Journal of Urgent Care Medicine

The Missing Key: Enhancing Care by Understanding Patients’ Emotions

Urgent message: Even with the utmost attention to proper protocols, current data, and vast clinical experience, patient emotions are the unforeseeable x factor in a positive encounter (and, sometimes, even positive outcomes). Author: Bob Stuart, MD and Bob Bichler, RN As providers, we have been trying to understand how we can be more helpful and effective with the patients to which we provide care. How can I best provide care which will feel most satisfying …

Tuberculosis: Post-Exposure Testing and Management

Urgent message: Patients who present after exposure to tuberculosis test the clinician’s ability to assimilate broad and generalized information, including a unique set of historical, clinical, and laboratory data required to customize appropriate, patient-specific assessment and treatment plans. By Jacqualine Dancy, PA-C, MPAS Not long after I contributed the article Tuberculosis Screening in Urgent Care Medicine (JUCM, July/August 2010), our urgent care clinic was faced with the exposure to tuberculosis of numerous employees at a …

ECG Challenge: A 73-year-old Male with Concerns About His Pacemaker

Urgent message: Identifying the most likely cause of a 73-year-old male’s sensation that his heart is “missing beats” — while being mindful of the most potentially serious sources—will guide decisions on the right course of action. The ECG you order will offer invaluable clues as to the appropriate steps to take. By John F. O’Brien, MD The patient is a 73-year-old male who presents with a primary complaint that it occasionally feels as if his heart is “missing …

Getting Paid: Ten Steps to Reducing Accounts Receivable

Urgent message: Unlike businesses that expect—and receive—full payment at the time services or goods are secured, urgent care centers often wait for full payment from third-party payors. Efficient management of accounts receivable is crucial to the center’s financial viability. By Alan A. Ayers, MBA, MAcc Practice Velocity Urgent care centers—which appeal to consumers on the basis of high-visibility locations, extended hours, and walk-in convenience—are often compared to “retail” businesses. Unlike stores, restaurants, and other “retailers” …

Case Report: Stye or Chalazion?

Urgent message: Patient discomfort, inconvenience, and concerns—warranted or not—over possible vision loss make it essential for the urgent care clinician to quickly distinguish between benign conditions and those requiring referral, and to be able communicate clearly with the patient. By Eric Langerman, medical student, Colleen Czerniak, pharmacy student, Mikayla Spangler PharmD, Shailendra Saxena, MD, PhDAny ocular pathology can be distressing to the patient, as such conditions can often disrupt activity and even provoke concern about …

Practice Management: Keys to a Financially Healthy Urgent Care Center: Patient and Payor Mix

Urgent message: The right mix of payors and patients might make the difference between profitability and the poorhouse. Apply the basic principles to your situation, and adjust accordingly. By Stacy Calvaruso Many factors contribute to the ultimate success or failure of an urgent care center. Some are beyond your control, but there are others on which you can exert a good deal of influence — with the right approach. Two such factors that have an …

In the Beginning: Doc’s In ERgent Care Clermont, Florida

(In the Beginning recounts the real-life experiences of urgent care owners who have taken the initiative to hang out the proverbial shingle and open a new start-up center. It will be an occasionally recurring feature available exclusively in the digital edition of JUCM.) From marketing to urgent care medicine to triathlons, it seems as though Dr. Cheryl Durstein Decker was literally and figuratively born to run, slowing down only occasionally to help others in her …

Investing in Expansion: Do It Yourself, or Take on Investors?

Urgent message: Sound finances and proven business management skills may be the most valuable assets for the urgent care operator looking to capitalize on past successes by expanding. by Michael Gotlieb Introduction Urgent care owners, like many other entrepreneurial businesspeople, have great opportunities in front of them, yet need assistance at times. Sometimes, that “assistance” is purely financial. Most often in inflection point cases like expansion; however, it is a combination of financial and business acumen …

In the Beginning: Medical Express Care, Dunmore, Pennsylvania

(In the Beginning recounts the real-life experiences of urgent care operators who have taken the initiative to hang out the proverbial shingle and open a new start-up center. It will be an occasionally recurring feature available exclusively in the digital edition of JUCM.) Ask Dr. Donna Eget about the greatest benefit to owning an urgent care center and she doesn’t miss a beat; to her, it is time—time with family and time with patients. The …

Case Report: Upper Extremity Deep Venous Thrombosis – Paget-Schroetter Syndrome

Urgent message: Vigilance for risk factors and diagnostic methods related to Paget-Schroetter syndrome in patients presenting to urgent care with relevant risk factors is essential to initiating therapy on site and timely referral to a hospital and/or vascular surgeon. Darshan Shah, MD, Shikhar Saxena, MD and Shailendra Saxena, MD, PhD Introduction Upper extremity deep venous thrombosis (UEDVT) is estimated to constitute 1% to 4% of all cases of deep venous thrombosis (DVT).1 The incidence may …