Practice Management
A 37-year-old man with a history of human immunodeficiency virus (HIV) presents to a free clinic in sub-Saharan Africa with painful genital ulcers that have a dirty surface, undermined border, and surrounding erythema. He also has tender inguinal lymph nodes. View the image taken (Figure 1) and consider what your diagnosis would be.
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A 68-year-old man with a long history of uncontrolled hypertension and hyperlipidemia presents with vision that has been decreased in one eye for the preceding 3 weeks. On examination, you see a fundus with diffuse retinal hemorrhages and swelling. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreData from the 2014 Urgent Care Chart Survey of 1,778,075 blinded patient visits to more than 800 different urgent care clinics, conducted by the Journal of Urgent Care Medicine, show that the 2 largest age groups of patients using urgent care centers were 21 to 30 years (17.1%) and 31 to 40 years (15.9%); the smallest age group was 51 to 60 years (11.9%). The survey’s methodology and data abstraction forms were initially designed in …
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Urgent message: Employee disengagement is pandemic in the American workplace. At urgent care centers, operators have to work especially hard to keep frontline staff members motivated. Re-engaging employees starts with a strong management culture committed to establishing affinity with employees and ensuring that systems and processes support day-to-day operations. ALAN A. AYERS, MBA, MAcc, Experity For many urgent care operators—clinically adept physician–owners who are likely green as entrepreneurs—it can be sobering to realize just how …
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Urgent message: Although chest pain in young adults is often benign, it is important to realize that emergency cases can sometimes be disguised as normal examination findings in adults. ZANA ALATTAR and JOHN SHUFELDT, MD, JD, MBA, FACEP This case demonstrates the importance of considering and ruling out rare cases of aortic dissection in patients with chest pain. We describe a case illustrating the approach to the management and work-up of chest pain in young …
Read MoreSEAN M. McNEELEY, MD The Return of Measles Key point: Measles is back, so watch for it among your patients. Citation: Centers for Disease Control and Prevention. Measles (rubeola). Atlanta, GA: Centers for Disease Control and Prevention [updated February 12, 2015; cited February 18, 2015]. Available from: http://www.cdc.gov/measles/hcp/index.html Unfortunately measles is making a comeback. Most likely because of decisions to delay or avoid immunizations, a measles outbreak began in California in December 2014 and has …
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Urgent message: Gastritis and peptic ulcer disease are a spectrum of diseases that can range from mild to serious; urgent care providers must be on the alert for these conditions. Early diagnosis and treatment, along with recommendations for follow-up care with appropriate specialists, can help prevent long-term sequelae. TRACEY Q. DAVIDOFF, MD Gastritis and peptic ulcer disease (PUD) represent a continuum along a path of inflammation of the gastric mucosa, from superficial irritation of the …
Read MoreThe Case The patient presented with wrist pain after a fall on an outstretched hand (FOOSH). View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreJOHN SHUFELDT, MD, JD, MBA, FACEP Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: Johnny Trey Dalton Attorney …
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