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

 
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Archive - October 2014


Diabetes

Treating glycemic control in the elderly

Treating glycemic control in the elderly

By Stacey Butterfield

The challenge in diabetes treatment used to be getting patients’ blood glucose low enough. But recent evidence has shown that, at least for elderly diabetics, hypoglycemia may be as much or more of a problem as hyperglycemia.

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Medicare

Release of Medicare pay data raises questions

By Charlotte Huff

The release of a massive amount of data about how much physicians had received from Medicare in 2012 was a sign of price transparency to some and an unwelcome intrusion to others. The raw data didn’t tell the entire tale, critics said.

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Palliative Care

A doctor seeks ways to encourage earlier palliative care talks

By Ryan DuBosar

Palliative care doctors are working on introducing the concept of palliative care across disciplines, with a particular focus on primary care. The goal is to introduce it earlier in the process of patient care, and earlier in the educational process of the physicians themselves.

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Flu Season

Data drive debate over antivirals, theory vs. practice

Data drive debate over antivirals, theory vs. practice

By Stacey Butterfield

Physicians should focus not only on influenza vaccinations but on treating patients who will get the disease whether they have been vaccinated or not.

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Disaster and Recovery

Joplin hospital rebuilds, better than before

Joplin hospital rebuilds, better than before

By Stacey Butterfield

After a tornado in 2011 destroyed St. John’s Medical Center in Joplin, Mo., a new facility will open that will focus on a patient-centered experience, from the aesthetics to the wayfinding to storage and security.

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Infectious Diseases

New antibiotics may change inpatient skin infection treatment

New antibiotics may change inpatient skin infection treatment

By Stacey Butterfield

Physicians have a few new drugs in their armamentarium for skin and soft-tissue infections.

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Infectious Diseases

A tasty potential solution to recurrent Clostridium difficile

A tasty potential solution to recurrent Clostridium difficile

By Stacey Butterfield

One hospital sought a way to treat recurrent Clostridium difficile infections in patients unwilling or unable to undergo fecal transplantation.

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Physician Profile

AMA’s immediate past president reflects on medicine’s future

By Ryan DuBosar

Ardis Dee Hoven, MD, FACP, used her year as president of the American Medical Association to bolster the role of primary care physicians across the field of medicine.

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President’s Message

Institute of Medicine report falls short on primary care training

By David A. Fleming, MD, MA, FACP

Organized medicine reacted with concern to a proposal to restructure graduate medical education that did not take into account the looming shortage in primary care.

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Washington Perspective

Government dysfunction: It’s enough to make a grown man cry

By Robert B. Doherty

A host of issues highlight the dysfunctional approach that federal and state governments have taken toward issues with a direct impact on health care.

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Editor’s Note

Managing diabetes meds more complicated in elderly patients

By Jennifer Kearney-Strouse

This issue covers topics including management of diabetes in the elderly, the public release of Medicare payments to physicians, and new approaches to antivirals as flu season begins.

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Practice Rx

Accurate coding of the Initial Preventive Physical Examination

By Brian Outland

It is important for internists to understand and plan for the Initial Preventive Physical Examination, a one-time visit for new Medicare beneficiaries.

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Practice Tips

Is ‘secure’ texting an oxymoron or a possibility?

By Margo Williams

Electronic health communication in health care must be secure. Text messaging is not, but it’s how many patients want to talk with their doctors. Consider the ramifications of a message that gets misplaced, and then consider other ways of communicating.

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FDA Update

New diabetes drug, LABA for COPD, skin antibiotic approved

New diabetes drug, LABA for COPD, skin antibiotic approved

By Stacey Butterfield

This update covers approval of a sodium-glucose co-transporter 2 inhibitor for diabetes, a once-daily long-acting beta-adrenergic agonist (LABA) for chronic obstructive pulmonary disease (COPD), and a new intravenous drug for bacterial skin and skin-structure infections.

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Test Yourself

From the MKSAP case studies

From the MKSAP case studies

A 60-year-old man is evaluated for chest pain of 4 months’ duration. He describes the pain as sharp, located in the left chest, with no radiation or associated symptoms; it occurs with walking one to two blocks and resolves with rest. Occasionally, the pain improves with continued walking or occurs during the evening hours. He has hypertension. Family history does not include cardiovascular disease in any first-degree relatives. His only medication is amlodipine. Following a physical examination and electrocardiogram, what is the most appropriate diagnostic test to perform next?

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Crossed Words

Going viral

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

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