ACP Internist - July/August 2011
Promoting literacy to increase adherence
Roughly 80 million Americans navigate health care's complexities with limited health literacy skills. Learn easy steps that help patients understand what they need to do, without formal literacy screening or potentially embarrassing questions.
Aiding patients' decisions on PSA screening
There are many tradeoffs made when advising patients about whether to routinely screen for prostate cancer using prostate-specific antigen. Amid side effects of treatments and conflicting guidelines from professional societies, physicians and patients must come to a decision. Addressing six points directly and honestly can help.
Tread lightly: Discussing obesity difficult for internists
Physicians are ill-equipped to dicuss obesity with their patients, a problem created by a lack of training in medical school, no clear guidelines on what screening should consist of, and a lack of confidence that patients would act on such counseling. But done properly, such discussions help twice as many patients lose weight.
Computers and Medicine
Use caution when seeking medical information online
Researching medical knowledge online involves knowing three different types of resources, summary sites, society sites and primary literature. Knowing when to use each ensures the physician makes the correct diagnosis, and preserves the patient's confidence.
Warfarin recalled, type 2 diabetes drug approved
Recalls, warnings, approvals and other regulatory news.
Priming to diagnose an atypical case, avoid representativeness
A patient's deteriorating mental health status points to an underlying cause. But it takes “priming” for an endocrinologist to look for the right diagnosis despite the lack of a prototypical case.
How today's health care teams can play to win
Chronic, complex diseases require a team approach. The size of these teams is growing, as are the types of people involved in them. Internists must be key players to provide high-value, cost-conscious care.
When will the lights go out on fee-for-service?
Reimbursement for medical care should be based on value, not on procedures. A long-term solution must include pilot programs of new approaches and stabilized reimbursement during their rollouts.
Are your patients health literate?
This month's issue wraps up health literacy, prostate cancer screening guidelines and a look at how “priming” guided a physician to make the correct diagnosis.
Medical School Debt
Med school debt becomes budgeting burden for primary care
A newly minted primary care physician graduates with a budget that can leave him or her $800 in the red each month. The debt leaves primary care physicians feeling undervalued compared to their subspecialist counterparts, especially since they consider their work to be as hard and as important.
Incentive programs yield mixed results for expectant internists
Three programs that promised more reimbursement for primary care delivered mixed results. The Centers for Medicare and Medicaid Services laid out who actually received more for participating in these programs, and how much.
Hang out a digital shingle
Establish your practice in the digital world as well, using a website and social media to bolster your presence.
ACP members tell Congress their views on SGR, health reform
Internists descended on Capitol Hill to explain how the legislative process impedes good clinical care. The legislators agreed with the doctors on that. But disagreement on health care reform left physicians and politicians with a cynical view.
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