Journal of Urgent Care Medicine

Code Case Files: An Established Adult Male Patient with 2 Days of COVID-Like Symptoms

Bradley L. Laymon, PA-C, CPC, CEMC PRESENTATION A 47-year-old established male patient presented after 2 days of COVID-like symptoms (fever >100.5°F, cough, headache). Symptoms were mild and constant. He denied chest pain, shortness of breath, abdominal pain, rash, dizziness, and nausea/vomiting/diarrhea. He reported trying to alleviate the symptoms with acetaminophen and guaifenesin, with minimal relief. He has no known allergies The patient, who had never tested positive for COVID-19, acknowledged recent exposure to a colleague …

What Qualifies Someone to Take X-Rays in the Urgent Care Center? It All Depends on Where You’re Located

X-rays are high on the list of services patients expect urgent care centers to provide when needed. Currently, however, a dearth of qualified technicians can make guaranteeing that they can do so somewhat challenging. The November issue of JUCM will start an in-depth discussion of how the industry can best approach meeting that challenge for the benefit of the patient and the individual operator. One essential part of that discussion will be answering the question …

Repairing Parallel Lacerations in the Urgent Care Center

Urgent message: Parallel lacerations or those that simply occur in close proximity pose a unique challenge for the urgent care clinician. Repairing either wound without inflicting further trauma on the other(s) requires both skill and familiarity with performing the appropriate technique. Patrick O’Malley, MD The Problem Lacerations in close proximity pose a unique challenge for the urgent care clinician. This situation is often encountered in the unfortunate setting of patients engaged in “cutting” behaviors. Narrow …

Getting the Most Out of Your Urgent Care Google Ads Budget in 2022

Urgent message: As urgent care volume has dropped from pandemic highs, the average cost per click of Google Ads for searches related to “urgent care” has gone up—often considerably.” Advertisers need to understand the factors that affect these costs in order to optimize their budgets. Ira Pasternack The Google Ads Auction Framework Google Ads is built on an auction model that determines the cost of “clicks.” Every time a search occurs, Google uses an algorithm …

Are Food/Drug Retailers Hiding their Retail Clinic “Failures?”

Urgent message: Over the past 15 years, the nation’s largest food, drug, and mass retailers have announced clinic initiatives with great fanfare. However, we’ve heard little as these initiatives have quietly retreated and re-trenched, coincidently during the same period that urgent care has boomed. Alan Ayers, MBA, MAcc is Senior Editor, Practice Management of The Journal of Urgent Care Medicine Retail clinics—does anyone care anymore? Given there’s not been an “industry” update tallying the number of …

Posterior Shoulder Pain—Not Always a Muscle Spasm

Urgent message: Patients present to urgent care with a variety of complaints, many of which are common—even if they are the result of an uncommon condition. It is important that the provider develop a broad differential diagnosis as they approach these problems. Richard A Ginnetti, MD, MBA, CPE and Justin Holschbach, MD CASE PRESENTATION History A 52-year-old male presents to urgent care with the chief complaint of new lower posterior neck and right shoulder pain …

A 60-Year-Old Woman with Dark, Painful Plaques on Her Legs

The patient is a 60-year-old woman who presents to urgent care after developing dark areas over both legs over the course of the past few days. They are extremely painful. On examination, there were violaceous and dark brown, retiform plaques, some depressed and some crusted, over the legs. The patient has a history of diabetes, hypertension, and chronic renal insufficiency for which she required hemodialysis. View the image and consider what your diagnosis and next …

An Unresponsive Pupil in the Urgent Care: Can A Diagnosis Be Made from the Bedside History and Exam?

Urgent message: Ocular complaints for which there is no immediate, obvious explanation do not necessarily have to be referred to the emergency room or ophthalmology. Employing the process of elimination to narrow down a broad differential, using the available evidence, can expedite the correct diagnosis while allowing the patient to remain in the urgent care. Kayla Penny, BS; Joseph LaRochelle, PharmD, BCPPS, FCCP; Deirdre Hooper, MD; Haley Caire, BS; and Kelsey Rooney, BS CASE PRESENTATION …

Case Report: Reoccurring Metatarsophalangeal Joint Pain

Urgent message: Acute or chronic hallux pain is a common complaint in urgent care. Due to the structure, several diagnoses can have similar presentation on history and exam. With this discussion, we examine a sesamoid stress injury. Sergio P. Ramoa, MD, MS INTRODUCTION The tibial (medial) and fibular (lateral) sesamoids are contained within the flexor hallucis brevis tendons along the metatarsal head.1 They have several roles such as absorbing weight, helping glide and reducing friction …

Case of a Nonhealing ‘Sunburn’ on a Toddler

Urgent message: Rashes are a common ailment, and their etiology can have overlapping appearances. In a case where rash does not improve with treatment, it is often necessary to reconsider the differential. Sergio Ramoa MD, MS INTRODUCTION It is common for providers to have difficulty diagnosing patients who present with rash due to the diverse appearances, as well as overlapping similarities, of different etiologies. Due to the extensive nature of rashes, this article will focus …

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