Practice Management
In the May issue of JUCM, Josh Russell wrote in his Letter from the Editor-in-Chief about thinking differently about follow-up. If you are not a physician, physician assistant or nurse practitioner and decided to skip his letter that month because it seemed too clinical, I urge you to go back and read it. One of the aspects of Urgent Care that separates us from other kinds of healthcare operations—or used to—is the tight collaboration between …
Read More
Urgent message: Whether due to reduced staffing needs or employee preference, some employees in urgent care are no longer scheduled for full-time hours. Changing from full-time to part-time status, however, may have consequences beyond simply working fewer hours. Alan A. Ayers, MBA, MAcc is President of Experity Consulting. There are any number of reasons why an urgent care owner or operator might want to change the status of an employee from full-time to part-time. Generally …
Read More
Urgent message: Urgent care centers play a vital role as a gateway into the health system for many children with acute care needs. Some of these needs require identification by the urgent care team, who may then need to stabilize the patient and initiate transfer to optimize clinical outcomes. Nikhil B. Shah, MD INTRODUCTION Pediatric office emergencies can be challenging for urgent care staff to manage. These high-stakes events do not occur frequently enough to …
Read More
Click Here to download the article PDF. A 67-year-old male presents to urgent care complaining of pleuritic chest pain and dyspnea. He has a history of lung cancer, but denies known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is describe on the next page.
Read More
Click Here to download the article PDF. A 23-year-old woman presents with a severely pruritic rash that developed on her leg and is spreading. The patient reports that 2 days prior to onset, she had gone hiking with her dog. She recalls going off-trail and brushing up against “woody vines and shrubs.” She denies sustaining insect bites and notes that the sun was particularly intense that day, so she wonders if this may be a …
Read More
Click Here to download the article PDF. A 45-year-old man presents with “asthma-like symptoms” that he says have “come and gone” for several years. He denies chest pain or a sense of racing heartbeat. A chest deformity is clear from observation. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
Read More
Improving antibiotic stewardship was an industry-wide mandate even before a 2018 study indicated that urgent care appeared to be more likely than other settings to overprescribe for common infections. While the methodologies could be questioned, especially in their take on the nature of urgent care visits, the point was well taken. Since then, urgent care as a whole has sought to improve providers’ prescribing habits more aggressively than ever. The initial awareness campaigns did a …
Read More
Urgent message: Low-dose naltrexone (LDN) is becoming more common as a treatment option for pain and thus will be increasingly prevalent in patients presenting to the urgent care setting. A thorough medication history, prioritization of non-opioid treatment options, and timely referral or transfer for severe uncontrolled pain are important considerations in the management of patients using low-dose naltrexone. Ting-Hsuan Chiang, MD; Kenneth Schmitt, BS; Ariana Nelson, MD INTRODUCTION Naltrexone is an opioid receptor antagonist approved …
Read More
Click Here to download the article PDF. Lyme Disease Diagnosis in Children of Different Racial Groups Take-home point: Black children with Lyme disease were more likely to have arthritis rather than cutaneous findings at the time of diagnosis. Citation: Hunt K, Michelson K, Balamuth M, et al. Racial differences in the diagnosis of Lyme disease in children. Clin Infect Dis. 2023;76(6):1129-1131. Relevance: Erythema migrans (EM) is commonly felt to represent the first clinical finding in …
Read More
Click Here to download the article PDF. Urgent message: Coinfection with COVID-19 and other respiratory pathogens can lead to a worsening clinical picture and requires careful assessment in the urgent care center. Marcia Taylor, MD, MSCR, FAAFP Citation: Taylor M. COVID-19 and RSV: coinfection requiring hospitalization. J Urgent Care Med. 2023;17(10):28-29. Key words: COVID-19, SARS-CoV-2, RSV, coinfection, pandemic ABSTRACT Patients who present with symptoms suspicious for COVID-19 and other respiratory conditions, regardless of vaccination status, …
Read More