Consequences of Increasing Copayments for Ambulatory Care Key point: Even small increases in cost-sharing were associated with fewer outpatient visits and more inpatient admissions among elders. Citation: Trivedi AN, Moloo H, Mor V. Increased ambulatory care copayments and hospitalizations among the elderly. N Engl J Med. 2010; 62: 320-328. Recently, many health plans have increased copayments for outpatient visits. Although the rationale, presumably, is to minimize unnecessary ambulatory care, the strategy could backfire if higher …
Read MoreClinical Challenge: March, 2010
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 live to submit a case for consideration, please w-mail the relevant materials and presenting information to [email protected]. The patient is a 14-year-old boy who presents with low back pain after failing from “a high height” and landing on his feet. Exam is normal except …
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The Case of a 57-year-old Man with Heart Fluttering and Lightheadedness
What happens when our patient so badly wants to be well that they talk us out of the correct diagnosis? “I think it is my anxiety” was the mantra accepted by the physician in this case. Though diagnoses are not always clear after the initial encounter, they are not up for negotiation. Patients have a vested interest, due to denial or human nature, in believing that nothing is seriously wrong with them. It can be …
Read MoreAre You Really Listening?
We all think we are great listeners. We “listen” to chief complaints, we listen to histories of present illness, we listen to heart and lung sounds. We spend the better part of the day “listening.” But are we really listening? Or are we just “hearing?” Hearing is the perception of sounds by the auditory nerves in the ear. Listening involves an attentiveness to hear with a purpose of understanding. hearing is a temporal lobe function, …
Read MoreCase Report: Gout vs. Cellulitis
Urgent message: Sometimes, cellulitis can be confused with gout – especially when it involves the area around a joint. A detailed history and physical exam, along with diagnostic testing, will help you reach definite diagnosis. Introduction Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. It is a type of monoarticular arthritis caused by deposition of monosodium urate crystals in and around the joint. Hyperuricemia (serum uric acid level >6.5 mg/dL) seems …
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2-year-old boy with sudden pain in left leg
The patient is a boy, age 2 years 8 months, who presents with the complaint of pain in the left leg that started five hours ago. There is no history of trauma. On exam, the child looks well and has a temp of 98.96 degrees (axillary) and a pulse of 114. In addition, he has a WBC of 17.7, with 73.7 percent granulocytes. The child\’s leg has no external findings. There is clear pain on …
Read MoreDeveloping Data: February, 2010
In each issue on this page, we report on research from or relevant to the emerging urgent care marketplace. This month, we share insight into the most common reasons patients choose to visit an urgent care center. These data reflect the results of a cross sectional survey of 1,006 patients who visited an urgent care clinic.1 Reasons named by less than 40% of patient included: transportation available at that time told to come by outside …
Read MoreCoding for Two Visits in One Day, Billing for Atypical Urgent Care Services, and Billing on the UB-04
Q. The patient in question is a new patient to the urgent care. At 10 a.m., she visited the urgent care with chief complaint of cough, headache, and myalgias. She was discharged home with a final diagnosis of cough and prescription for ibuprofen and cough syrup. At 3 p.m., she retuned with a complaint of headache and was treated with IM headache medications and sent home with a diagnosis of headache with pain meds. How …
Read More‘Sorry’ Shouldn’t Be the Hardest Word
The following movies, in my opinion, are non-starters on first dates. In no particular order: Sophie’s Choice (tragic) Schindler’s List (depressing) The Exorcist (freaky) The English Patient (mind-numbing boredom) Terms of Endearment (heart-wrenching) and finally, Love Story (sappy). You may, if you were born before 1960, remember the tagline and memorable quote in Love Story. “Love means never having to say you’re sorry.” Oh please, even in 1970, when I was 10-years-old, I knew that …
Read MoreMake Connectivity Part of Your Marketing Strategy
We live in an entirely new business world these days: a world in the midst of rapid change and new rules. Three words seem to embody this new reality: • leverage • integration • alliances These three words apply well to urgent care clinic sales and marketing. They can also be viewed as essential to the concept of connectivity. Here, we will review how connectivity can be used to enhance an urgent care clinic’s occupational …
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