The patient is a 25-year-old male who presented to urgent care after falling from a height of two stories, landing flat on his feet. He is able to ambulate, though only with pain. In addition, he complains of back pain. He is generally healthy, and no neurological deficit was found. View the image taken and consider what your diagnosis would be.
Read More17-year-old male with quickly spreading rash
The patient is a 17-year-old male who awoke with intensely itchy scattered vesicles over his arms, face, and legs the day after returning from a camping trip. Additionally, his right eye was edematous and nearly swollen closed. He reported that over the course of the day, the rash seemed to get worse and spread to more areas on his body. View the image taken and consider what your diagnosis would be.
Read MoreDeveloping Data: May, 2008
As an emerging distinct practice environment, urgent care is in the early stages of building a data set specific to its norms and practices. In Developing Data, JUCM will offer results not only from UCA’s annual benchmarking surveys, but also from research conducted elsewhere to present an expansive view of the healthcare marketplace in which urgent care seeks to strengthen its presence. In this issue: Among patients visiting emergency rooms in the U.S., how is …
Read MoreCoding for Services Attempted But Not Completed, and Other Reader Queries
DAVID STERN, MD (Experity) Q.I can’t find any documentation that tells us specifically how we should code when a provider tries to remove a foreign body, but is not successful and decides that the patient should go to the ER. Do we just code for an office visit or do we also code for the removal of the foreign body since the provider did try, albeit unsuccessfully, and decided the patient needed to be seen …
Read MoreAbstracts In Urgent Care: May, 2008
Duration of IV Antibiotic Treatment for Children with Pyelonephritis Key point: Rates of renal scarring were similar in children who received long- or short-course IV antibiotics. Citation: Bouissou F, Munzer C, Decramer S, et al. Prospec- tive, randomized trial comparing short and long intravenous antibiotic treatment of acute pyelonephritis in children: Dimercaptosuccinic acid scintigraphic evaluation at 9 months. Pediatrics. 2008;121:e553-e560. Whether the mode and duration of antibiotic treatment prevent development of renal scars in children …
Read MoreClinical Challenge: May, 2008
This male patient presents to urgent care after, he claims, falling from a ladder. He refuses to give further details, except to say that the distance he fell was “not high.” View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreMay 2008
Prescription Drug Abuse and the Drug-Seeking Patient
Urgent message: The urgent care clinic is a prime target for prescription drug abusers seeking possibly inappropriate prescriptions. Clinicians must be vigilant to screen, intervene, and refer such patients. Marcelina Behnam, MD and Mark Rogers, MD Over the past several years, prescription drug abuse has become a problem of epidemic proportions for urgent care centers and emergency departments around the country. There has been an increase both in visits related to the acquisition of these …
Read MoreRekindling the Doctor-Patient Relationship
Lee A Resnick, MD, FAAFP The joy of practice is two-fold: Intellectual and Relational. The intellectual side of us thrives on the challenge of complex medical decision making and computational fact-finding. Understanding and applying pathophysiology is what we trained for, and what most of us consider to be a joyful brain exercise. However, since we do not practice medicine in a vacuum, the relational side of patient care is equally important to job satisfaction. It …
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