StuWilli, Author at Journal of Urgent Care Medicine

A 5-Month-Old with Symptoms Beyond the Presenting Complaint

Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, …

Urgent Care Evaluation of Arrhythmias

Urgent message: Initial evaluation of a patient with an arrhythmia in the urgent care setting can be as difficult as it is critical to the patient’s survival—one key concern being sudden cardiac death, which occurs in roughly 328,000 cases annually. Riaz Fabian, DO Introduction Cardiac arrhythmias are a group of conditions in which a patient has an abnormal heart rate or rhythm. They are caused by any disruption of the electrical conduction system of the …

A 3-Year-Old with Lesions on His Thumb

A mother brings her 3-year-old son to urgent care with multiple skin lesions on his thumb, which he frequently sucked for comfort. The grouped configuration of lesions was painful and had developed over the last 5 days to become vesicles. Upon exam, you note that the boy has a nearly healed cold sore on his lip, pain in his wrist, and an elevated temperature. View the photo and consider what your diagnosis and next steps …

A 21-Year-Old Male with Persistent Ankle Pain Following Trauma

The patient is a 21-year-old male who presents with persistent ankle pain 4 weeks after suffering a trauma. He fell while scaling the exterior of his dormitory, trying to gain entry into a second-floor window because he’d locked his keys inside. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 44-Year-Old Man with Intermittent Dizziness

Case A 44-year-old man presents to your urgent care center complaining of intermittent dizziness. He denies shortness of breath, fever, chest pain, and syncope. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

2018 Current Procedural Terminology (CPT) Code Changes

There are 314 code changes in the CPT manual for 2018, with 172 new codes, 60 revised codes, and 82 deleted codes. Most of the changes affect surgery procedures, but the updates include several changes that are relevant to urgent care. For your convenience, we have listed these changes in expected relevance to urgent care: Radiology Codes for x-rays of the chest and abdomen have been deleted and replaced with codes based on the number …

Nurse-Only Visits in Urgent Care: An Analysis of Outcomes and Patient Satisfaction Relative to Traditional Care

Urgent message: As shown in an in-house study by one urgent care operator, protocol-driven, nurse-only care of specific presenting complaints may be one way to help curb healthcare spending while not compromising on quality of care or threatening patient-satisfaction scores. Kyle Coon and Brett Whyte, MD Abstract Basic healthcare costs are rising at a staggering and, it’s widely considered, unsustainable rate. As a result, lower-cost alternatives that maintain quality and satisfaction are being explored across …

A Snapshot of Pediatric Urgent Care Operations

In October, we offered a glimpse at the operating hours of pediatric urgent care centers around the country. We also promised to share more on that growing segment of the urgent care marketplace—and this month we’re following through on that. The data below are drawn from a sample of 35 U.S. pediatric urgent care centers, and are part of a larger pool that we expect to be the subject of an expansive article in a …

Urgent Care 2.0: Health Systems Taking the Retail Approach to the Next Level

Urgent message: Spurred by disruptive market entrants and burgeoning consumerism, health systems are increasingly adopting retail principles to better meet consumers’ shifting expectations. Thus, urgent care stakeholders, either as standalone operators or partners with a hospital/health system, must further expand upon their retail offerings in order to fend off increased competition. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice Management Editor of The Journal of …

If the Patient Can’t Go to Urgent Care, Urgent Care Goes to the Patient

Another urgent care entrepreneur is taking her show on the road, this time in and around Colorado Springs. The brainchild of nurse practitioner Eileen Flavin, Anywhere Urgent Care is a house calls-only urgent care that boasts it offers 90% of the “essential” urgent care services available in clinic locations (leaving out x-rays and ultrasound, but including basic labs, simple suturing, and treatment for an array of complaints) as well as the off-hours convenience that’s become …