HSC Study Shows Urgent Care as More Convenient and Less Expensive Than Emergency Rooms

Study Shows Urgent Care as More Convenient and Less Expensive Than Emergency Rooms

A study recently completed by the Center For Studying Health System Change (HSC) discusses the potential impact of the growth of urgent care to improve access to care and reduce costly emergency room visits.   The study concentrates on six market areas that tend to have a high number of urgent cares with varying affiliations with hospital systems.

HSC Research Brief  – July 2013
Tracy Yee, Amanda E. Lechner, Ellyn R. Boukus

As the U.S. health care system grapples with strained hospital emergency department (ED) capacity in some areas, primary care clinician shortages and rising health care costs, urgent care centers have emerged as an alternative care setting that may help improve access and contain costs. Growing to 9,000 locations in recent years, urgent care centers provide walk-in care for illnesses and injuries that need immediate attention but don’t rise to the level of an emergency. Though their impact on overall health care access and costs remains unclear, hospitals and health plans are optimistic about the potential of urgent care centers to improve access and reduce ED visits, according to a new qualitative study by the Center for Studying Health System Change (HSC) for the National Institute for Health Care Reform.

Across the six communities studied—Detroit; Jacksonville, Fla.; Minneapolis; Phoenix; Raleigh-Durham, N.C.; and San Francisco—respondents indicated that growth of urgent care centers is driven heavily by consumer demand for convenient access to care. At the same time, hospitals view urgent care centers as a way to gain patients, while health plans see opportunities to contain costs by steering patients away from costly emergency department visits. Although some providers believe urgent care centers disrupt coordination and continuity of care, others believe these concerns may be overstated, given urgent care’s focus on episodic and simple conditions rather than chronic and complex cases. Looking ahead, health coverage expansions under national health reform may lead to greater capacity strains on both primary and emergency care, spurring even more growth of urgent care centers.

Click here to read the full story – http://www.hschange.org/CONTENT/1366/

Inc.com Article – 3 Reasons To Consider Franchising Now

Inc.com Article – 3 Reasons To Consider Franchising Now

This article points out 3 reasons to consider investing in a franchise and why it makes sense – franchises create jobs, sales have grown and lenders are lending.  There are excellent source documents included in the article.

How To Treat Bee and Wasp Stings

 By: Ellen Sullivan
A fun summertime day or plans to get that yard work done can quickly fade away when a bee or wasp shows up on the scene and someone gets stung!Most stings from bees or wasps typically don’t require medical attention although may cause discomfort. However, there are times when a person who has been stung does need medical attention and sometimes immediate action to help prevent shock or in some cases death. When in doubt call a healthcare provider, visit an urgent care center, or go to the nearest emergency room or call 911.

Here is what medical experts such as WebMD suggest to do following a sting:

Remove the Stinger  – Scrape the area with a fingernail or use tweezers to remove it. Don’t pinch the stinger — that can inject more venom.

 Control Swelling. -Ice the area. If you were stung on your arm or leg, elevate it. Remove any tight-fitting jewelry from the area of the sting. As it swells, rings or bracelets might become hard to get off.

Treat Symptoms– For pain, take an over-the-counter painkiller like acetaminophen or ibuprofen. Do not give aspirin to anyone under age 18.

For itchiness, take an antihistamine. You can also apply a mixture of baking soda and water or calamine lotion.

Follow-Up – It might take 2-5 days for the area to heal. Keep it clean to prevent infection

Experts at eMedicineHealth.com indicate that medical problems from bee and wasp stings are broadly broken down into two categories:

Local reactions (only the part of the body near the sting is affected)

  • Immediate pain, redness, swelling, and itching at the sting site may occur.
  •  A large (greater than four inches across) local reaction may develop over the next 12-36 hours.
  •  A bacterial skin infection, although uncommon, may also begin during the first 12-36 hours (or even after the first few days).
  •  These may cause an enlarging area of redness at the sting site. It may be difficult to tell a local skin reaction and a local bacterial skin infection apart.

Systemic or allergic reactions (parts of the body away from the sting are affected)

  • Hives (raised itchy bumps on the skin) and itching all over the body
  •  Swelling of the mouth or throat or both
  • Wheezing
  •  Shortness of breath or other difficulty breathing
  •  Nausea
  •  Vomiting
  •  Anxiety
  •  Chest pain
  •  In severe cases, marked difficulty breathing, unconsciousness, and even death may occur.

Call 911 immediately if the person has:

  •  Trouble breathing
  •  Feelings of faintness or dizziness
  •  Hives
  •  A swollen tongue
  •  A history of severe allergy reaction to insect stings

WebMD outlines these steps if the person has if the person does have severe allergy symptoms (anaphylaxis):

 Call 911

  •  Seek emergency care if the person has these symptoms or a history of severe allergic reactions (anaphylaxis), even if there are no symptoms:
  •  Difficulty breathing or wheezing
  •  Tightness in the throat or a feeling that the airways are closing
  •  Hoarseness or trouble speaking
  •  Nausea, abdominal pain, or vomiting
  •  Fast heartbeat or pulse
  •  Skin that itches, tingles, swells, or turns red
  •  Anxiety or dizziness
  •  Loss of consciousness

 Inject Epinephrine Immediately – If the person has an anaphylaxis action plan from a doctor for injecting epinephrine and other emergency measures, follow it. Otherwise, if the person carries an epinephrine shot or one is available:

  •  Inject epinephrine if the person is unable to.
  •  If the person has a history of anaphylaxis, don’t wait for signs of a severe reaction to inject epinephrine.
  •  Read and follow patient instructions carefully.
  •  Inject epinephrine into outer muscle of the thigh. Avoid injecting into a vein or buttock muscles.
  •  Do not inject medicine into hands or feet, which can cause tissue damage. If this happens, notify emergency room staff.
  •  The person may need more than one injection if there’s no improvement after the first. For an adult, inject again after 10 to 20 minutes. For a child, inject again after 5 to 30 minutes.

 Do CPR if the Person Stops Breathing

  •  For a child, start CPR for children
  •  For an adult, start adult CPR.

 Follow Up

  •  Make sure that someone stays with the person for 24 hours after anaphylaxis in case of another attack.
  •  Report the reaction to the person’s doctor.




Photo: Credited to: http://www.public-domain-image.com


When Was Your Last Tetanus Booster?

by: Ellen Sullivan
Do you know when you had your last tetanus booster? Has it been 10 years since your last one? Many of us don’t think about it until we get a cut or a wound and then we wonder if we need one. If you did write it down, now may be a good time to go back and see when you are due for another. By the way, men under age 59 are three times more likely than women to get tetanus because they have not had booster shots.

 What is tetanus and how do you get it? Well, it is a potentially fatal disease caused by bacteria found in dirt, dust and soil. The bacterial live all over the world and the disease can occur in both humans and animals. Tetanus is the only vaccine-preventable disease that is not contagious. You can’t catch Tetanus from someone else. It happens when dust or dirt comes in contact with an open wound  that can be from a from a pinprick to a deep wound. Some of the typical wounds that lead to Tetanus infections are cuts, scrapes, lacerations, animal bites, tattoos, postsurgical wounds, body piercings – even splinters! An infection can set in as little as two days or as long as a couple of months. Once Tetanus is inside the bloodstream, the bacteria grow, produce a deadly toxin that can cause spasm and paralysis of muscles.

Symptoms of Tetanus include headache, sweating, fever, difficulty swallowing and stiffness of the jaw (lockjaw) and abdominal muscles. Lockjaw is the most dangerous symptom because it can lead to death by suffocation.

What can you do to prevent tetanus? That is something that you can do by getting a regular tetanus vaccine booster shot. You probably received several tetanus shots when you were a child. Even though you may have, tetanus immunity does not last forever. The Center for Disease Control recommends that you get a tetanus booster every ten years. If you do get injured during that time, your doctor may request that you have another booster if it has been longer than five years since your last one. If you are traveling internationally , you’ll want to be up to date with your immunity because tetanus may be more common where you’re visiting, especially if you are visiting a developing country.

Tetanus boosters shots are easy to get. You can call your family doctor. We keep them on hand here at Doctors Express. You can walk in without an appointment any day of the week  even on the weekend – and receive your booster shot.

Be sure to write down the date you receive your booster so you won’t wonder next time!


What is the difference between an EMR and an EHR?

By: Ellen Sullivan

An electronic medical record (EMR) is a digital version of a paper chart that  contains all of a patient’s medical history from one practice. An EMR is  mostly used by providers for diagnosis and treatment. Instead of relying on paper charts, the EMR allows providers to easily store data, track it over time, identify when patients should be contacted for services and to be able to measure indicators used to monitor health. An EMR is typically used in a provider office and is basically a computerized version of the hard copy record.

 There are standards for documenting in the medical record. The main concern, or the chief complaint or why the patient is a key part of the medical history. Other information includes a family medical history. Immunizations are also recorded. Documentation of the physical examination and  details of the physician’s findings, particularly as related to the  complaint and any other observations. Vital signs such as pulse, breathing rate, temperature, and blood pressure are recorded. A  diagnosis and assessment as related to the chief complaint will be documented,  followed by a treatment plan or plan of care. This plan of care addresses how to manage the condition along with the appropriate medications, lab tests, or other  interventions. Discharge notes, follow-up care, referrals to specialists and test results are also documented.

There are benefits to the EMR which include:

Information is readily available to providers. It can also be shared via a secure portal to another provider when needed. Examples of how this can help includes transfer to an emergency room or if information is being to sent to another physician for follow up care.

  • The chances of errors in medication and treatments reduced especially reducing errors due to poor handwriting.
  • They are easily stored and not susceptible to damage from fire, flood or other calamities.
  • Records can be easily reviewed with alerts set up to ensure that important information is not overlooked that may impact patient care. This is important from a patient safety perspective.

Electronic health records (EHR) are designed to contain and share information from all providers involved in the care of a patient. EHR data can be created, managed and consulted by authorized providers and staff. It also allows patients to take their health record with them and it can be shared with other health care providers, specialists, hospitals, outpatient or ancillary providers.

Most patients want to know if their records are safe and if they are kept private. In 1996, Congress passed the Health Insurance Portability and Accountability Act known as HIPAA, in order to help protect personal  health information, including medical records. This law gave patients more  control over their health information, set limits on the use and release of  their medical records, and established a series of privacy standards for health  care providers which provides penalties for those who do not follow these EMR   safety and EHR security standards.

Here is a link to an article that further discusses this topic http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/


Follow Legal Guidelines When Considering Purchasing A Franchise

Seeking legal counsel is an important component in due diligence when considering not only the purchase of a franchise, but through the lifecycle of the business.  Understanding the legal climate and specific regulations impacting the decision making will help reduce risk and potentially avoid  future litigation.

Here is an article by The Witterman Law Firm P.C. discussing the importance of following legal guidelines when considering the purchase of a franchise.

Click here to view the article – Follow Legal Guidelines When Considering Purchasing A Franchise

Potential franchisees are advised to follow all legal guidelines

By : The Witterman Law Firm, P.C. posted in Franchising on Thursday, June 13, 2013.

Georgia entrepreneurs wanting to buy into a franchise may see a business opportunity leading to dancing dollar signs, but they need to follow the legal requirements to operate this type of business. A franchise is an agreement between the operator, or franchisee, and the franchise, or business, to use the business brand and marketing strategies to realize a faster return on their investment. Theoretically, it may sound simple on paper. But building a successful franchise takes careful planning and solid business advice.

Franchises can include either starting from scratch or taking over an existing business. There are as many franchising opportunities as there are types of businesses, and before embarking on this type of endeavor the franchisee should decide what they want in a business. It brings greater risk than working a 9-to-5 job, the hours are longer and there is always the possibility of losing money. But owning a franchise can also generate greater financial rewards.

After doing the research and attending franchise workshops and webinars on the topic, finding a trustworthy franchise broker is an important first step. An ethical broker can help the franchisee avoid making bad business decisions that might lead to legal trouble. Deciding whether to take on a business partner or go solo is also critical, as is learning the laws regarding employees’ rights on the job. Small businesses are the backbone of Georgia’s economy, and entrepreneurs with a clear understanding of the legal landscape can avoid litigation more easily.

Georgia is one of 26 states with business opportunity laws in effect. Many of those laws ban sales of business opportunities unless the seller provides potential purchasers with a pre-sale disclosure document that was previously filed with a designated state agency. Unlike some other states, however, no filing is required in Georgia. This is an important detail, and potential franchise operators can obtain legal counsel from a business and commercial lawyer.

Source: Advantage Business Magazine, “Are You Thinking About Buying A Franchise? Here Are 10 Things You Need To Know“, Ellen Sullivan, June 10, 2013

Source: http://www.alpharettagabusinesslawblog.com/2013/06/potential-franchisees-are-advised-to-follow-all-legal-guidelines.shtml

Entrepreneur Magazine Article – Two Medical Pros Change Course With an Urgent-Care Franchise

Two Medical Pros Change Course With an Urgent-Care Franchise </a

This article ran in Entrepreneur Magazine August 2012 about our opening a Doctors Express Center. We were the 16th Doctors Express to open in the country and the first to open in Florida. It has been a very rewarding experience to be part of a quality-driven, affordable business that meets the needs in local communities.