Journal of Urgent Care Medicine

A Case of Late-Onset Diabetes

Urgent message: Previously undiagnosed diabetes in elderly patients is too frequently a precursor to the diagnosis of pancreatic cancer. Incidental and unexpected diagnosis of diabetes in older patients in urgent care, especially in normal or underweight individuals, should prompt a discussion about vigilant monitoring for other symptoms of malignancy and close follow-up with a primary care provider. Joshua Russell, MD, MSc, FCUCM, FACEP CASE PRESENTATION A 72-year-old woman with a history of hypertension presented to …

A 10-Year-Old with Fever, Headache, Muscle Aches, Nausea—and a Suspicious Rash

The patient is a 10-year-old girl who presents to urgent care with 3 days of fever, headache, muscle aches, nausea, and a skin rash. She has a temperature of 102°F. On examination you find numerous erythematous macules and purpura on her palms and the soles of her feet. The patient is immunocompetent with an unremarkable medical history. Her mother recounts no recent travel from their home in North Carolina, but notes that the patient spent …

A 35-Year-Old with a Persistent, Frequent Cough

The patient is a 35-year-old woman who presents with a frequent, light cough of several months’ duration. Her medical history is unremarkable, including no history of COVID-19. She is a former “social smoker” who worked out on a treadmill sporadically before the cough began. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Avoiding Defamation Lawsuits in Urgent Care

Urgent message: People are unlikely to trust their healthcare to a provider with a sullied reputation, so speaking ill of a provider can cost them in terms of patient revenue or future employment opportunities. Understanding the causes and defenses for defamation can help you protect your reputation and your business. Alan A. Ayers, MBA, MAcc We live in a nation where the First Amendment should protect “free speech,” particularly among public figures. Yet, Google “defamation …

Urgent Care Billing: Best Practices Scorecard

When it comes to measuring your financial performance, metrics translate the actions of others into insight. They provide visibility into the efficacy of your overall billing process. But while they may shine a light on where you need to improve, they don’t tell you how to do it. For a better understanding of how well your clinic is optimizing the billing process, look at your everyday practices. Our revenue cycle management (RCM) experts compiled 10 …

A 58-Year-Old Male with Chest Pain

The patients is a 58-year-old male who presents with chest pain. He describes it as sharp, lasting seconds, and worsened by lifting objects at work. Review the initial ECG taken and consider what your diagnosis and next steps could be. Resolution of the case is described on the next page. (Case presented by Tom Fadial, MD, Assistant Professor, McGovern Medical School, The University of Texas Health Sciences Center of Houston.)

A 22-Year-Old with Chronic Foot Pain

The patient is a 22-year-old male who presents for a pre-employment physical. During the exam, he mentions foot pain of several years’ duration, the origin of which he has no explanation. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

R-E-S-P-E-C-T

“Do you know what the first question anyone gets asked at these things nowadays?” asked a member at a recent industry event. I didn’t know the answer, and when I heard it, I was speechless. He said, “They ask you how many urgent cares you have.” Who are we becoming when this is our measurement of worthiness? When did size become the first thing that matters in our getting to know one another? Can we …

Your Best Investment Is Growing Your Own Business

Urgent message: Many urgent care operators took full advantage of opportunities to serve their communities during the pandemic, accumulating cash in the process. While many question what comes next, there’s no better time to grow your own urgent care business. Alan A. Ayers, MBA, MAcc is President of Experity Networks and is Senior Editor of The Journal of Urgent Care Medicine. On March 11, 2020, the World Health Organization declared COVID-19 a pandemic, and within …

A 6-Year-Old Girl with Papules on Her Abdomen

A 6-year-old girl presents to urgent care for vaccinations at the start of the school year. Her father asks the pediatric provider to look at bumps that developed on her abdomen about 4 weeks ago. They consist of tiny papules, some scattered and some in linear configurations. The patient is asymptomatic without pain or itching. Her father is concerned because they have not resolved. View the image in this context and consider what your diagnosis …