The authors report a clinically relevant and possible cause of haemolytic anaemia from ingestion of a Mexican tea from the Neem tree, also known as Azadirachta indica, in a 35-year-old Hispanic man who was found to have glucose-6-phosphate dehydrogenase deficiency.
Background and Objectives: There has been a growth in the demand for convenient, walk-in access in health care across the United States, resulting in primary care practices seeing a shift in services to urgent care centers (UCCs). In order to incorporate the flexibility of a UCC and improve primary care access and preventive care for our regular patients, the University of North Carolina (UNC) Family Medicine Center (FMC) established a UCC within the practice. This report describes that process and the impact of the new UCC on our academic practice.
Methods: With the support of the UNC health care system, our primary objectives were to provide enhanced access for patients with acute problems, decrease emergency department (ED) utilization, and increase enrollment of new patients for ongoing primary care. As part of our intervention, we asked providers to respond to a series of questions at the end of each visit. These questions, along with data regarding number of visits and revenue, were tracked longitudinally.
Results: By the end of our first year, we were treating about 900 patients per month, of which approximately one-third would have otherwise visited the ED. We averaged 115 new patients establishing care per quarter. In addition to the success of this new service line, our primary practice maintained provider continuity and grew at a higher rate than prior to opening the UCC.
Conclusions: The opening of urgent care at the UNC FMC provided improved access for our patients, increased the number of patients empaneled in our primary care practice, and provided a new revenue stream.
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