Practice Management
Urgent message: Urgent care providers have a clinical, legal, and moral obligation to provide appropriate treatment for patients with pain. The first article in a two-part series addresses strategies for managing acute pain. TRACEY Q. DAVIDOFF, MD The interpretation of pain by patients is very subjective and not easily measured. That makes management of pain in the urgent care setting difficult. Current pain scales are often inaccurate or not truly reflective of a patient’s real …
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Urgent message: The differential diagnosis of neck pain is broad. A systematic and effective approach is required to rule out life-threatening conditions. RANIER NG, DO, and MICHAEL ROWANE, DO, MS, FAAFP, FAAO Neck pain is a frequently encountered complaint in urgent care. About two-thirds of the population will experience neck pain at some point in their lives.1 Many patients experience a sense of debilitation with every movement of their neck. Patients may perceive neck pain …
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Urgent message: Infants who cry excessively pose a challenge to physicians and parents. A systematic approach to the history and physical exam can guide the diagnostic approaches to determine if a benign – or serious – condition is responsible. Toni Clare Hogencamp, MD Crying is a primitive form of communication that infants rely on to communicate their distress. Because infants cannot verbalize their discomfort, they must rely on their cry to communicate with caregivers. Estimates …
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Urgent message: Patients with palpitations often present to urgent care clinics. Making the correct diagnosis requires knowledge of underlying pathophysiology and thorough differential diagnosis. EBRAHIM BARKOUDAH, MD, and JEFFREY P. COLLINS, MD Case Record A 75-year-old woman with no prior history of cardiac disease complained of “palpitations” but neither lightheadedness nor syncope. She denied excess caffeine intake or use of illicit drugs and had no other significant past medical history on triage. The patient’s initial …
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Urgent message: Lymphadenopathy is a common presenting issue in urgent care. Most cases are benign, but be on the alert for “red flags” that could signal malignancy. MARIA V. GIBSON, MD, PHD, and DANIEL A. CHERRY, MD Consider how you would manage the following patient presenting with lymphadenopathy. A 39-year-old male truck driver presented to the urgent care clinic with a 2- to 3-week history of “swollen glands” in both sides of his groin. They …
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Urgent Message: Patients with tooth-related complaints increasingly are presenting to urgent care centers. Managing these cases can be a challenge because physicians often receive limited training in this area. KATHERINE HURST MSC, MD, and RICHARD E. WALTON DMD, MS Tooth or tooth-related complaints are common presenting issues in patients seen at urgent care centers because of the limited availability of dental services in the evenings and on weekends. More patients also are seeking emergency dental …
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