Practice Management
Case A 67-year-old male presents with acute mid-low back pain following a fall. He describes the pain as “dull and constant.” When asked if the pain is worse with range of motion, he replies, “I think so.” Physical exam reveals he is afebrile, has a pulse of 102, respirations 20, and blood pressure 122/78. His abdomen is soft and nontender without rigidity, rebound, or guarding; there is no bruising or distention. His back appears normal, …
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Urgent message: Prescribing Miralax and an enema would likely have killed this patient. He nearly died in the hospital. Can you figure out why? WILLIAM A. GLUCKMAN, DO, MBA, FACEP, CPE, CPC Constipation, a common urgent care complaint, can be a symptom of many things, not all of them obvious, and some life-threatening. In this tricky case, the underlying problem is one that many urgent care physicians would not consider in a differential diagnosis, yet …
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