Journal of Urgent Care Medicine

Master the Distinction Between Level 3 and Level 4 Visits with These Best Practices

A recurring issue for healthcare practitioners is the frequency with which they find themselves contemplating whether a patient encounter should be classified as a level 3 or level 4 office visit. With a staggering 79% of ambulatory patient visits falling within these categories, this query has become exceedingly common among providers. Complicating matters further, the coding guidelines from the American Medical Association (AMA) contain gray areas that can contribute to additional confusion.[1] This article aims …

Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms

Urgent Message: Steroid overprescribing is a universal urgent care issue. While systemic steroids have several indications in which the preponderance of evidence supports their use in the urgent care setting, indication creep has led to their use outside of these scenarios resulting in significant risk for avoidable and unjustifiable adverse reactions. Citation: Hansen P. Systemic Steroid Stewardship in Urgent Care: Recognizing Indication Creep to Limit Avoidable Harms. J Urgent Care Med. 2023;18(3);29-32 Author Affiliation: Paul …

Pediatric Knowledge Needs Assessment: A Pilot Study

Urgent Message: Pediatric emergency medicine researchers have an opportunity to enhance collaboration with general emergency medicine and acute care clinicians to bridge the gap between research and dissemination of evidence-based care recommendations. Bashar S. Shihabuddin, MD, MS, FAAP, FACEP; Jessica Fritter, MACPR, ACRP-CP; Charmaine B. Lo, PhD MPH; Rachel Stanley MD, MHSA; Michael Weinstock, MD Citation: Shihabuddin B, Fritter J, Lo C, Stanley R, Weinstock M. Pediatric Knowledge Needs Assessment: A Pilot Study. J Urgent …

The Cost of Fear

I have a story I want to share with you, but I’m finding it hard to do without it reeking of privilege. This is a story about feeling 100% welcomed in one place when you don’t feel that way in many others. This is a rare for me, and perhaps it will feel like a poor example to you. Yet, it is part of my lived experience and brought something home for me that made …

Leadership Must Guide Behavior Change for the Next Phase in Urgent Care

Ben Barlow, MD, is Chief Medical Officer of Experity As I’ve discussed before, urgent care medicine is ready for its next phase, and exceptional leadership is needed to make urgent care a shining light within a struggling house of medicine. Engaging your team and setting one priority goal is the best approach for solidifying a behavior change that leads to exceptional results. Picking one goal is the easy part. Getting all team members to engage …

Amazon Less of a Threat Than UC Leaders Might Think

Amazon recently made headlines by offering One Medical 24/7 on-demand virtual care access and limited brick-and-mortar office access for Prime members for a rock-bottom price of just $9 a month. After investing $3.9 billion in the concierge platform for primary care, Amazon has yet to gain the traction it needs to realize a return, many observers believe. While urgent care operators are absorbing the chatter around Amazon and likely struggle to process the real-world threat …

Stewardship Program Reduces Antibiotic Prescriptions in UC

An antibiotic stewardship intervention at Mayo Clinic lowered unnecessary antibiotic prescribing for upper respiratory infections in outpatient settings, including urgent care centers, according to a new study in Open Forum Infectious Diseases, which posted during Antibiotic Awareness Week. Provider education, data reporting, and a red-flag notification system helped to influence prescribing patterns. The program was implemented at Mayo Clinic facilities in four states in 2020 with a goal to reduce antibiotic use for tier 3 upper respiratory infection …

Anti-seizure Meds Can Lead to Rare Organ Injury

A new FDA warning is being added to prescribing information for the anti-seizure drugs levetiracetam and clobazam because the agency found they can cause a rare but serious hypersensitivity: drug reaction with eosinophilia and systemic symptoms (DRESS). Diagnosis of DRESS can be difficult because symptoms vary and may be confused with other reactions. DRESS may start as a rash and can include fever and swollen lymph nodes or injury to the liver, kidneys, lungs, heart, …

Why Consumers Love Urgent Care

A high-level view of the urgent care landscape in the New York Times last week cited not only the urgent care market’s growth but also its benefits. The news item calls out the 60% increase in patient visits from 2019 to 2020 as well as the impressive revenue projections for this year—estimated at $48 billion. CityMD’s chief medical officer explains in the interview with NYT how patients seeking services at an urgent care center can be …

Consumer Cash Pay Applied to Deductibles in 2 States

For consumers with high deductible health plans—which have become the rule these days rather than the exception—cash-pay options have become more attractive. In some cases, cash pay is actually a better price than the insurer’s negotiated rate, so it makes sense for a consumer who is paying out-of-pocket regardless to skip their insurance altogether. The only downside would be the fact that the direct, out-of-pocket expenditure would not be applied to the threshold of the …