More debate about mammography

This issue covers the debate about breast cancer screening, medication adherence, and the ethics of students who follow up on patients by using the electronic medical record.


The benefits of mammography are perennially debated, with many factors affecting the pros and cons. Overdiagnosis has been one of the recent issues potentially tilting the scales: A study published in Annals of Internal Medicine earlier this year found that almost 39% of invasive cancer detected with biennial screening in women ages 50 to 69 was overdiagnosed. But while overdiagnosis can have harmful effects such as unneeded testing and procedures, some women may be willing to take that risk. The trick, experts say, is balancing data on benefits and harms against patients' individual preferences and characteristics and, above all, respecting their autonomy. Read our story for the latest on this ever-changing issue.

Another complicated topic is medication adherence, the subject of another story this month. Although physicians realize that many patients, even those with serious medical conditions, don't take their medications as prescribed, it's still often difficult to do anything about it. Staff Writer Mollie Durkin talked to experts in medicine and technology about the best ways to determine if patients are adhering (simply asking if they are is not enough), why a trusting relationship is important, and what new tools might be on the horizon to help.

Speaking of technology, a recent study found that medical students at one facility often reviewed their former patients' EHRs to see how their conditions resolved and follow up on their outcomes. Although understandable, and arguably even responsible, this practice raises questions of medical ethics that may not have come up as readily in the days of paper charts. Our story gets the opinions of educators and ethicists on what's allowable and when.

Many physicians may be interested in volunteer work, but some aspects may be different from what they might imagine, according to our Q&A with an ACP Member and seasoned volunteer. Pediatric patients are far more common than adults, for example, and project management often takes up more time than hands-on clinical care.

Last but not least, ACP will hold Internal Medicine Meeting 2017 in San Diego from March 30-April 1. As always, our staff will be on site to bring you the latest news. Check our Twitter feed (and follow the hashtag #im2017) and our daily e-mail dispatches to stay up-to-date, and go online for more meeting information, including registration. Let us know which sessions interest you most.

Sincerely,

Jennifer Kearney-Strouse
Executive Editor