity for the forward-thinking urgent care operator. Urgent care began as a suburban phenomenon—and continues to be, as evidenced by the Urgent …

Ear Pain Mimics: It’s Not All About Otitis Media

Urgent message: Though ear pain is often due to otitis media or externa, it is important to include other diagnoses, some of which could be life-threatening, “can’t miss” causes. Introduction Patient complaints of ear pain (otalgia) are seen frequently in the urgent care setting. It can be frustrating for patients and providers when a patient’s ear pain has no obvious cause. Differential diagnoses include several primary and secondary causes of otalgia. (See Table 1.) Lab …

It’s Time to Offer Greater Flu Protection—for the Good of Your Community and Your Business

The Centers for Disease Control and Prevention says influenza season is off to its earliest start in 10 years. By mid-November 30 states had confirmed cases. These facts have been detailed on local and national TV news programs and in major newspapers and online news sources. And yet, many people who intend to get vaccinated haven’t done so. Your urgent care providers could be the catalysts for getting them to take that step, possibly saving …

Happy Thanksgiving! Now Please Pass the Salmonella

Joyous (or even politically charged) family get-togethers are a holiday tradition for most Americans. Some holidays are also occasions for more inherent risk than others, however, with Thanksgiving near the top of the list of the most potentially dangerous. Whether it’s Uncle Ned trying out his new electric carving knife after one too many cocktails or an undercooked turkey carrying Salmonella—something the Centers for Disease Control and Prevention warns about annually—people in your community are …

Are You Doing Enough to Protect Your Clinicians? The Data Suggest ‘Probably Not’

Envision four actual nurses who work in your urgent care operation. You probably picture them smiling, or engaged in their jobs and providing care to patients. Now picture one of them being physically or verbally assaulted in the workplace—YOUR workplace. New data from the American Nurses Association suggest that’s a very real, and quantified, likelihood; workplace violence is so common that one out of four nurses acknowledges they’ve been the victim of assault of one …

Much Ado About Toilet Bluing (and Other Drug Testing Requirements)

Alan A. Ayers, MBA, MAcc is Practice Management Editor of The Journal of Urgent Care Medicine and is Chief Executive Officer of Velocity Urgent Care. Urgent message: While any urgent care’s preferred “toilet bluing” method for urine specimen drug screen collects would seem a mundane matter, a careless or haphazard approach can result in unintended and potentially serious consequences. Urgent care centers that provide occupational medicine and drug testing services are required to follow specific …

CDC Takes Another Stab at EVALI Guidance as Flu Season Picks Up

In consideration of mounting cases of influenza—and the respiratory concerns they bring with them—the Centers for Disease Control and Prevention has updated its guidelines on diagnosing and treating patients with signs of e-cigarette or vaping lung injury (EVALI). Urgent care providers, and all healthcare professionals, are urged to ask patients with symptoms of respiratory or gastrointestinal illness (or symptoms such as fever, chills, or weight loss) if they use, and how often they use, e-cigarettes …