Overlooking PAD in primary care

Peripheral artery disease (PAD) is a common, and significant, problem estimated to affect up to 12% of people in the United States. But although it's an ideal disorder for effective management in the primary care office, patients with PAD are often overlooked or misdiagnosed, experts say. One of the chief problems is that PAD symptoms can be mistaken for natural signs of aging, or dismissed until the disease is more widespread. In our cover story, Kathy Holliman examines some key ways to improve PAD diagnosis and treatment.

We've written before about the best way for internists to ensure that their primary care patients are also getting good mental health care. Typical challenges include difficulties making referrals and obtaining adequate reimbursement. Stacey Butterfield looks at some innovative programs that are turning existing models on their heads.

Rates of recommended vaccination in adults are far from optimal, coming in well short of the federal government's Healthy People 2010 goal of 60% among high-risk patients younger than 65. William Schaffner, MACP, president of the National Foundation for Infectious Diseases, speaks with ACP Internist about some of the obstacles to increasing adult vaccination rates.

Those of you who've made the trip to ACP's annual meeting in the past are no doubt familiar with the Herbert S. Waxman Clinical Skills Center. At Internal Medicine 2011, taking place this month in San Diego, one of the featured activities will involve simulation of the ophthalmoscopic examination. For an inside look at how the model works and how to put one together, turn to our Learning to Learn column.

If you're attending Internal Medicine 2011 this year, you can visit the Waxman Center in person. The ACP Internist staff will also be on site to bring you the latest news. Our blog and our Twitter feed will be updated daily, and we'll be sending you up-to-date coverage via our daily e-mail dispatches. Stop by our booth at the ACP Resource Center to say hello and share your ideas. If you're not attending, you can reach us, as always, by e-mail.

Jennifer Kearney-Strouse