Practice Management
Urgent message: As urgent care’s role in the continuum of care continues to evolve, the practitioner must take steps to create a culture that supports proper patient identification, drug safety, and adherence to lab standards. Phillip Disraeli MD, FAAFP In the 1988 report To Err is Human, the Institute of Medicine defined patient safety as “freedom from accidental injury.” The ensuing media coverage focused on the 98,000 deaths that IOM estimated occur each year due …
Read MoreIn early 2008, UCA revamped its annual survey in conjunction with researchers at Massachusetts General Hospital and Harvard University with the goal of assuring that the UCA Benchmarking Committee’s efforts produced a scientifically valid report.Here we present some of the findings from this landmark survey, to which 436 urgent care centers responded.In this issue: What percentage of physicians working in urgent care are board certified – and how does that compare with primary care? The …
Read MoreUrgent care centers are fertile ground for angry patients. Our patients are often sick and in pain, they often have long waits to be seen, and they are frustrated by an inefficient healthcare system that has landed them in urgent care in the first place. Additionally, most of our patients are starting a new relationship with us, and they have not yet built any trust. Their prior healthcare experiences are most often lousy at best, …
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The patient is a 10-year-old boy who received a blow to the forearm when he fell at home. He presents with local swelling and tenderness on exam, complaining of severe pain in his wrist. View the x-rays taken and consider what your diagnosis and next steps would be.
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The patient is a 53-year-old woman who presents with a red plaque on her calf. She reports that she first noticed it two months ago. You find that the plaque is non-pruritic and asymptomatic. The patient, who is in good general health, admits no new medications and says that none of her family members have a rash or skin lesion of any kind. View the images and consider what your next steps would be.
Read MoreShould the Elbow Extension Test Be Used to Rule Out Bony Injury? Key point: Full elbow extension had a negative predictive value for fracture of 98.4% in adults and 95.8% in children. Citation: Appelboam A, Reuben AD, Benger JR, et al. Elbow extension test to rule out elbow fracture: Multicentre, prospective validation and observational study of diagnostic accuracy in adults and children. BMJ. 2008; 337: a2428. The objective of this study was to determine whether …
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