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December 2006 jucmcov_1206 11/29/06 10:23 AM Page 1 ™ JUCM ™ THE JOURNAL OF URGENT CARE MEDICINE www.jucm.com | The Official Publication of the Urgent Care Association of America DECEMBER 2006 VOLUME 1, NUMBER 2 FEATURES 10 Urticaria and Angioedema: A Case- Based Discussion 29 A Delicate Balance: Managing Your Practice, Caring for Your Patients DEPARTMENTS 16 Abstracts in Urgent Care 20 Insights in Images 34 Health Law 35 Occupational Medicine 38 Coding Q&A 40 Developing Data PUBLICATION BRAVEHEART A Project1 11/28/06 3:51 PM Page 1 Coming soon. From the makers of PATANOL® solution (olopatadine hydrochloride ophthalmic solution) 0.2% ©2006 Alcon, Inc. 10/06 PAT06511JA 38480_CHC-OL200006_CS_Dec_ASz_r1 1 11/7/06 5:54:35 PM editor_1206 11/29/06 10:42 AM Page 1 LETTER FROM THE EDITOR-IN-CHIEF The Power of Research edical progress is driven by Ultimately, these research topics, and many others like research. Opinions must be con- them, will raise urgent care medicine where it belongs—to tinuously challenged in order the forefront of the healthcare delivery discussion. Mto assure the greatest likelihood I encourage all of our readers to transform the undeniable of efficacy, quality, and safety. Over enthusiasm and passion you have for the value and virtues the last century, research has focused of urgent care medicine into an equivalent passion for prov- on examining the innovative diag- ing its value and virtues. There are many research resources nostic and therapeutic approaches to available through your local medical schools, hospitals, and disease and prevention that form the medical societies, as well as grant money available through backbone of clinical medicine as we know it today. many health policy foundations like Robert Wood Johnson While science continues to make expansive strides along and AHRQ. multiple clinical fronts, a new area of research interest evolves: Let’s call it Healthcare Delivery: Models and Quality. The “We are positioned study of issues such as accessibility, cost, patient satisfac- tion, efficiency, and clinical integration has generated keen uniquely to play a role in interest by the likes of such policy giants as the Robert Wood Johnson Foundation and the Agency for Healthcare Research the study of unique and Quality (AHRQ). Examining the use of technology to sup- port improved healthcare delivery and quality is also generat- healthcare delivery paradigms.” ing excitement in the research community. Conquering the problems that plague our nation’s emergency services system You do not have to have any research experience to deserves additional notice, as well. produce a simple study of excellent quality, and, often, Urgent care medicine is positioned uniquely to play a lead- research money is earmarked for non-academic physicians ing role in the study of unique healthcare delivery paradigms. and practices to ensure a “real-world” perspective. I need not convince all of you of the role urgent care plays in JUCM is already working to publish several pieces of addressing the issues of access, cost, quality, satisfaction, original research that will both highlight the value of our and the use of technology to improve healthcare delivery. discipline and analyze some of its finer points. Our pledge is We do, however, collectively need to convince the scientif- to disseminate original research designed by urgent care ic and public communities of such. clinicians for urgent care clinicians as often as possible. I JUCM™, The Journal of Urgent Care Medicine is unique in encourage you to join the ranks of the researchers who that it serves as a forum for ALL of us to challenge our will fuel the continued growth of our dynamic discipline. assumptions, to prove and reprove the value of urgent care Hope you enjoy. Hope you’re inspired. medicine and its role in improving healthcare delivery and qual- Sincerely, ity. Consider the following potential topics: Ⅲ Cost-of-care savings in urgent care vs. ED for non-life threatening illness and injury Ⅲ Management of chest pain in urgent care: outcomes analysis Ⅲ Efficacy of return-to-work programs/efficacy of urgent cares vs. primary care and orthopedics at minimizing Lee A. Resnick, MD lost days due to injury Editor-in-Chief Ⅲ Use of technology to reduce errors and improve efficiency JUCM, The Journal of Urgent Care Medicine www.jucm.com JUCM The Journal of Urgent Care Medicine | December 2006 1 Project1 9/20/06 10:00 AM Page 1 TOC_1206 11/29/06 10:27 AM Page 3 The Official Publication of the Urgent Care Association of America December 2006 VOLUME 1, NUMBER 2 CLINICAL 10 Urticaria and Angioedema: A Case-based Discussion The intense itchiness and discomfort of acute urticaria and angioedema bring many to urgent care, seeking relief and a reassuring explanation. Your goal: identify the likely cause(s) and implement a treatment plan. See how three distinct cases were resolved. By Kent Knauer, MD PRACTICE MANAGEMENT 7 From the Executive 29 A Delicate Balance: Director Managing Your Practice, DEPARTMENTS Caring for Your Patients 16 Abstracts in Urgent Care 20 Insights in Images You earned multiple degrees, made 34 Health Law it through internship and residency, and established yourself as a 35 Occupational Medicine competent clinician. Now you’re 38 Coding Q & A wrestling with the same financial issues as every other entrepreneur. 40 Developing Data Here’s an overview of some key challenges. By Kevin J. Ralofsky, MBA www.jucm.com JUCM The Journal of Urgent Care Medicine | December 2006 3 Project1 11/13/06 4:14 PM Page 1 NATIONAL CONFERENCE May 9-12, 2007 Hilton Daytona Beach ESORT • DAYTONA BEACH, FL • DAYTONA ESORT Oceanfront Resort R Daytona Beach, Florida PRECONFERENCE WORKSHOPS Starting a New Urgent Care Center Billing and Coding Essentials Integrating Occupational Medicine Procedures Workshop DUAL BUSINESS TRACKS Introduction to the Business of Urgent Care Medicine Advanced Issues in Urgent Care Medicine CLINICAL TRACK Updates and Essentials of Clinical Urgent Care FOR MORE INFORMATION: Call 877-MYUCAOA or www.ucaoa.org Mixed Education Perfectly Networking HILTON DAYTONA BEACH OCEANFRONT DAYTONA HILTON Relaxation Daytona Beach TOC_1206 11/29/06 10:27 AM Page 5 JUCM EDITOR-IN-CHIEF Lee A. Resnick, MD Case Western Reserve University Department of Family Medicine University Hospitals Medical Practices EDITOR-IN-CHIEF Lee A. Resnick, MD [email protected] JUCM EDITORIAL BOARD EDITOR Tanise Edwards, MD, FAAEM Masahiro Morikawa, MD J. Harris Fleming, Jr. Author/editor (Urgent Care Medicine) Case Western Reserve University; [email protected] Nahum Kovalski, BSc, MDCM University Hospitals Case Medical Center CONTRIBUTING EDITORS Terem Immediate Medical Care Marc R. Salzberg, MD, FACEP Nahum Kovalski, BSc, MDCM Peter Lamelas, MD, MBA, FAAEP Stat Health Immediate Medical Care, PC Frank Leone, MBA, MPH MD Now Urgent Care Walk-In John Shershow, MD John Shufeldt, MD, JD, MBA, FACEP Medical Centers Urgent Care Association of America David Stern, MD, CPC Melvin Lee, MD John Shufeldt, MD, JD, MBA, FACEP ART DIRECTOR Baptist Minor Medical Clinics; NextCare, Inc. Tom DePrenda Metro Memphis Physicians Group Mark D. Wright, MD [email protected] Elizabeth A. Lindberg, MD The University of Arizona The University of Arizona JUCM ADVISORY BOARD 2 Split Rock Road, Mahwah NJ 07430 Michelle H. Biros, MD, MS Benson S. Munger, PhD University of Minnesota; The University of Arizona PUBLISHERS Editor-in-Chief, Academic Emergency Peter Rosen, MD Peter Murphy Medicine Harvard University School of Medicine [email protected] Kenneth V. Iserson, MD, MBA, FACEP, David Rosenberg, MD, MPH (201) 847-1934 FAAEM University Hospital Health System of Stuart Williams The University of Arizona Cleveland; Case Western Reserve [email protected] Daniel R. Konow, PA-C, MBA University School of Medicine (201) 529-4004 RediMed Kurt C. Stange, MD, PhD Steven Lelyveld, MD, FACEP, FAAP Case Western Reserve University Mission Statement University of Chicago Pritzker School JUCM The Journal of Urgent Care Medicine supports of Medicine the evolution of urgent care medicine by creat- ing content that addresses both the clinical prac- tice of urgent care medicine and the practice UCAOA BOARD OF DIRECTORS management challenges of keeping pace with an William E. Meadows III, MD, President ever-changing healthcare marketplace. As the Official Publication of the Urgent Care Association Daniel R. Konow, PA-C, MBA, Vice President of America, JUCM seeks to provide a forum for Margaret M. Simat, Secretary the exchange of ideas and to expand on the Kevin J. Ralofsky, MBA, Treasurer core competencies of urgent care medicine as Jim Gore, MD, Director they apply to physicians, physician assistants, and John J. Koehler, MD, Director nurse practitioners. Cindi Lang, RN, MS, Director JUCM The Journal of Urgent Care Medicine (JUCM) makes Ken Palestrant, MD, Director every effort to select authors who are knowledgeable in their fields. However, JUCM does not warrant the expertise of any Lee Resnick, MD, Director author in a particular field, nor is it responsible for any state- David Stern, MD, CPC, Director ments by such authors. The opinions expressed in the articles and columns are those of the authors, do not imply endorse- Amy Tecosky, Director ment of advertised products, and do not necessarily reflect the opinions or recommendations of Braveheart Publishing or the Lou Ellen Horwitz, Executive Director editors and staff of JUCM. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested by authors should not be used by clinicians without evaluation of JUCM The Journal of Urgent Care Medicine (www.jucm.com) is published through a part- their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s prod- nership between Braveheart Publishing (www.braveheart-group.com) and the Urgent Care uct information, and comparison with the recommendations of Associationof America (www.ucaoa.org).
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