JUCM, The Journal of Urgent Care Medicine December 2008

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™ DECEMBER 2008 VOLUME 3, NUMBER 3 THE JOURNAL OF URGENT CARE MEDICINE® www.jucm.com | The Official Publication of the Urgent Care Association of America IN THIS ISSUE FEATURES 11 Managing Foot Fractures in Urgent Care 20 BOUNCEBACKS: The Case of a 37-Year-Old Female with Flu-Like Symptoms 34 Failing to Plan—or Planning to Fail? Designing a Clinic for Success DEPARTMENTS 27 Insights in Images: Clinical Challenge 31 Abstracts in Urgent Care 38 Health Law 40 Occupational Medicine 41 Coding Q&A 48 Developing Data A BRAVEHEART PUBLICATION THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SYMPTOMS Causes of Stroke in Patients Less than Age 40 Cause <a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 26" href="http://viewer.zmags.com/publication/5648e32d?page=26">THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY</a> THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 48" href="http://viewer.zmags.com/publication/5648e32d?page=48">CareerOpportunitiesDoctor's Walk-In Clinic Tampa</a> CareerOpportunitiesDoctor's Walk-In Clinic Tampa<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 20" href="http://viewer.zmags.com/publication/5648e32d?page=20">Urgent Care Owners:rceo fsi oJt i</a> Urgent Care Owners:rceo fsi oJt i<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 14" href="http://viewer.zmags.com/publication/5648e32d?page=14">MANAGING FOOT FRACTURES IN URGENT CAREFigu</a> MANAGING FOOT FRACTURES IN URGENT CAREFigu<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 4" href="http://viewer.zmags.com/publication/5648e32d?page=4">ComprehensiveresultswithoutrestrictionsTh</a> ComprehensiveresultswithoutrestrictionsTh<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 11" href="http://viewer.zmags.com/publication/5648e32d?page=11">FROM THE EXECUTIVE DIRECTOREverything Speaks</a> FROM THE EXECUTIVE DIRECTOREverything Speaks<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 6" href="http://viewer.zmags.com/publication/5648e32d?page=6">DOCTORS WHO USE EHRs SAYTHEY HELP IMPROVE T</a> DOCTORS WHO USE EHRs SAYTHEY HELP IMPROVE T<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 36" href="http://viewer.zmags.com/publication/5648e32d?page=36">Practice ManagementFailing to Plan—or PlanningT</a> Practice ManagementFailing to Plan—or PlanningT<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 10" href="http://viewer.zmags.com/publication/5648e32d?page=10">JUCM CONTRIBUTORSI t’s likely that patient</a> JUCM CONTRIBUTORSI t’s likely that patient<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 2" href="http://viewer.zmags.com/publication/5648e32d?page=2">Get rid of the pink in a blink.*VIGAMOX® soluti</a> Get rid of the pink in a blink.*VIGAMOX® soluti<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 18" href="http://viewer.zmags.com/publication/5648e32d?page=18">MANAGING FOOT FRACTURES IN URGENT CAREmetat</a> MANAGING FOOT FRACTURES IN URGENT CAREmetat<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 17" href="http://viewer.zmags.com/publication/5648e32d?page=17">MANAGING FOOT FRACTURES IN URGENT CAREmetat</a> MANAGING FOOT FRACTURES IN URGENT CAREmetat<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 52" href="http://viewer.zmags.com/publication/5648e32d?page=52">02!#4)#% 6%,/#)495RGENTå#AREå3OLUTIONS</a> 02!#4)#% 6%,/#)495RGENTå#AREå3OLUTIONS<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 24" href="http://viewer.zmags.com/publication/5648e32d?page=24">THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY</a> THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 39" href="http://viewer.zmags.com/publication/5648e32d?page=39">FAILING TO PLAN—OR PLANNING TO FAIL? DESIGNING A</a> FAILING TO PLAN—OR PLANNING TO FAIL? DESIGNING A<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 23" href="http://viewer.zmags.com/publication/5648e32d?page=23">THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY</a> THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 8" href="http://viewer.zmags.com/publication/5648e32d?page=8">JUCM EDITOR-IN-CHIEFLee A. Resnick, MDCase West</a> JUCM EDITOR-IN-CHIEFLee A. Resnick, MDCase West<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 28" href="http://viewer.zmags.com/publication/5648e32d?page=28">TussionexPennkinetic® Rev. 01/2008 1ETU1186-030</a> TussionexPennkinetic® Rev. 01/2008 1ETU1186-030<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 29" href="http://viewer.zmags.com/publication/5648e32d?page=29">INSIGHTS IN IMAGESCLINICAL CHALLENGEIn eac</a> INSIGHTS IN IMAGESCLINICAL CHALLENGEIn eac<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 34" href="http://viewer.zmags.com/publication/5648e32d?page=34">ABSTRACTS IN URGENT CARE Although this stud</a> ABSTRACTS IN URGENT CARE Although this stud<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 25" href="http://viewer.zmags.com/publication/5648e32d?page=25">THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY</a> THE CASE OF A 37-YEAR-OLD FEMALE WITH FLU-LIKE SY<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 49" href="http://viewer.zmags.com/publication/5648e32d?page=49">ServicesBUSINESS BROKER SERVICES – Own a busy,</a> ServicesBUSINESS BROKER SERVICES – Own a busy,<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 37" href="http://viewer.zmags.com/publication/5648e32d?page=37">FAILING TO PLAN—OR PLANNING TO FAIL? DESIGNING A</a> FAILING TO PLAN—OR PLANNING TO FAIL? DESIGNING A<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 42" href="http://viewer.zmags.com/publication/5648e32d?page=42">OCCUPATIONAL MEDICINEThe Herd Mentality andOc</a> OCCUPATIONAL MEDICINEThe Herd Mentality andOc<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 30" href="http://viewer.zmags.com/publication/5648e32d?page=30">INSIGHTS IN IMAGES: CLINICAL CHALLENGETHE RE</a> INSIGHTS IN IMAGES: CLINICAL CHALLENGETHE RE<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 41" href="http://viewer.zmags.com/publication/5648e32d?page=41">HEALTH LAWreview diagnostic imaging, then evalu</a> HEALTH LAWreview diagnostic imaging, then evalu<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 13" href="http://viewer.zmags.com/publication/5648e32d?page=13">ClinicalManaging Foot Fracturesin Urgent Care</a> ClinicalManaging Foot Fracturesin Urgent Care<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 32" href="http://viewer.zmags.com/publication/5648e32d?page=32">Billers</a> Billers<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 44" href="http://viewer.zmags.com/publication/5648e32d?page=44">CODING Q&Alisted in CPT is for 73600 (radiologi</a> CODING Q&Alisted in CPT is for 73600 (radiologi<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 38" href="http://viewer.zmags.com/publication/5648e32d?page=38">FAILING TO PLAN—OR PLANNING TO FAIL? DESIGNING A</a> FAILING TO PLAN—OR PLANNING TO FAIL? DESIGNING A<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 22" href="http://viewer.zmags.com/publication/5648e32d?page=22">BouncebacksThe Case of a 37-Year-OldFemale wit</a> BouncebacksThe Case of a 37-Year-OldFemale wit<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 27" href="http://viewer.zmags.com/publication/5648e32d?page=27"></a> <a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 3" href="http://viewer.zmags.com/publication/5648e32d?page=3">(moxiﬂoxacin hydrochloride ophthalmicsolution) 0</a> (moxiﬂoxacin hydrochloride ophthalmicsolution) 0<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 5" href="http://viewer.zmags.com/publication/5648e32d?page=5">LETTER FROM THE EDITOR-IN-CHIEFA Defense of Fa</a> LETTER FROM THE EDITOR-IN-CHIEFA Defense of Fa<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 47" href="http://viewer.zmags.com/publication/5648e32d?page=47">CareerOpportunitiesLife’s too short to practice</a> CareerOpportunitiesLife’s too short to practice<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 43" href="http://viewer.zmags.com/publication/5648e32d?page=43">CODING Q&ACoding Symptoms of Infections,Modi</a> CODING Q&ACoding Symptoms of Infections,Modi<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 45" href="http://viewer.zmags.com/publication/5648e32d?page=45">PHYSICIAN - Urgent Care, Occupational Medicine,</a> PHYSICIAN - Urgent Care, Occupational Medicine,<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 51" href="http://viewer.zmags.com/publication/5648e32d?page=51"></a> <a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 33" href="http://viewer.zmags.com/publication/5648e32d?page=33">ABSTRACTS IN URGENT CAREOn ED Crowding, Blunt</a> ABSTRACTS IN URGENT CAREOn ED Crowding, Blunt<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 15" href="http://viewer.zmags.com/publication/5648e32d?page=15"></a> <a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 16" href="http://viewer.zmags.com/publication/5648e32d?page=16">MANAGING FOOT FRACTURES IN URGENT CAREof t</a> MANAGING FOOT FRACTURES IN URGENT CAREof t<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 7" href="http://viewer.zmags.com/publication/5648e32d?page=7">™The Official Publication of the Urgent Care A</a> ™The Official Publication of the Urgent Care A<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 40" href="http://viewer.zmags.com/publication/5648e32d?page=40">HEALTH LAWStrategies on Responding toVariable</a> HEALTH LAWStrategies on Responding toVariable<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 19" href="http://viewer.zmags.com/publication/5648e32d?page=19">sion fracture. However, avulsion fractures run pe</a> sion fracture. However, avulsion fractures run pe<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 1" href="http://viewer.zmags.com/publication/5648e32d?page=1">™ DECEMBER 2008</a> ™ DECEMBER 2008<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 35" href="http://viewer.zmags.com/publication/5648e32d?page=35">ABSTRACTS IN URGENT CAREA Little Hand Hygiene</a> ABSTRACTS IN URGENT CAREA Little Hand Hygiene<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 12" href="http://viewer.zmags.com/publication/5648e32d?page=12"></a> <a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 50" href="http://viewer.zmags.com/publication/5648e32d?page=50">DEVELOPING DATAInGenaerlryal2H00o8sp, iUtaClA</a> DEVELOPING DATAInGenaerlryal2H00o8sp, iUtaClA<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 46" href="http://viewer.zmags.com/publication/5648e32d?page=46">CareerOpportunitiesJANESVILLE, WISCONSIN Dean</a> CareerOpportunitiesJANESVILLE, WISCONSIN Dean<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 21" href="http://viewer.zmags.com/publication/5648e32d?page=21">MANAGING FOOT FRACTURES IN URGENT CAREFigu</a> MANAGING FOOT FRACTURES IN URGENT CAREFigu<a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 9" href="http://viewer.zmags.com/publication/5648e32d?page=9"></a> <a title="JUCM, The Journal of Urgent Care Medicine December 2008 page 31" href="http://viewer.zmags.com/publication/5648e32d?page=31">H.C. Chin, MDAnshin Medical HealthcareNew York,</a> H.C. Chin, MDAnshin Medical HealthcareNew York,