StuWilli, Author at Journal of Urgent Care Medicine

January 2015

Developing Data: January, 2015

Data from the Bureau of Health Professionals show that lack of access to primary care in the United States is driving the heightened demand for urgent care utilization. As of 2013, approximately 60 million individuals in the United States lacked access to primary care, an increase from 56 million in 2007. The lack of access is driven by a number of factors, including inconvenient hours, stringent scheduling requirements, and overcapacity at primary care physician offices. …

Fracture Codes, Strapping and Splint Application Codes, S9088 Code

Q. When is it appropriate to use fracture codes without manipulation? If a patient comes in with pain in a finger after a fall and an evaluation and management is performed, x-rays are taken to confirm a fracture, the finger is splinted, and the patient is referred to an orthopedist, would that treatment constitute billing for fracture care? If not, what must we do to be able to bill these? A. CPT suggests that only …

Medical Boards: Part 1

John Shufeldt, MD, JD, MBA, FACEP I have been practicing medicine for nearly 30 years. I have received countless letters from law firms for records requests and notifying our group or me of an impending issue. I’m kind of numb to it. Conversely, anytime I get a letter from the medical board, I go into SVT. I am sure it is the same way with the physician assistant and nursing boards. You just start thinking, …

The Sword and the Shield: Best Hiring Practices for Urgent Care Facilities

Urgent message: It is imperative that urgent care centers utilize the various tools at their disposal to recruit the best candidates, while implementing best practices that mitigate the potential for lawsuits. DAMARIS L. MEDINA, ESQ. Urgent care is one of the fastest growing segments of American health care. Historically, many urgent care facilities were considered small businesses because they employed fewer than 15 people, making them exempt from certain hiring discrimination claims under The Federal …

Periostitis in secondary syphilis

Urgent message: Be on the lookout for periostitis in patients with syphilis who present with extremity pain. MAY MOHTY, MD, FAAP, FAAUCM, and CASEY PHILIPSBORN, MSIV Syphilis (from the Greek word Syphlos, meaning crippled) is an infectious disease caused by the spirochete species Treponema pallidum. Patients can present with manifestations of any of the three stages of syphilis, ranging from a painless ulcer to an asymptomatic rash, to general paresis and dementia, among a myriad …

The ‘Control’ Paradox

Lee A. Resnick, MD, FAAFP Influenza is off to a fast start this year and volumes are ballooning. ‘Tis the season to be swamped in urgent care, and without a good approach, urgent care clinicians can quickly become overwhelmed, burned out, and irritable. Pile on the stress of the holidays and the demands of family and loved ones and you’ve got a recipe for disaster. Work-life balance is important for all of us, yet feels …

Abstracts in Urgent Care: January, 2015

Fatigue and inappropriate antibiotic prescription Key point: As the day goes on, resistance to prescribe potentially inappropriate antibiotics seems to fade. Citation: Linder JA, Doctor JN, Friedberg MW, et al. Time of day and the decision to prescribe antibiotics. JAMA Intern Med. 2014 Oct 6; doi: 10.1001/jamainternmed.2014.5225. [Epub ahead of print] Previous research has shown that resistance to making the easier choice tends to fade as fatigue increases. Physicians make many difficult decisions during …

Repair of Lacerations of the Face and Scalp: Part 2

Urgent message: Evaluation and treatment of injuries of the cheek, ear, nose, lips and tongue are explored to help urgent care clinicians more confidently manage these presentations. TOYIN FAPOHUNDA-ADEKOLA MD, MBA In Part 1 of this series, we covered the evaluation and management of scalp, brow, and eyelid lacerations. In Part 2, we will explore injuries of the cheek, ear, nose, lips and tongue. As previously discussed, careful evaluation of neurovascular function and appreciation of …

Creating an Inclement-Weather Policy for Your Urgent Care Center

Alan A. Ayers, MBA, MAcc, is Practice Management Editor for JUCM, serves on the Board Directors of the Urgent Care Association of America, and is Vice-President of Strategic Initiatives for Practice Velocity. Urgent Message: Every urgent care center should have a policy addressing the various issues of communication, safety, pay, operations, and human resources that will undoubtedly come up when bad weather strikes. If the paradigm shift fueling the success of the urgent health-care model …