UCA’s Survey Committee has conducted two annual member surveys, to date, designed to establish benchmarks in an industry for which data have been sorely lacking. In Developing Data, we will share one or two tidbits from the second annual survey and other sources in an effort to help readers get a sense of what their peers are doing, and what kind of trends are developing as urgent care evolves. In this issue: Are payors reimbursing …
Read MoreProper Coding for Removal of Foreign Bodies
Q.Recently we removed a tampon that was retained for one week. What is the code for removing a foreign body from the vagina? A.Although this procedure involves significant work, and the resultant foul odor can leave an exam room unusable for hours, the procedure is considered to be a part of the E/M. Of course, this is hard to understand, since there is a code for removing a foreign body from the external ear canal …
Read MoreAbstracts In Urgent Care: October, 2007
Insights In Images: October, 2007
The patient pictured presented with two hours of intense pain and redness along the left side of her head and down her left arm. Though this could easily be mistaken for an infectious process, it was actually reflex sympathetic dystrophy (RSD), also referred to as complex regional pain syndrome (CRPS) type I. By any name, however, this is a rare and poorly understood neurological condition. It may manifest by way of sensory, focal autonomic, or …
Read MoreClinical Challenge: October, 2007
The patient is a 52-year-old tourist who presents with a four-day day history of abdominal pain, constipation, not passing gas, and nausea. The patient was not comfortable but was hemodynamically stable. Temperature was normal, pulse was 94, BP was 195/99. The abdomen was markedly distended. WBC was 11. 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 …
Read MoreEffective Occupational Medicine Sales Through Effective Questioning
A productive occupational medicine sales effort is predicated on your ability to identify a prospect’s need and then to match that need with your services. Both require knowing when and how to ask the right questions. Why is Questioning So Important? Invariably, you begin your association with a prospect as“just another salesperson.” You must set yourself apart from the start. Breaking the ice to pique interest is one area in which well-constructed questions can secure …
Read MoreHiring an Employee
JOHN SHUFELDT, MD, JD, MBA, FACEP Let’s be honest, we have all done it: hired someone who, in retrospect, had only two brain cells, both of which turned out to be mutually inhibitory. Have I told you about the time (many years ago) when I hired a provider who, on a busy day, locked himself in the bathroom and screamed, “If you don’t get me some more help, I am going to start drinking?” Since …
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Supraventricular Tachycardia in a Child with Williams Syndrome after Nebulized Albuterol
Urgent message: Clinicians must be prepared for the possibility of supraventricular tachycardia after administration of nebulized albuterol in patients of any age, especially in the presence of heart disease. Muhammad Waseem, MD, Padma Gadde, MD, and Gerard Devas, MD Asthma is the most common lung disease in children. Five percent of children in the United States have asthma, and status asthmaticus—the leading cause of admission due to asthma exacerbation—accounts for approximately 10% of visits to …
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Evaluation, Identification, and Treatment of Urinary Tract Infections
Urgent message: Urinary tract infections are a common cause of abdominal pain and a common presenting complaint in urgent care. Proper diagnosis, treatment, and patient education on preventive measures are key to optimal outcomes. William Gluckman, DO, MBA, FACEP, Karen Keaney Gluckman, MSN, APN, C, CWCN, CCCN The global term urinary tract infection (UTI) incorporates cystitis and infection involving the bladder (a lower tract source), as well as pyelonephritis, an infection involving the kidneys (an …
Read MoreWhat About Retail Health?
There is plenty of posturing going on within organized medicine with regard to the “retail health” revolution. Concerns have been raised regarding continuity of care, the “corporatization” of medicine, kickbacks to pharmacies, and the quality of care provided by nurse practitioners and physician assistants. American Academy of Family Physicians, the American Medical Association, and the American Academy of Pediatrics have all chimed in. Only the AAP has come out consistently opposed to the idea on …
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