StuWilli, Author at Journal of Urgent Care Medicine

Dealing With Employee Termination: Smart Strategies for Optimizing Your Team

Urgent message: Letting employees go is never easy. This article offers tips for protecting your business and yourself if termination is necessary. Among the key recommendations are compiling documentation and seeking legal advice. ALAN A. AYERS, MBA, MAcc Practice Velocity Letting an employee go, whether due to job performance or economic necessity, is never a pleasant situation. Although an urgent care center strives to provide high-quality patient care, it’s also a business. This means that …

An Age-Based Approach to Fever of Uncertain Origin in the Pediatric Patient

Urgent message: Fever in pediatric patients, while frequent, is rarely the result of a serious illness. Urgent care practitioners must be able to consistently distinguish between serious and benign causes with a minimum of invasive testing. BRENDAN KILBANE, MD, FAAP Introduction Ever is one of the most common chief complaints in pediatric patients who present for urgent evaluation. A surprising number of families continue to suffer from “fever phobia,” with one study noting that 91% …

Developing Data: April, 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 …

Judgment Day

Lee A. Resnick, MD, FAAFP Carl Jung said, “We should not pretend to understand the world only by the intellect. The judgment of the intellect is only part of the truth.” In medicine, reliance on intellect alone is a significant danger. Ignorance of cultural, social, and even psychological context can mislead the clinician and risks misdiagnosis and error. Yet the very basis of medical decision-making is rooted in the rule of intellect. Evidence-based medicine is, …

Primary Care in the Urgent Care Setting, E/M Codes With Other Services, Penicillin Injection

DAVID STERN, MD (Practice Velocity) Q. Can physicians see regular patients and schedule routine care at urgent care facilities? If so, can the urgent care center bill for those services at a separate, lower rate than the urgent care rate? A.Special attention should be paid to payor contracts in these situations. If the insurance company views your patient’s visits as urgent care even though you provided primary care, the patient could be responsible for higher …

Abstracts in Urgent Care: April, 2013

Soft cast versus rigid cast for treatment of distal radius buckle fractures in children Key point: Buckle fractures of the distal radius can be safely and effectively treated with a soft cast and only a single orthopedic outpatient clinic appointment. Citation: Witney-Lagen C, Smith C, Walsh G. Soft cast versus rigid cast for treatment of distal radius buckle fractures in children. Injury. 2012 Dec 21. pii: S0020-1383(12)00516-5. doi: 10.1016/j.injury.2012.11.018 Buckle fractures are extremely common and …

It Seemed Like a Good Idea at the Time

JOHN SHUFELDT, MD, JD, MBA, FACEP Have you seen poster with the phrase, “IT COULD BE THAT THE PURPOSE OF YOUR LIFE IS ONLY TO SERVE AS A WARNING TO OTHERS?” Have you ever had “one of those days” where you believed the poster was a sign from God directed only to you? Over the years I have heard hundreds of patients and numerous friends and acquaintances mutter the phrase, “It seemed like a good …

Clinical Challenge: April, 2013

In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient, a 37-year-old woman, presented after a blow to her left hand. View the image taken (Figure 1) and consider what your diagnosis would be.

Hodgkin Lymphoma

Urgent message: Close follow up is necessary for pediatric patients with vague presentations, lest a diagnosis of childhood cancer be missed. JANET D. LITTLE, MD Introduction This case presentation reflects the challenge of diagnosing childhood cancers in a timely and accurate way. The presenting signs and symptoms are oftentimes nonspecific and can mimic those of common childhood conditions.1 The frequency of delayed diagnosis for childhood cancers is high, and reflects the importance of close follow-up …

Author: StuWilli