Practice Management
Urgent message: The differential diagnosis of neck pain is broad. A systematic and effective approach is required to rule out life-threatening conditions. RANIER NG, DO, and MICHAEL ROWANE, DO, MS, FAAFP, FAAO Neck pain is a frequently encountered complaint in urgent care. About two-thirds of the population will experience neck pain at some point in their lives.1 Many patients experience a sense of debilitation with every movement of their neck. Patients may perceive neck pain …
Read MoreShoulder Pain in a Young Male Urgent message: Traumatic injury isn’t the only factor to be weighed in patients with subluxation. Author: Ralph S. Bovard, MD Author Information: Ralph S. Bovard, MD, is a staff physician in the Department of Orthopedics and Sports Medicine, University of Minnesota Physicians, Minneapolis, MN. Case Presentation An 18-year-old male presented to the clinic with a complaint of left shoulder pain. He had been riding on a metro bus a …
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The patient, a 6-year-old boy, presented after falling on his outstretched right hand. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreRisk Factors for Clinical Failure in Cellulitis and Skin Abscess Key point: Hospitalized patients with obesity may experience clinical failure because of inadequate antibiotic dosing. Citation: Halilovic J, Heintz BH, Brown K. Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess. J Infect. 2012; 65(2): 128-134. Although most individuals with cellulitis or skin abscess are managed as outpatients, hospital admission is sometimes necessary. Several risk factors for hospitalization have been identified. …
Read MoreThe patient, a 3-year-ld male, suffered a blow to his left wrist. 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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Urgent message: Infectious flexor tenosynovitis is an orthopedic emergency that can cause long-lasting disability through tendon necrosis and permanent digital contracture if unrecognized or mismanaged. MARY A. LANE, MD Flexor tenosynovitis is an inflammation of the tendon sheath that can be caused by either introduction of infection or various inflammatory conditions ranging from autoimmune arthropathies to crystal joint depositions. Flexor tenosynovitis caused by infection is an orthopedic emergency. It can cause long-lasting disability through tendon …
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Urgent message: Hiring the right candidate for a job at an urgent care center is an art and a science, but a variety of tools exist to facilitate the process. WILLIAM MARTY MARTIN, PSYD, MPH, MA, MS This article is designed to equip urgent care clinic owners with the tools they need to hire better than they have in the past. After reading it, you will be able to: (1) organize your hiring process around …
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Urgent message: Infants who cry excessively pose a challenge to physicians and parents. A systematic approach to the history and physical exam can guide the diagnostic approaches to determine if a benign – or serious – condition is responsible. Toni Clare Hogencamp, MD Crying is a primitive form of communication that infants rely on to communicate their distress. Because infants cannot verbalize their discomfort, they must rely on their cry to communicate with caregivers. Estimates …
Read MoreLee A. Resnick, MD, FAAFP In my last column I examined the recent study by the Center for Studying Health System Change which reviewed data from the 2008 National Hospital Ambulatory Medical Care Survey (NHAMCS). I identified critical flaws in the definitions used to distinguish “appropriate” emergency department (ED) visits from “non-urgent” or so-called “routine” visits. I concluded that the study missed a tremendous opportunity to identify alternatives for the vast majority of patients with …
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