Practice Management
A new predictive model from the University of Chicago indicates we should prepare for a flu season that’s “worse than average.” One important indicator in the model is the severity of flu in Australia, where the seasons are ahead of those in the U.S.; Australians just suffered through their worst flu season on record. The data underscore the importance of getting immunized early in the season—as in, now—especially for those at highest risk, such as …
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Neither company has confirmed it, but The Wall Street Journal reports that CVS Health has offered to buy Aetna in a deal that could have vast implications in the retail health and insurance marketplaces. The combined company would have much stronger bargaining power when negotiating deals with health systems, payers, and pharmaceutical companies, than either company does alone. For starters, as the WSJ article points out, CVS’s pharmacy benefit management arm would see “a huge …
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Urgent message: Opioid abuse, addiction, and resultant deaths have drawn the attention of both the medical community and legislative bodies from the local health department to the White House. Urgent care is a frequent destination for addicts trying to secure drugs illicitly—but it also has the potential to be the first stop on the road to recovery. Jason M. Ramos and Robert S. Crausman, MD, MMS Case Presentation Manny is a middle-aged white male who …
Read MoreUrgent care insiders know our industry continues to grow and evolve, and understand that convenience, cost, and quality of care are what keeps patients coming back. Data from outside the industry diving a bit deeper into the “why” of patient volume has been a bit scarce, however. A Harris Poll commissioned by Mercy Health System of Southeastern Pennsylvania takes a step toward remedying that shortage, however. Not surprisingly, a strong majority (66%) of the 1,700 …
Read MoreCase A 48-year-old woman presents with several red lesions that are extremely pruritic. They are scattered haphazardly on the back of her leg. A few of the lesions are still smooth nodules, but others are now excoriations; she just can’t stop scratching them no matter how hard she tries. She estimates they appeared nearly a month ago. She reports a history of atopic dermatitis, but “this doesn’t feel like the same thing.” View the photo …
Read MoreQ: Do you have information on the 2017-2018 influenza vaccine codes? A: The American Medical Association (AMA) recently published a list of new and revised vaccine codes on their website (https://www.ama-assn.org/sites/default/files/media-browser/public/cpt/vaccine-long-desc-july-2017.pdf). These codes will be published in the 2018 Current Procedural Terminology (CPT) manual. The two new influenza vaccines on the list are: 90682, “Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use” 90756, …
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The patient is a 26-year-old man who presents after 3 days of palpitations. He denies any chest pain, shortness of breath, diaphoresis, fever, or dizziness. He does use home oxygen (2 L/min), but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented X 3 Lungs: Clear to auscultation bilaterally Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, or guarding Extremities: No pain …
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The patient is a 9-year-old boy who was brought in by his parents with right knee pain. He reports that he twisted it while reenacting Star Wars battles in the backyard with friends. His parents did not witness the injury. 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.
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Urgent message: Back pain is a common complaint in the urgent care setting. Common causes of musculoskeletal back pain include overuse and work-related injury. Other causes can include disc herniation, metastasis, osteoporosis, arthritis, spinal stenosis, and nephrolithiasis. Crystal N. Bharat MD, Ronald Dvorkin, MD, and Glenn G. Gray MD Case Presentation A 65-year-old female complained of 1 day of low back pain radiating to her left flank, which was aggravated with movement. Symptoms began while …
Read MoreUrgent message: Urgent care centers must use all reasonable efforts to comply with informed-consent and consent-to-minors laws. This should include consulting with legal counsel on the specific laws of the state and developing protocols to shield the center from possible litigation. 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 Medical practices like urgent care centers …
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