Archive - March 2013
Start with bloodwork to diagnose anemia
Anemia is fairly common, but its many etiologies complicate diagnosis. It affects more than one in five black and Hispanic people, one in 10 seniors and one in five of those over the age of 85. Learn how to fine-tune the diagnosis to best help patients.
New research links empathy to outcomes
Everyone wants to have a physician who understands what they’re feeling, but it’s not just about human contact; better clinical outcomes can result from physician empathy.
Decision-making rules for diagnosing PE may save lives
Early detection of pulmonary embolism is critical, which puts the primary care internist on the front lines of preventing a patient’s continual deterioration that culminates in death. Patients are as likely to present in the office with symptoms as they are at the emergency department.
Warning about using sodium oxybate
This regulatory update covers warnings against mixing sodium oxybate with alcohol and against using dabigatran in patients with mechanical heart valves.
Internists should pursue innovative practice models
The patient-centered medical home and the accountable care organization allow internists to do a better job caring for patients, and there is at least some early evidence that they may reduce the costs of care.
Physicians, firearms and frustration over gun violence
Physician silence on gun control puts children and adults at risk from a person using firearms to harm them, in their classrooms, in their own homes, in their workplaces and on their neighborhood streets.
The Patient’s Voice
Patients and families can help reinvent health care
True engagement requires listening and learning, making patients and families partners not just in decisions about their individual care but in designing practices and systems that will work for them.
Anemia often hides in plain sight
Learn how doctors can best spot anemia, or improve patient relationships and possibly outcomes by using empathy.
ICD-10 advice, and clarifying transitional care management
The reset compliance date of Oct. 1, 2014, means that internists must move forward with transition and education plans for using the new ICD-10 codes. Start by examining documentation needed to assign the new codes.
How to financially survive in a hospital-owned practice
As more and more practices move to a hospital-employed model, internists will have to engage in due diligence about how the change affects billing, service contracts and collections.
Value-based payments a new source of reimbursement, penalties
Value-based payments are meant to adjust Medicare and Medicaid payments according to performance. Take concrete actions to recoup more reimbursement and avoid nonparticipation penalties.
Officer, Treasurer and Regent election results announced
Meet the incoming Chair-elect of the Board of Regents, the new Treasurer and new Regents who will be confirmed at Internal Medicine 2013.
New sessions, credits and speakers at Internal Medicine 2013
Learn about the upcoming products, programs and services that will be offered at Internal Medicine 2013 in San Francisco.
From the MKSAP case studies
A 45-year-old woman is evaluated in the emergency department for headache and impaired consciousness 60 minutes after onset of symptoms. She has a history of hypertension treated with lifestyle modification. The patient has a 20-pack-year smoking history. On physical examination, blood pressure is 158/68 mm Hg, pulse rate is 68/min and regular, and respiration rate is 16/min. Nuchal rigidity is noted. The pupils are reactive and symmetric in size and shape. On neurologic examination, the patient requires constant painful stimuli to follow commands and answer questions and moves the left side of the body less than the right. Results of funduscopic examination are shown. What is the most appropriate diagnostic test?
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