Practice Management
Urgent message: In the absence of controlled outpatient trials, the author proposes urgent-care specific guidelines for treatment of community-acquired MRSA, informed by clinical experience and local and regional case reports. Michael Dickey, MD The goal of any treatment is to maximize the chance of a positive outcome for a patient. The purpose of a treatment guideline is to maximize the chance of positive outcomes in groups of patients that present with a similar disease states. …
Read MoreLee A. Resnick, MD, FAAFP Have you ever wondered how many urgent care centers there are in the U.S.? So did UCA. Partnering with researchers at Harvard University and Massachusetts General Hospital, UCA has completed the first-ever sampling frame of urgent care centers across the country. Our goal was to produce an objective, scientifically valid assessment of the size of the urgent care industry. Estimates have flown around the industry for years, but until now …
Read MoreThe patient is a 10-year-old boy who received a blow to the forearm when he fell at home. He presented with local swelling and tenderness on exam, complaining of severe pain in his wrist. View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read More
Urgent message: Atypical chest pain in a young male offers a challenge solved by ordering—and assessment—of the appropriate imaging. Shannon Dowler, MD The patient is a 20-year-old white male who presented to urgent care with a two-week history of mild dyspnea, with the onset of chest pain in the prior 24 hours. He denied wheezing, vomiting, and recent trauma, and reported that he has tried no medications for his symptoms. Further discussion with the patient …
Read MoreUrgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …
Read MoreYou thought you were alone on an island trying to navigate through the trials of urgent care. You thought you were the only one faced with the clinical and financial challenges. Hopefully, you have discovered the Urgent Care Association (UCA), attended one of the conferences, and shared in the delight of collaborating with colleagues who share your questions, your challenges, and your desire to make a difference one patient at a time. Hopefully, you recognize …
Read MoreModes of Administration of Antibiotics for Symptomatic Severe Urinary Tract Infections Key point: There is no evidence suggesting that oral antibiotic therapy is less effective for treatment of severe UTI than parenteral or initial parenteral therapy. Citation: Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database of Systematic Reviews. 2007, Issue 4. Urinary tract infection, worldwide, is a major source of disease in children and adults. Although standard management …
Read MoreAs 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 mar- ketplace in which urgent care seeks to strengthen its presence. In this issue: How is patient satisfaction affected by the length of …
Read More