Journal of Urgent Care Medicine

Back Pain, an Urgent Care Visit—and a Devastating Outcome

Click Here to download the PDF Urgent message: By the time an adverse outcome occurs in the urgent care center, it’s too late to go back and ensure the documentation reflects the care the patient received. Lyndsie Pfeifer, DO; Marta Fratczak, Kinkela Harkins, and Michael Weinstock, MD Citation: Pfeifer L, Fratczak M, Harkins K, Weinstock M. Back pain, an urgent care visit—and a devastating outcome. J Urgent Care Med. 2023;17(8):13-17. Key words: back pain, documentation …

A Cause of Dizziness Not to Be Missed

Urgent message: Most cases of vertigo are benign. This includes etiologies such as benign paroxysmal position vertigo, labyrinthitis, and psychogenic causes. However, there are serious, “can’t miss” etiologies which should be considered during the urgent care evaluation of a dizzy patient. Cody McCoy, DO and Michael Weinstock, MD Citation: McCoy C, Weinstock M. A cause of dizziness not to be missed. J Urgent Care Med. 2023;17(5):13-16. Key words: dizziness, vertigo, disequilibrium, BPPV INTRODUCTION Dizziness presents …

When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

Urgent message: Fever in patients presenting to UC is often attributable to viral infections, urinary tract infections, otitis media, cellulitis, or pneumonia. When the source is not apparent after the initial evaluation, however, it is important to expand the differential in order to avoid missing less common, serious diagnoses. Samidha Dutta, DO; Caleb Marsh, OMS-IV, UP-KYCOM; Michael Weinstock, MD CASE PRESENTATION A 74-year-old man with a history of Parkinson’s disease and diabetes presented with 2 …

A Legal Quandary: A Diagnosis of Cellulitis…That Isn’t

Michael Weinstock, MD; Gabby Gostigian, MD; and Matthew Delaney, MD Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. INTRODUCTION Cellulitis from a wound infection in the urgent care is common, and so is our management: wound care and antibiotics. But consider a scenario in …

Psychiatric Manifestations of Organic Disease: Don’t Get Fooled!

Urgent message: Mistaking medical symptoms for psychiatric disease can delay care and lead to adverse outcomes. Elizabeth Yeager-Cordial, MD; Janell Ison, DO; Robert Becker, MD; Courtney Boyd, MD; and Michael Weinstock, MD Citation: Yeager-Cordial E, Ison J, Becker R, Boyd C, Weinstock M. Psychiatric manifestations of organic disease: don’t get fooled! J Urgent Care Med. 2022;16(11):11-15. CASE PRESENTATION A 23-year-old man presented with a strange complaint: visual hallucinations. He had no psychiatric history and was …

No Troponin, No Problem: Reimagining Chest Pain Assessment in Urgent Care

Most urgent care providers loathe when a patient checks in with chest pain because, typically, they are presenting because they’re worried about a heart attack, and we’re worried we don’t have the tools to exclude this diagnosis. It’s no surprise that we’re met with consternation when we suggest they may have come to the wrong place for care. But is unavailability of troponin testing a worthy scapegoat? And is the practice of ED referral for …

<strong>What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? </strong><strong>A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes</strong>

What Is the Acceptable Miss Rate for a Major Adverse Cardiac Event (MACE)? A Follow-Up Survey After Release of the American College of Emergency Physicians (ACEP) Clinical Policy on Acute Coronary Syndromes

Urgent message: Previously JUCM-published research revealed that even very low risk for a major adverse cardiac event left clinicians uncomfortable with discharging patients per 2018 ACEP guidelines. What can be learned from a follow-up study reflecting the updated version? Rebekah Samuels, OMS-III; Francesca Cocchiarale; Samidha Dutta, DO, PGY-3; Jarryd Rivera, MD; Amal Mattu, MD; Michael Pallaci, DO; Paul Jhun, MD, FAAEM; Jeff Riddell, MD; Cameron Berg, MD; and Michael Weinstock, MD. Citation: Samuels R, Cocchiarale …

See You in Court: Practice and Documentation Change from a Mock Trial

Urgent message: “Mock trials” are a valuable tool to help urgent care providers offer better medical care, record more appropriate documentation, and learn about medical proceedings. Michael Weinstock, MD; Kaetha Frost, DO; Heath Jolliff, DO; Amal Mattu, MD; Seth McIntire, DO; Marc Calvert, JD; Mark Kitrick, JD; and Matt Delaney, MD Citation: Weinstock M, Frost K, Jolliff H, Mattu A, McIntire S, Calvert M, Kitrick M, Delaney M. See you in court: practice and documentation …

A Legal Quandary: Poor Care…or Malpractice?

Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and, therefore, mis- or missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. Michael Weinstock, MD and Charles Pilcher, MD Back pain is usually back pain, whether it’s from a muscular strain or another self-limiting, non-serious cause. But there is potential danger lurking below the surface, …

A Novel Method for Blinding Reviewers to Gender of Proceduralists for the Purposes of Gender Bias Research

Urgent message Gender bias, whether overt or subconscious, may be to blame for disparities in hiring practices, salary, and advancement in medical schools, the urgent care setting, and any healthcare workplace. Recognizing the value of gender-neutral assessment may not only “even the playing field,” but increase the likelihood of identifying the best candidates for clinical positions. Michael Pallaci, DO; Jennifer Beck-Esmay, MD; Adam R. Aluisio, MD, MSc; Michael Weinstock, MD; Allen Frye, NP; Ashley See, …