bnapolitano, Author at Journal of Urgent Care Medicine

A 27-Year-Old Man with a Lesion on One Hand

A 27-year-old man presents complaining of a single skin lesion on his hand. He reports that it first appeared as a smooth nodule that ulcerated and spread in a lymphangitic fashion. He grew worried when he started to have a fever. The only unusual activity he’d done in the last few weeks was clean out one of his large saltwater aquariums to prepare for purchasing new fish. View the photo and consider what your diagnosis …

Dealing with the Emotional Impact of a Merger or Acquisition

Urgent message: Urgent care has seen significant merger and acquisition activity in recent years, which is certain to cause worries, frustrations and stresses for employees. Understanding the problems—as well as the opportunities—associated with a change in ownership better positions employees to assure both the company and their career interests are well served. Alan A. Ayers, MBA, MAcc is Chief Executive Officer of Velocity Urgent Care, LLC and is Practice Management Editor at The Journal of Urgent …

Abstracts In Urgent Care – January 2019

A Brief Introduction Happy New Year! 2018 is now behind us and it was another great year for urgent care. We are fortunate to work in one of the most dynamic and rapidly growing fields in medicine. I find it thrilling that the future of urgent care is ours to define and design. According to data from the UCA, last year nearly 150 million patients received care in U.S. urgent care centers (UCCs). These patients …

Cat Scratch Disease Presenting as Parinaud’s Oculoglandular Syndrome

Urgent message: Cat scratch disease caused by the bacteria Bartonella henselae typically presents as isolated lymphadenopathy in the region draining the inoculation site (cat scratch or saliva), as well as systemic symptoms such as a fever and malaise. In otherwise healthy people, oculoglandular symptoms are occasionally seen as a complicated presentation. CSD should be included in the differential diagnosis of these symptoms. Joseph V.M. Kelly, MD, MBA, Nicholas Baltera OMS I, and Ronald Dvorkin, MD, …

A 57-Year-Old Man with 3 Days of Lightheadedness

The patient is a 57-year-old man who complains of lightheadedness for the last 3 days. He has a history of a heart stent placed 4 years ago and has been asymptomatic since that time. He denies vomiting, diarrhea, chest pain, shortness of breath, abdominal pain, or paresthesias. No recent travel. He takes metoprolol and clopidogrel. There is a family history of hypertension Upon exam, you find: General: Sitting comfortably in a chair, alert, breathing comfortably …

The Connection Between Age and Choosing a Healthcare Setting

If you’ve worked in more than one setting—say, a traditional primary care office and an urgent care center—you’ve probably noticed differing patient preferences. It’s self-evident, for example, that patient who go to urgent care centers prioritize being able to see a provider today over waiting a few days to see their “regular” doctor. You may have been too busy treating those patients to notice that certain preferences can be age-specific, however. Advisory Board conducted a …

Watch Out: Employer Health System Networks Are Getting Tighter

The pressure to demonstrate the value you provide to employers, compared with telemedicine, on-site clinics, and other venues for on-demand primary care, is increasing as employer health system networks continue to become more exclusive. An article posted recently by HealthLeaders suggests that employers and insurers believe tightening their provider selections will raise quality and cut costs. Regardless of whether that logic proves fruitful in the end, the result today is that provider networks are smaller. …

The Chase for a Universal Flu Vaccine is Picking Up Speed

Every October (or earlier), the call goes up that it’s time for patients to get their annual flu shot. Urgent care providers are inundated with messages from all corners of healthcare, pleading with them to vaccinate as many people as time and patient preference allows. Advances in artificial intelligence could put a stop to that at some point, however. No, it can’t program patients to follow your advice by getting immunized. Rather, as noted in …

Multistate Telemedicine Practice Could Be a Boost or a Drain for Urgent Care Business

It’s typical for healthcare providers who are licensed in one state to be permitted to treat patients only in that state. A new set of regulations could open to door to treating patients in multiple states, however—at least virtually. Currently, 24 states belong to the Interstate Medical Licensure Compact, which reduces barriers that prohibit providers from treating patients in multiple states if they’re only licensed in one. Physicians do have to apply and pay fees …

Raw Turkey Products Are Causing Salmonella Infections Across Half the Country

Cases of multidrug-resistant Salmonella infections have increased nearly 32% across 26 states and the District of Columbia over the past 6 weeks, according to a new report from the Centers for Disease Control and Prevention. The CDC and public health officials in some affected states have traced the cases back to raw turkey products. Urgent care providers should be vigilant for patients presenting with nausea, vomiting, abdominal cramps, diarrhea, fever, chills, headache, or blood in …