July/August 2009


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A brave new world of consumer gene tests

Direct-to-consumer tests are easy, cheap—and sometimes wrong. Yet, patients are handing them to their doctors on a weekly basis and asking for advice. Learn how to work with patients after they've sought out genome-wide analysis and then bring the results to doctors to sort out subtle meanings from often fallible tests.

Cardiac care critical for diabetic patients

Even the experts feel like they're missing potential cardiological complications in diabetic patients. They consider how to screen this population effectively for the 3% of patients who experience cardiac-related deaths.

The most promising drugs in the pipeline for primary care

An expert sorts through the drug research pipeline to find novel medicines that are relevant to internal medicine, including rivaroxaban for VTE, telcagepant for migraines and anacetrapib for increasing HDL.

Research at SGIM meeting targets prevention

From smoking to weight loss to vaccination, much of the research at the Society for General Internal Medicine annual meeting focused on preventive medicine. Researchers from around the country shared data on their efforts to keep patients healthy.

Medicine and management: hits from Hospital Medicine

An expert discusses managing aortic dissection as a disease for life. Also, highlights from Hospital Medicine 2009 discuss caring for the pregnant patient, documenting care for the best reimbursement and ways to improve handoffs from shift to shift.

For tobacco dependent, pharmacotherapy is the best medicine

Evidence is mounting that most smokers will require some sort of pharmacotherapeutic intervention to help them quit. Experts parse out prescriptions, but don't discount behavioral strategies for quitting.

Digoxin, Biosite Triage Cardiac Panel, insulin pumps recalled

A summary of approvals, recalls, warnings and alerts digested by ACP Internist from the Food and Drug Administration's alerts.

Start at the top to get to the bottom of a diagnosis

ACP Member C. Christopher Smith reconsiders a patient's self-reported diagnosis of irritable bowel syndrome to uncover the true cause of his symptoms.

Leadership Day launches new legislation for primary care

ACP members lobby their congressional representatives to plead their case for saving primary care, as well as introduce the “Preserving Patient Access to Primary Care Act of 2009,â€ï¿½ which proposes incentives to pay for care coordination and medical education.

Genomics impacts everyday practices in unexpected ways

The hospitalization of a relative sets a leader in genomic research musing about how far medical practice has advanced in treating a common condition, and how far cutting-edge advances could go.

Looking back: Some constants amid change

Looking back at the history of health care reform to gain insight on the future of primary care medicine.

What's new in ACP Hospitalist

What's new in ACP Hospitalist and other College publications, including a review of the impact of ICU glucose control for critically ill patients and the highly anticipated launch of MKSAP 15.

Universal care frees doctors to take ‘all measures required’

The ability of physicians to meet the new demands of a modern Hippocratic oath requires universal coverage as outlined by ACP.

Three keys to health care reform: change, buy-in and unity

Politicians acknowledge needing more primary care physicians, but paying for it requires support from elected officials and from the College.

Shared visits improve access, productivity and satisfaction

Shared office visits offer 90-minute blocks of time to groups facing common and chronic conditions. A few distinct models have gained broad acceptance by doctors and their patients.

Success Story: From peer review to practical application

While using the Epley Maneuver undoubtedly relieves benign paroxysmal positional vertigo, training staff in a new method presented obstacles. One physician explains how he implements dedicated teaching time for staff.

Future claims: Moving toward ICD-10 and new standards

ICD-10 and transactions standards are changing. ACP's practice management staff advise how to stay up-to-date across the entire office as Medicare expands its 13,000 diagnosis codes to more than 68,000.

The stimulus package and buying EHRs

The recent federal economic stimulus package set aside more than $17 billion for doctors and hospitals to adopt EHRs. ACP has developed extended guides to answer physician's questions about the incentives.

The search for answers is in his blood (and yours)

Joel Moake, FACP, explains his four-decades-long pursuit of new information in the field of hemostasis/thrombosis, and what attracted him to internal medicine.

Chapter awardees for spring 2009

In recognition of their outstanding service, these exceptional individuals received chapter awards in April, May and June 2009.

Obituaries

Included in this month's listings are former ACP President Ralph O. Wallerstein, MACP.

Urgent update on acute diarrhea

Unlike many of the conditions an internist treats, most doctors have had personal experience with diarrhea.

MKSAP quiz: Rash on the back of elbows and knees

A 50-year-old woman is evaluated for a rash on the back of her elbows and knees. A similar rash has occurred in the past, with her first episode as a young adult.A 50-year-old woman is evaluated for a rash on the back of her elbows and knees. A similar rash has occurred in the past, with her first episode as a young adult.