Developing Data: November, 2007
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: The 2007 Professional Research Consultants National Consumer Survey asked patients …
Read MoreAddressing Problem-based Coding and Other Challenges
Q.We are a fairly new urgent care center and could use some help on E/M coding. I have read on various urgent care websites that we can bill each visit as a new patient visit (as long as it isn’t a follow-up to an existing problem). Can you please give me some direction on where I can find this information? A.What you are referring to is “problem-based coding.” Never code in this way unless you …
Read MoreAbstracts In Urgent Care: November, 2007
Effectiveness of Oxycodone, Ibuprofen, or the Combination in the Initial Management of Orthopedic Injury-Related Pain in Children Key point: Oxycodone, ibuprofen, and the combination all provide effective and similar analgesia for mild-to-moderate orthopedic injuries in children. Ibuprofen, alone, is a legitimate and effective choice. Citation: Koller DM, Myers AB, Lorenz D, et al. Pediatr Emerg Care. 2007;23(9):627-633. Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have …
Read MoreClinical Challenge: November, 2007
Case The patient is a 10-year-old boy who experienced a direct blow to the elbow approximately six hours prior to presentation. He had incomplete range of motion with minimal local swelling and considerable pain. 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 MoreWhen Urgent Care is the Safest Place to Turn
JOHN SHUFELDT, MD, JD, MBA, FACEP In retrospect, it was bound to happen: An estranged husband received information from his insurance company about his wife’s outpatient treatment. He called the patient accounting office to confirm the residential address his wife gave to the registration clerk. He thanked the woman who supplied him with the information profusely, then got in his car and drove to the domestic violence shelter where his wife was recovering from the …
Read MoreEmphasizing the Positive Gets Results in Occ Med Sales
A successful occupational health sales professional should develop a mechanism to monitor his or her choice of words and commit to using the English language to the mutual advantage of both the provider and the sales prospects. However, sales professionals often make poor word choices at critical moments. Negative words abound in our daily vocabulary. Frequently used negative words include bad, poor, problem, complication, unacceptable, and difficult. When calling on an occupational medicine prospect, these …
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No Appointment Needed: The Resurgence of Urgent Care Centers in the United States
Urgent message: A new report from the California Health Care Foundation, excerpted here, examines how the growth of urgent care is influencing delivery of healthcare—and what the prospects for the future of the industry might be. Prepared for the California HealthCare Foundation by Robin M. Weinick, PhD and Renée M. Betancourt, BA The days of having a family doctor in town who cared for all of a patient’s health needs are long gone. In their …
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Ruptured Ectopic Pregnancy with a Negative Urine Pregnancy Test
Urgent message: Ectopic pregnancy must be considered in women of childbearing age who present with abdominal pain—even if ‘ruled out’ by a negative hCG test. Yi-An A. Lee, MD, MPH, Gino Farina, MD, and Helene Lhamon, MD The incidence of ectopic pregnancy is estimated to be 19.7 per 1,000 pregnancies and is responsible for 9% of pregnancy-related deaths.1 Ectopic pregnancy is always near the top of the differential diagnosis for abdominal pain in women of …
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The Case of a 46-Year-Old Man with Neck and Upper Back Pain
This article is the second in a series that will sequentially answer the following questions: What is the incidence of bouncebacks? What is the incidence of bounceback admissions? What is the incidence of deaths in patients recently discharged from the ED? What percent of bouncebacks occur because of medical errors? How can we use this information to improve patient safety? In the September issue of JUCM, we discussed several studies which found the incidence of …
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