StuWilli, Author at Journal of Urgent Care Medicine

To P.E. or not to P.E.

John Shufeldt, MD, JD, MBA, FACEP In last month’s column, I presented an overview of capital sources that can be used to fund your urgent care start-up or expansion. This month I will discuss the different sources of debt and equity capital. Much of the decision regarding which capital source is best for you is determined by your stage of development. For a startup, you will probably have to use traditional bank debt or raise …

Telephone Interpreting: Improving Healthcare Outcomes and the Bottom Line

Urgent message: Using interpreters in the urgent care setting can help you provide quality healthcare and save time and money. Bruce Merley Imagine that it is late Friday night and you and a nurse are the last remaining staff on duty at your urgent care center. A couple arrives and the woman appears to have several facial cuts and bruises. When you greet them, the man responds in a language you do not understand. You …

Technology in Urgent Care: Digital or Conventional Imaging?

Urgent message: More and more urgent care clinics are wrestling with whether to offer digital or conventional x-rays. In this article, Registered Technologist Trip Hale offers expert advice on how to make the decision. Trip Hale, RT, (R) Introduction For today’s urgent care clinics, imaging is an internal part of providing complete diagnostic and treatment services. Because reimbursement for diagnostic studies is lower for physician-owned than for hospital or outpatient imaging facilities, a well-planned and …

Spontaneous Pneumothorax

Urgent message: In patients with chest pain, check chest films carefully to avoid missing an uncommon diagnosis. Joseph Toscano, MD Introduction The traditional differential diagnosis for chest pain includes spontaneous pneumothorax. Chest x-ray is necessary for confirming the diagnosis, and sometimes the findings can be subtle. As in dealing with any infrequently encountered condition, clinicians should consider the diagnosis and closely examine every chest film they order to avoid missing this uncommon diagnosis. Case Presentation …

Closed Hand Injuries

Urgent message: Even a seemingly minor hand injury can result in lifelong disability if evaluation and treatment are incorrect. TRACEY QUAIL DAVIDOFF, MD Introduction The hand is a vital part of human anatomy allowing us to interact with our environment in nearly infinite ways. The functional aspects of the hand are a direct extension of the brain, allowing us to initially make stone tools, play musical instruments, make intricate crafts, type, communicate, and appreciate our …

January 2012

Reforming Patient Expectations

In my last column, I addressed the contribution of unrealistic patient expectations to unsustainable healthcare costs. I postulated that the competing societal goals of preserving freedom of choice while providing healthcare for all will produce a futile tug-of-war. I further warned that leaving the solutions to politicians and government administrators will inevitably lead to myopic reforms that threaten the doctor-patient relationship and fail to consistently incentivize good care. In this month’s column, I’d like to …

Developing Data: January, 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 urgent 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. In this …

Abstracts in Urgent Care: January, 2012

USPSTF to Advise Against Routine Prostate Cancer Screening Key point: The US Preventative Services Task Force has concluded that healthy men should not undergo routine prostate-specific antigen testing. Citation: Harris G. US panel says no to prostate screening for healthy men. New York Times website. Available at: www.ny-times.com/2011/10/07/health/07prostate.html. Accessed December 6, 2011. The recommendation was based on an analysis of five trials and applies to men of all ages. The Times quotes the task force’s …

Clinical Challenge: January, 2012

The patient, an otherwise healthy 25-year-old, fell and suffered a blow to the right hip. The injury was not weight-bearing. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.