The patient, a 76-year-old male, presented with a complaint of palpitations. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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Paraphimosis
Urgent message: Most cases of paraphimosis can be managed in the urgent care setting and prompt treatment is necessary to avoid complications. MOHAMED A. FAYED, MD Overview An uncircumcised male’s penis consists of the penile shaft and glans penis covered by foreskin. At birth, the foreskin and glans penis are fused, which is called physiologic phimosis. Approximately half of uncircumcised males have fully retractable foreskins by age 10 years; by age 17, the foreskins of …
Read MoreCommercial Motor Vehicle Medical Examinations – Act Now to Participate!
JOHN SHUFELDT, MD, JD, MBA, FACEP This is not the call you want to receive. “Dr. Shufeldt, one of urgent care centers your group just purchased was named in a multimillion dollar suit. The allegation is that one of the center’s providers performed a DOT physical on a driver who was reportedly overweight, had Type II diabetes, had hypertension and undiagnosed sleep apnea. While driving, he fell asleep, crossed the median and a struck a …
Read MoreWhat’s In a Test? The Psychology of Patient Expectations
Lee A. Resnick, MD, FAAFP The impact of patient expectations and pressures on high utilization rates in this country is a subject of significant discussion but surprisingly little study. A literature review produces scant evidence of scientific inquiry in this area. And yet, most clinicians would say that patient expectations are perhaps an even stronger motivation for utilization than fear of malpractice suits. In an ever-competitive, service- oriented industry like urgent care, this can only …
Read MorePreventive Medicine, Preventive Medicine Counseling
DAVID STERN, MD (Practice Velocity) Q. How do you code for a Sexually Transmitted Diseases (STD) screening visit in a patient who has no symptoms? Can you use a preventive medicine code (99387-99397) and still receive reimbursement? A.You would code based on the service provided. If you performed a physical and collected the specimen to send to the lab, then you would bill the appropriate preventive medicine Evaluation and Management (E/M) code. If the only …
Read MoreDeveloping Data: September, 2013
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). In …
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56-year-old woman who tripped and hit her right hand
The x-ray and the photo were taken on a 56-year-old woman who tripped and hit her right hand. View the images taken (Figure 1) and consider what your diagnosis would be.
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4-year-old boy with a blow to his left leg
This x-ray was taken on a 4-year-old boy with a blow to his left leg. View the image taken (Figure 1) and consider what your diagnosis would be.
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79-year-old female with pain at the base of her left thumb & no trauma
This x-ray was taken on a 79-year-old female with pain at the base of her left thumb and no clear history of trauma. View the image taken (Figure 1) and consider what your diagnosis would be.
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