Practice Management
David Gahtan MS, PA-C and Joshua Russell, MD, MSc, FCUCM, FACEP Whether we like it or not, electronic medical records are here to stay. And their takeover has been swift. Over recent decades, the EMR has gone from an obscure, bare-bones, often clunky digital notepad to a ubiquitous and powerful tool which tracks enormous amounts of patient data. To continue to practice medicine, we’ve had no choice but to go along for the ride. It’s …
Read More
Download the article PDF: A 30-Year-Old Male with Chest and Leg Pain—and a History of Polysubstance Use A 30-year-old male with history of polysubstance use presents after a motor vehicle collision. He reports chest and leg pain, and denies nausea, vomiting, or shortness of breath. He has no known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read More
Download the article PDF: A 59-Year-Old with a Painful Finger Skin Lesion A 59-year-old woman presents with a painful skin lesion near her fingernail which has developed over the past week. She reports a history of advanced non-small cell lung cancer, for which she was recently started on erlotinib. On examination you observe a glistening, hemorrhagic papule at the lateral nail fold with surrounding erythema and edema. The patient denies trauma or exposure to skin …
Read More
A 41-year-old male presents with knee pain after playing basketball in his driveway with his teenage son. He reports that he had sudden pain and heard a “pop” as he landed after jumping. He is unable to fully extend his leg. 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
One of the key “selling” points of urgent care has always been that if patients who don’t have limb- or life-threatening concerns are able to get acute care someplace other than the emergency room, they would go there, thereby lowering cost, wait times, and risk associated with the ED. Now there’s evidence to support the first part of this premise, thanks to a new report from Mesirow Investment Banking. As seen in the graph below, …
Read More
Download the article PDF: Six Tips to Bulletproof Your Chart: Lessons from the Exam Room and the Court Room Urgent message: In the event that you are taken to court over care that is alleged to have been insufficient, negligent, or otherwise poor, your own documentation at the time care is provided can be your saving grace or your undoing. William Sullivan, DO, JD INTRODUCTION Providing proper medical care in urgent care centers is only …
Read More
Urgent message: Headache is most often a benign complaint among patients presenting to urgent care. Vigilance for risk factors and appropriate use of validated screening criteria are essential to uncovering potentially life-threatening etiologies. Paul Hansen, MD Citation: Hansen P. More than a simple headache: using the SNNO-OP10 criteria to screen for life-threatening headache presentations. J Urgent Care Med. 2023;17(9):18-21 ABSTRACT Introduction: Headache is most commonly a benign complaint among urgent care patients. Chronic subdural hematomas, …
Read More
Download the PDF: The Best Time to Plant a Tree Urgent Care is definitely ready to start Driving Change again. The pandemic taught us how to be in crisis-response mode all day every day, to roll with wave after wave after wave of external changes, to constantly pivot and adapt, to maintain a furious pace because our communities needed us to. It also diminished opportunities to improve other skills—longer-term thinking, broader-scope planning, finer-tuning on quality …
Read More
Download PDF: End of the Public Health Emergency: What’s Next? With expiration of the national Public Health Emergency (PHE) as of May 11, the revenue cycle management (RCM) industry has to adjust to the “new normal.” Some emergency declarations were tied to the end of the PHE and others are not. While not a comprehensive list, I’ve outlined some of the most urgent care-relevant changes below. Payers Coverage for COVID-19 Testing, Treatments, and Vaccines During …
Read More
Urgent message: In December 2022, Congress passed the Mainstreaming Addiction Treatment Act (W-Waiver), which would remove federal patient caps and allow any healthcare provider with a standard DEA controlled-medication license to prescribe buprenorphine. Alan A. Ayers, MBA, MAcc is Senior Editor of The Journal of Urgent Care Medicine and President of Experity Consulting. For over a decade, the question of whether or not to prescribe buprenorphine/naloxone (Suboxone) products in urgent care has resurfaced with regularity. With …
Read More