StuWilli, Author at Journal of Urgent Care Medicine

A 42-Year-Old Man with Thumb Pain After a Fall

A 42-year-old man arrived at your urgent care center complaining of thumb pain a day after taking a fall while skiing. You find that the pain is worse with movement in any direction; in addition, he exhibits limited ability to grip anything using his thumb. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. <1–nextpage–> Differential Diagnosis Avulsion …

What HIPAA Is and What It’s Not

Urgent message: While many people perceive HIPAA as a law governing patient privacy, protection and standards for personal health information is only one aspect of this law, which was originally intended to regulate health insurance. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine. Introduction Ask anyone—even the owner of an urgent care center—what HIPAA is, …

Boerhaave Syndrome in a 41-Year-Old Female

Urgent message: While Boerhaave syndrome is a rare finding, a relatively high number of cases may present in the urgent care setting. As such, awareness of and vigilance for related symptoms are essential to taking a proper history and, ultimately, early diagnosis of acute, subacute, or chronic Boerhaave syndrome. John Shufeldt, MD, MBA, JD, FACEP, Amber Hawkins, and Carli Nichta, MS4 Introduction Boerhaave syndrome is a spontaneous esophageal rupture indicated in some cases by …

Abstracts in Urgent Care – December 2017

GLENN HARNETT, MD Innovative Rapid Tests Show Promise in Influenza Key point: Novel DIAs and rapid NAATs had markedly higher sensitivities for influenza A and B in both children and adults than did traditional RIDTs, with equally high specificities. Citation: Merckx J, Wali R, Schiller I et al. Diagnostic accuracy of novel and traditional rapid tests for influenza infection compared with reverse transcriptase polymerase chain reaction: a systematic review and meta-analysis. Ann Intern Med. 2017;167(6):394-409. …

Approach to Ingested Foreign Bodies in Children

Urgent message: Less than one out of a hundred cases of children ingesting foreign bodies requires surgical intervention. Identifying which children that could apply to, which need endoscopic removal, and those who can wait for spontaneous passage is an essential role for the urgent care provider. Herlene Chatha, MD and Hansel Otero, MD The case: An otherwise healthy 2-year-old boy is brought to your urgent care center by his parents, who are concerned that he …

How Urgent Care Cultivates Competition in Healthcare

Urgent message: U.S. healthcare has been a monolith of inefficiency, limited access, and untenable costs for decades, due mainly to a lack of healthy competition. Today’s healthcare landscape, however, spurred by converging market forces, is rapidly evolving into a competitive marketplace, with urgent care being one of the key catalysts for this welcomed and long overdue change. Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice …

Opioid Crisis: What Next, and What’s Lurking?

It pains me to write this column. The opioid epidemic is arguably the most catastrophic and enduring public health crisis since the flu epidemic of 1918—yes, even worse than the HIV/AIDS epidemic of the ‘80s. Since 2000, over 200,000 people have died from overdoses of prescription opioids alone, another 300,000 from heroin and synthetic opioids. Now synthetic fentanyl has infiltrated the market with the most toxic opioid ever known. The overdose death curve is steepening. …

Study Shows Promise in Rural Urgent Care Opportunities—for Patients and Operators

A study by West Virginia University has shown that urgent care not only has great potential to improve the chance for positive health outcomes in rural areas, but also holds great promise for operators who are willing to make the investment in the country. Joshua Hall, associate professor of economics and director of the Center for Free Enterprise at WVU’s College of Business and Economics, led a team of researchers who considered the entry of …

Data Quantify Value of Physician Ed in Reducing Antibiotic Prescriptions

Kaiser Permanente in Southern California reports that using computer alerts to inform physicians when antibiotics may not be the best course of treatment for sinusitis reduced the chance of an antibiotic being prescribed—with some qualifiers. The study, published recently in the American Journal of Managed Care, tracked nearly 22,000 cases of acute sinusitis in adults in primary care and urgent care offices. Researchers found that clinical decision support was associated with a 22% decrease in …

Do You Really Know What’s in that IV Bag?

A New York urgent care center, several of its staff members, and a company that manufactures practice devices for medical education are all being sued by a woman who claims she became serious ill by being given a nonsterile solution that was actually intended only for training purposes. The suit alleges that in December 2014 staff administered IV fluids from a practice IV bag made by Wallcur LLC instead of the proper sterile solution that …