Practice Management
Urgent message: Do not be fooled by the diagnosis made by clinicians before you. Many seemingly benign symptoms can be harbingers of more serious pathology. JESSICA HOFFMANN, MS-4, and JOHN SHUFELDT, MD, JD, MBA, FACEP Chronic back pain is a common presentation in both the urgent care and emergency department (ED) settings. Care-on-demand providers often find themselves deciding how extensive a workup to do for a patient with acute-on-chronic back pain. After a patient has …
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Urgent message: Polypharmacy—taking multiple medications to treat several chronic medical problems—puts patients at increased risk of developing additional health issues when they are prescribed even more medications for acute conditions in an urgent care center. JASMEET SINGH BHOGAL, MD It is not uncommon for patients, especially elderly patients, presenting to an urgent care center to have multiple medical problems. This makes it more likely that they are taking multiple medications as well. In fact, according …
Read MoreLee A. Resnick, MD, FAAFP What can Joseph Heller and Goldilocks teach us about managing no-win situations in urgent care? As it turns out, if you look under the covers of Baby Bear’s bed, you might find something meaningful, perhaps even something that’s “just right.” Take the classic no-win situation when patients present to urgent care with chest pain. Without a definitive and reliable test to guide our decision making, we are stuck with the …
Read MoreQ. We sometimes have patients come in to our urgent care center with an insurance payor that we do not have a contract with. We do not want to turn them away, but we do want to guarantee our payment. Do we have to submit a claim to the insurance company in such cases? Currently, we offer these patients a self-pay discount, and they pay us in full at the time of service. A. Typically, …
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Urgent message: Rapid growth of the urgent care industry has led to increased competition but little differentiation among urgent care providers, which consumers tend to view as “pretty much the same.” The opportunity for urgent care is thus to foster patient loyalty by creating differentiated brands, which starts by taking a process approach to the patient experience. ALAN A. AYERS, MBA, MAcc Urgent care is maturing into a big business. In 2015, the industry’s nearly …
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A new mother is concerned because her baby boy was born with scattered pustules on his neck. The baby is full term and was born to a mother who had adequate prenatal care and no evidence of sexually transmitted infections. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreCase A 68-year-old man with a long history of uncontrolled hypertension and hyperlipidemia presented with unilateral decreased vision for the last 3 weeks. On exam, you saw a fundus with diffuse retinal hemorrhages and swelling.
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This image was taken of a 3-year-old boy who presented with history of 3 days of fever and headache and 1 day of diffuse lymphedema of his neck and parotid glands. The area surrounding each parotid gland was tender to palpation. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreCase An 80-year-old man woke up with a localized area of erythema on his forehead. He didn’t think much of it, until the lesion slowly became white and then started turning blue over a few hours. He says that the lesion is painful and is getting larger and darker. He denies the presence of headaches, muscle pain, abdominal pain, sweating, and tremors.
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