StuWilli, Author at Journal of Urgent Care Medicine

Understanding the Freestanding Emergency Department Phenomenon

Urgent message: FSEDs have a role to play in our health care system but it’s not to supplant urgent care centers. ALAN A. AYERS, MBA, MAcc, Experity Introduction Freestanding emergency departments (FSEDs) are walk-in medical facilities—structurally separate and distinct from a hospital—that hold themselves out to provide emergency care to the general public. While they claim many similarities to hospital EDs—capabilities to diagnose and stabilize cardiac arrest, stroke symptoms, breathing problems and trauma—there are also …

Management of Ocular Complaints in Urgent Care: Part 2

Urgent message: Whether benign or vision-threatening, acute eye conditions seen in the urgent care setting require careful evaluation and triage, based on access to the right tools and knowledge of key clues to diagnosis. SARVOTHAM KINI, MD In Part 1 of this article in January, we discussed urgent care management of foreign bodies in the eye, corneal abrasion, red eye, scleritis, and conjunctivitis. In Part 2, we will review subconjunctival hemorrhage, uveitis, iritis, keratitis, acute …

Patient Satisfaction Surveys: Seeing Opportunities in Our Failures

Lee A. Resnick, MD, FAAFP It is well known, and exhaustively preached, that a satisfied customer will tell 2-3 people while a dissatisfied one will tell 8-10 (with some estimates as high as 20). Measuring and tracking patient satisfaction has become a focus of most every practice owner, much to the chagrin of their employees, who often view this as a way to publicly embarrass and unfairly harass the staff. And yet, whether we are …

February 2014

Tricks of the Trade: Ear Suction Kit

Urgent Message: Most urgent care centers don’t carry commercial equipment for ear suction but a kit can be assembled with readily available supplies. Author: Ali Ahmadizadeh, MD, is an attending physician in the Department of Otolaryngology at New York Head and Neck Institute, Lenox Hill Hospital, New York, NY. Otorrhea is one of the most frequent clinical presentations in urgent care. Examination of the ear ideally requires ear suction, but that is not possible in …

7-year-old girl with twisted knee after fall

The patient, a 7-year-old girl, presented after falling and twisting her left knee. View the image taken (Figure 1) and consider what your diagnosis would be. Click to the next page below to see the resolution to this case!

27-year-old man with a cough and fever

This x-ray was taken on a 27-year-old man with a cough and fever. View the image taken (Figure 1) and consider what your diagnosis would be

Developing Data: January, 2014

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care).

ICD-10

Q. My staff keeps telling me that my documentation will have to change in order for them to properly choose an ICD-10 diagnosis code. Is that true? A. Documentation practices should not have to change but it will be helpful to understand the granularity of the new codes. There is greater specificity including laterality, temporal factors, contributing factors, symptoms, manifestations, and anatomic location. Thus, if you currently gloss over details in the medical record, you …

Abstracts in Urgent Care: January, 2014

Metabolic Consequences of Insufficient Sleep Key point: A small, randomized, controlled crossover study demonstrates changes in a critical insulin-signaling pathway in peripheral tissue. Citations: Broussard JL, Ehrmann DA, Van Cauter E, Tasali E, Brady MJ. Impaired insulin signaling in human adipocytes after experimental sleep restriction: A randomized, crossover study. Ann Intern Med 2012;157(8):549-557. and Cappuccio FP, Miller MA. A new challenge to widely held views on the role of sleep. Ann Intern Med 2012;157(8):593-594. Small …