Welcome back to our weekly Urgent Care RAP Friday lesson. As always, these are small snippets from HippoEd's Urgent Care Rap podcast. If I have provided enough value/you want to buy, use my link for $25 off. I get a small amount of money if you use my link & helps me continue to do what I love--urgent care medical education & sharing with you all. Link: here
This a summary of HippoEd’s UC rap May 2020 podcast chapter titled: “Legal lessons: Migraine vs stroke.”
Headaches are probably one of the most common CC's in urgent care. It is also one of the chief complaints that I commonly write a lengthy medical decision note—specifically noting presence or absence of alarm features, summary of my neuro exam, if I have recommended an ER visit, and /or if I have discussed symptom & time-specific follow-up
The podcast chapter reviews a medical legal case of a woman with hx of migraines, presenting for CC of migraine headache, seeking migraine medication refill and stating she felt somewhat confused and disoriented. She had a second visit 3 days later—with worse HA and neurologic deficits. Pt note stated patient was disoriented and complained of vision changes. Pt was discharged home and accused of drug seeking. Patient had another bounce back 3 days later and was found to have a large embolic stroke. Patient sued both physicians
Medical legal cases are always scary, but this was such an interesting case. You learn a lot from other people's mistakes & cases such as these, so hope this will help you in seeing those HA patients and you'll be able to catch these more ominous diagnoses!