Caring for patients in the shadows

This issue also covers suicide prevention, e-consultations, and new treatments for migraines.


Undocumented patients have always been a part of internists' practices, but with current policies cracking down on illegal immigration and stepping up deportation efforts, it may be even more difficult to provide them with adequate care. Patients who are not in the country legally may limit their contact with the health care system for many complex reasons, including fear for themselves and their families and inability to pay. Our story offers advice on caring for undocumented patients in today's climate, including tips on establishing cultural competency and building rapport.

The deaths of Kate Spade and Anthony Bourdain have recently focused a spotlight on suicide and potential ways it might be prevented. Clinicians, especially primary care physicians, may be in a good position to help. Staff writer Mollie Durkin reviews the literature surrounding screening for suicide and looks at how doing so can be incorporated into clinical practice, including how to train staff and follow up on results.

With the rise of EHRs and telemedicine, e-consults have become more common, offering primary care physicians a formal way to get subspecialist input, especially in underserved areas. But a recent survey revealed problems with these systems, too, such as increased stressors for the referring physicians. Our story looks at the survey's results and offers tips on how to make e-consult systems work better in practice, as well as in theory.

Migraines can be an intractable condition for many patients, so news of new drugs to prevent them, plus possibly more in the pipeline, has been greeted with enthusiasm. But some headache experts' reactions have been a bit more measured, given the limited data available on long-term effects and safety. Our story offers a review.

If you're looking for a new internal medicine podcast to listen to on your way home from work or at the gym, we have you covered. Our story provides an in-depth survey of what's available in the field, including a new offering, Annals On Call, from Annals of Internal Medicine. Another story looks at cardiac event recovery, and in a Q&A, a physician explains why she sometimes gives gifts to some of her patients.

What are your thoughts on caring for undocumented patients? Which internal medicine podcast is your favorite? Let us know.

Sincerely,

Jennifer Kearney-Strouse
Executive Editor