StuWilli, Author at Journal of Urgent Care Medicine

Painful Nose Crusting in a Child

Urgent message: Common nasal infections can have serious health consequences if not quickly diagnosed and treated. Introduction Both children and adults present to urgent care centers with nasal pain. Infectious causes of such pain include impetigo, furuncles, and nasal vestibulitis (NV). Noninfectious causes include squamous cell cancer and lupus vulgaris. A careful physical examination and a thorough medical history can allow the health-care provider to rule out more serious conditions or to transfer the patient …

Understanding the Impacts of Health-Care Reform on Urgent Care

Urgent message: Urgent care plays a vital role in reducing medical expenses and improving population health by enabling the right care, at the right place, by the right provider, at the right price. Introduction Health-care reform, quality of care, and costs are center stage topics for politicians and the general public. As medical providers and administrators in the United States, we share in the challenge of understanding this complex system. Whereas traditional approaches in the …

Abstracts In Urgent Care – November 2016

Sean M. McNeely, MD

Income Tax Liability from Phantom Income

Urgent message: How physician and entrepreneur investors structure their urgent care center may expose them to an income tax liability from phantom income, but there are steps they can take to ensure there are sufficient funds to cover it. Introduction Income taxes are one of life’s certainties for most working Americans. Typically, however, income taxes are paid only on cash received during the course of a year. For example, a Form W-2 received by an …

Pediatric Oral Lesions in the Urgent Care Setting

Urgent message: Being able to recognize the distinct oral lesions of common illnesses in children is essential, but it can be difficult to conduct an oral examination in frightened young children. Introduction Inspecting intraoral lesions in children will often confirm a diagnosis, but getting uncooperative patients to let the clinician visualize such lesions is challenging. Here we provide helpful examination tips and review common pediatric infectious and allergic oral lesions and their treatment. Techniques for …

High Cost of Care Elsewhere May Be Nudging ACA Patients to Urgent Care

Patients whose health is insured under marketplaces created via the Affordable Care Act (ACA, aka “Obamacare”) have become acutely cost conscious when it comes to their own care—to the extent that they may not be getting the care they need, according to a new survey. While that paints a picture of a dysfunctional system, urgent care may be reaping some rewards as patients seek out quality care that won’t cost them as much as a …

Disclosure and Billing Practices Are Central to Suit Against Adeptus

“Surprise” bills are a common complaint among patients who’ve visited freestanding emergency departments (FSEDs). While that hasn’t stopped their growth, billing practices have become the subject of pending legislation around the country—and, now, one basis of a suit against Adeptus Health, the nation’s largest operator of FSEDs. The Oklahoma Law Enforcement Pension (OLEP) has initiated a class action lawsuit against Adeptus, its private equity firm, and its officers related to its secondary stock offering, claiming …

To Boost Flu Shot Rates—and Revenue—Go Where the Patients Are

It’s been well documented that higher flu shot rates equate to lower incidence of potentially deadly seasonal influenza cases. It’s also been shown that some patients are less likely than others to get a flu shot. Some think they don’t need it or can’t afford it. However, you can reach those who claim it’s too inconvenient to get a shot, or that they simply don’t have the time, by setting up shop wherever people congregate. …

Maintenance of Certification: The Odyssey Continues

These are by far the most frequent questions I am asked by urgent care physicians: “My primary board certification is expiring. Do I have to recertify? Which of the urgent care boards should I take?” If you have been in urgent care practice long enough, you’ll come to a painful moment of truth: Our primary board certification is in a specialty we no longer practice, covering competencies we no longer use. To make matters worse, …

CDC, Pew Set Agenda for Antibiotic Prescriptions in Outpatient Settings

Reducing the rate of antibiotic resistance—let alone treating patients effectively and efficiently—means prescribing the right drug for the right pathogen at the outset. Unfortunately, it doesn’t always happen that way, so the Centers for Disease Control and Prevention (CDC) and the Pew Charitable Trusts and other public health and medical experts to determine how much U.S. outpatient antibiotic use is inappropriate and to set national targets for improving antibiotic prescribing. They found that at least …