Urgent message: The patient punctured his hand with a power screwdriver. It turned out to be the least of his problems. Frank Fannin, MD, EMT-P Introduction Hand Injuries are common and a major concern in urgent care settings as a source of potential significant disability and liability. A detailed history and focused exam are paramount to appropriate treatment and disposition. In the following case, a potentially devastating finding turns out not to be all that …
Read MoreWorkplace Bullying and its Costs to the Urgent Care Operation
Urgent message: More than one third of U.S. employees say they have been bullied in the workplace. Does your practice have a policy in place to thwart this insidious problem? If not, it should. Alan A. Ayers, MBA, MACC What is the Difference Between Diversity and Tolerance? According to one definition, diversity is anything that makes you different while tolerance is not persecuting people who are different. Many urgent care operations strive for a unified …
Read MoreWhat To Look for in a Medical Transcriptionist
Urgent message: Sending your dictation to India or the Philippines may save you money, but do you really want a transcriptionist whose first language isn’t English? Author: Mary Goehring Author Credit: Mary Goehring is CEO of Transcription Plus, LLC (www.transcriptionplus.net) in Bristol, Connecticut. She can be reached at (860) 583-2818 or [email protected] Introduction No one will disagree that errors cost money–in any business. Medical errors account for more deaths in America than breast cancer, AIDS, …
Read MoreMissing a ‘Cancer’
JOHN SHUFELDT, MD, JD, MBA, FACEP My worst fear: I miss a cancer. Of all things to miss, I worry about this the most. Miss a myocardial infarction, stroke, or appendicitis and you figure it out quickly because it smacks you right in the face. Conversely, cancer simmers along. A few months or even years go by and everything seems fine, then all hell breaks loose. The symptoms reach epic – if not life-threatening – …
Read MoreClinical Challenge: March, 2012
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 14-year-old male, presented with a twisted ankle and a complaint of difficulty with weight bearing. View the image taken (Figure 1) and consider what …
Read MoreCoding for I&D Follow-Up, R-codes and POS 20, Coding for Compression Bandage
DAVID STERN, MD (Practice Velocity) Q.We have so many MRSA (methicillin-resistant Staphylococcus aureus) I&Ds (incision and drainage). The follow-up for changing the packing are numerous and time-consuming, and it feels wrong to have them just included in the global procedure like any other wound check or suture removal. What’s the right way to handle this? Annie Miranda, Hopewell Junction, NY A. This is a complicated question. To code these procedures, you can consider using the …
Read MoreDeveloping Data: March, 2012
These data from the 2010 Urgent Care Benchmarking Survey are based on responses of 1,691 US urgent care centers; 32% were UCA members. The survey was limited to “full-fledged care centers” accepting walk-ins during all hours of operation; having a licensed provider and x-ray and lab equipment onsite; the ability to administer IV fluids and perform minor procedures; and having minimal business hours of seven days per week, four hours per day. The 2010 survey …
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Buy or Lease Your Next Urgent Care Site?
Urgent message: After location, how to pay for an urgent care site is crucial to your success. Here’s how to think it through. MICHAEL ZELNIK, CCIM Once you’ve found the right location for your next urgent care (see An Urgent Care Site That Maximizes Revenue, JUCM, September 2011), your focus can turn to analyzing the risks and benefits of leasing or purchasing property in the trade area you’ve identified. This analysis should be more than …
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Ureterolithiasis: Leaving No Stone Unturned
Urgent message: Symptoms from stones in the ureter can mimic other conditions, making for a diagnostic dilemma in urgent care. Imaging is the key to accurate assessment and appropriate treatment. WILLIAM GLUCKMAN, DO, MBA, FACEP and KATE ABERGER, MD Ureterolithiasis, which literally translates to stones in the ureter, is sometimes referred to improperly as “kidney stones,” which are properly known as nephrolithiasis. Although stones do form within the kidney, they do not typically cause acute …
Read MoreThe Ruckus About ‘RUC’
Lee A. Resnick, MD, FAAFP Perhaps you are unaware about the secretive, biased way that physician reimbursement is determined in this country. Perhaps you would be surprised to learn that the committee tasked with these determinations is composed of only 2 primary care physicians … out of 29 members! Perhaps you didn’t know that their recommendations are unregulated and largely given a rubber stamp by the Centers for Medicare & Medicaid Services (CMS). Perhaps you …
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