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

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Archive - April 2014


Hypertension

For hypertension, how low to go?

For hypertension, how low to go?

By Charlotte Huff

Updated blood pressure guidelines may have created more questions than closure, internists have found, as they try to determine how aggressively to treat hypertension and what goals to set for subpopulations of patients, such as those with diabetes. Experts react to the “paradigm shift” in lowering hypertension.

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Men’s Health

Maintaining men’s health in middle age

Maintaining men’s health in middle age

By Leah Lawrence

Adrenopause, somatopause, andropause … manopause? They all give internists pause when considering men’s health as they reach middle age. As men try to maintain optimum health, doctors need to define what exactly that is.

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Rehabilitation

Refine your referrals to physical rehab with thought, timeliness

Refine your referrals to physical rehab with thought, timeliness

By Stacey Butterfield

Internists can vastly improve outcomes for patients by referring more patients to physical rehabilitation earlier, more often, and for more conditions than they might think.

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Hospital Medicine

Unique state of payments as Maryland uses uniform prices

By Stacey Butterfield

Hospital charges in Maryland have been set by the state for 4 decades, and more reforms are on the way. The effort has led to all insurers paying the same price for the same services in the same hospitals, and now, the state is looking to improve facilities’ readmission rates and other quality metrics.

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Conference Coverage

Potential changes questioned for advanced cardiac life support

Potential changes questioned for advanced cardiac life support

By Jessica Berthold

The Advanced Cardiac Life Support guidelines are due out in 2015 and may pose some shocking changes: faster beats-per-minute chest compressions, a de-emphasis on hypothermia, and a new length of time for continuing cardiopulmonary resuscitation.

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President’s Message

ACP and the ‘house of medicine’

By Molly Cooke, MD, FACP

ACP’s outgoing president reflects on her past year, milestones the College has achieved, and what future goals remain.

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Washington Perspective

What did 11 years, 16 patches, and $154 billion get us? Nothing

By Robert B. Doherty

There are plenty of examples of wasteful government spending, but the sustainable growth rate formula is hard to top.

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Resident’s Corner

Better, not broken: pursuing empathy during medical training

Empathy is a crucial element to good care and improved patient outcomes. Why doesn’t medical education promote more of it?

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Editor’s Note

Hypertension guidelines lead to vigorous debate

By Jennifer Kearney-Strouse

This issue includes stories centered on various aspects of hypertensions, as well as topics specific to mean’s health, electronic health records and physical rehabilitation referrals.

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Practice Rx

ICD-10 will require more precision in documenting visits

ICD-10 will require more precision in documenting visits

By Debra Lansey

ACP staff answers questions that have arisen as members ramp up their efforts to comply with the new implementation standards.

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Practice Tips

Connecting the dots—why benchmarking matters

By Margo Williams

Efficient practices not only run better, they offer better patient outcomes. Benchmarking is the first step in this process because it shows where to focus attention first.

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FDA Update

Cardiac risks of testosterone, saxagliptin under investigation

Cardiac risks of testosterone, saxagliptin under investigation

By Stacey Butterfield

This regulatory update covers an FDA review of the risk of stroke, heart attack and death in men taking testosterone products, as well as a possible increase in heart failure associated with saxagliptin.

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Practice Management

EHRs’ advantages may carry malpractice risks as well

By Alicia Gallegos

Electronic health records have numerous advantages but also some potential pitfalls, as design flaws, complex templates and structured progress notes may lead to more complexity and more challenges to defense against malpractice.

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College Watch

ACP Annual Business Meeting

The ACP Annual Business Meeting will occur at Internal Medicine 2014 in the Orange County Convention Center on Saturday, April 12, from 12:45 p.m. to 1:45 p.m.

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Test Yourself

From the MKSAP case studies

From the MKSAP case studies

A 59-year-old woman is evaluated in the emergency department for midsternal chest pain. The pain began several hours ago as a vague ache in her left upper sternal region that progressed in intensity and severity. The pain abated spontaneously after approximately 45 minutes. She had no further chest pain until several hours later, when it recurred unprovoked by exertion. She has no shortness of breath, nausea or vomiting, syncope, previous history of chest pain, or known cardiac disease or risk factors for venous thromboembolism. Medical history is significant for hyperlipidemia and hypertension. She does not smoke cigarettes. Medications are simvastatin, aspirin, lisinopril, and hydrochlorothiazide. Following a physical exam, electrocardiogram and chest radiograph, what is the most appropriate initial management?

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Crossed Words

Spitting into the wind

ACP Internist’s puzzle feature challenges readers to find clues placed horizontally in rows to reveal an answer written vertically.

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