StuWilli, Author at Journal of Urgent Care Medicine

CDC Cautions Providers Over Multidrug-resistant Yeast Infections

Urgent care centers see their share of patients seeking relief from yeast infections. The Centers for Disease Control and Prevention (CDC) is warning healthcare facilities around the country of a multidrug-resistant type of yeast that has caused deadly hospital infections across the globe. Most commonly, Candida auris has caused healthcare-associated invasive infections such as bloodstream infections, wound infections, and otitis. Officials started taking note of international reports of C auris infections when it became clear …

UCA Seeks Accommodations for Small Practices in Proposed CMS Payments System

A new payment system being considered by the Centers for Medicare and Medicaid Services (CMS) will have to make more accommodations for smaller practices—such as many urgent care centers—if there’s any hope of it succeeding, according to comments the Urgent Care Association (UCA) submitted to CMS. In its current form, the Merit-Based Incentive Payments System (MIPS) would require some clinicians to get an exemption from MIPS by participating in an Advanced Alternative Payment Model or …

Urgent Care 2.0: A Paradigm Shift?

In my last column, I presented ways that urgent care medicine can mature as a discipline and a health-care service. I discussed opportunities for expanding our value in a changing system. This month I suggest that one such opportunity, already in the pipeline, could dynamically augment urgent care’s role in what many consider to be the number one public health crisis: type 2 diabetes. The annual incidence of prediabetes and diabetes in U.S. adults is …

July/August 2016

Time Preference

In 2015, Merchant Medicine (Shoreview, Minnesota) released data from a detailed national study conducted in 2014 of U.S. patients’ preferences regarding retail clinics versus urgent care clinics versus primary-care physicians’ offices. The survey involved more than 2,000 adults between the ages of 18 and 54 years and was conducted by Sparks Research and Merchant Medicine on behalf of DXM Marketing Group. Urgent care is still sometimes viewed as being only for nights and weekends, but …

Plantar Warts, Digital Nerve Block in Lacerations, and Established Patients

Q. We had a patient present with 12 plantar warts. The provider used liquid nitrogen to freeze all 12 of the warts. What code should I bill for this procedure? A. In this case, you would bill Current Procedural Terminology (CPT) code 17110, “Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions.” Use only code 17110 once because the …

Abstracts In Urgent Care – July 2016

SEAN M. McNEELEY, MD Dexamethasone May Be Worthwhile in Treating Adult Asthma Key point: Dexamethasone is almost as good as prednisone in treating asthma in adults. Citation: Rehrer MW, Liu B, Rodriguez M, et al. A randomized controlled noninferiority trial of single dose of oral dexa- methasone versus 5 days of oral prednisone in acute adult asthma. Ann Emerg Med. 2016 April 22. doi: 10.1016/ j.annemergmed.2016.03.017. [Epub ahead of print.] In a randomized placebo-controlled trial …

Knee Pain in an 8-Year-Old Boy

Case An 8-year-old boy presents to an urgent care center with left knee pain that he has had for 3 days. The pain is worse with walking, and his mother says that he has been limping and will not put full weight on the leg. He reports no trauma, fever, vomiting, or numbness. His mother reports that she has given him ibuprofen but that this has not relieved his pain. View the image taken (Figure …

Foot Injury in a Weekend Warrior

A 46-year-old weekend warrior presents to an urgent care center 3 hours after injuring his right ankle and foot while playing basketball. He reports moderate to severe pain over the lateral side of the ankle and foot, which started after he jumped for a rebound and came down on the foot while it was in plantar flexion and inverted. However, he can walk. He reports no paresthesia or pain at the midfoot or proximal fibula, …

Nonspecific Numbness and Tingling

Urgent message: Though the cause of nonspecific numbness and tingling will often be benign, serious illnesses should be included in the differential diagnosis. Introduction Many patients at urgent care centers present with numbness and tingling. The symptoms can be caused by variety of underlying benign or potentially malignant pathologies. The medical history and physical examination play a central role in the determination of the cause of numbness. Numbness that is limited to a part of a limb suggests mononeuropathy, whereas numbness that involves most …