American College of Physicians: Internal Medicine — Doctors for Adults ®

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How to spot eating disorders in primary care

From the February ACP Internist, copyright 2013 by the American College of Physicians

Eating disorders affect a substantial portion of the U.S. population, men as well as women, and internists can often be the first to suspect something is wrong. But diagnosing a condition such as anorexia nervosa, bulimia nervosa, or binge eating disorder is a complicated proposition. Some primary care physicians may be reluctant to screen for eating disorders for fear of getting in over their heads, experts say, and some patients, especially those with anorexia, will go to great lengths to hide their problems. In our story, Terri D’Arrigo looks at the most common signs and symptoms of eating disorders, the most efficient ways to screen for them, and which patients are most at risk.

Patient self-management of chronic conditions is not a new idea, but the best ways to make it work are often under debate. The most important, some experts say, are flexibility and patience. Physicians might not always have time for the lengthy patient engagement that’s required for lasting change, so turning the nitty-gritty over to a trained health coach might be advantageous. In addition, clinicians will need to figure out what makes each patient tick, and what triggers will motivate them to permanently engage in their own care. Charlotte Huff examines different strategies for making patient self-management work in a primary care office.

It’s winter, but that doesn’t mean patients or physicians can forget about skin cancer, which should be a concern at all times of the year. As with eating disorders, primary care physicians can often be the first ones to notice a problem. Experts recommend focusing especially on high-risk populations, such as patients with fair skin and blue eyes, and keeping an eye out for the “ugly duckling sign,” that is, a mole that looks different from others. Read what to watch for in your patients.

2013 will bring big changes in practice management, and it can be difficult for physicians to keep track. Neil Kirschner, ACP’s senior associate for regulatory and insurer affairs, provides an overview of what to expect in terms of both incentives and penalties. Finally, read a profile of Ruth-Marie (Rhee) Fincher, MD, MACP, a leader in medical education, and learn more about ACP’s latest international efforts in India.

Do you have a comment or question about our coverage? Please let us know. We always enjoy hearing from you.

Sincerely,
Jennifer Kearney-Strouse, Editor

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