November/December 2015


Illustration by David Cutler

Calculating risk for cholesterol drugs

Differing guidelines and a new class of drugs may cause uncertainty on the part of patients and practitioners.

Wearable tech shows promise in clinical care

Smart watches and fitness trackers could offer a remote connection to patients, as well as a way of tracking their progress on meeting health goals. But their application depends on the patient and the physician.

Chronic pain program provides model for small practices

New laws in Kentucky meant to curb opioid misuse were drafted from the standpoint of law enforcement and not medical practice, leading to areas of confusion for clinicians and their staff. ACP created a model that practices could follow to improve care for patients.

Screening for PTSD after life-threatening medical events

Internists are in position to screen for and spot signs of post-traumatic stress disorder following life-threatening medical events such as heart attack and stroke. Yet this is not always part of usual care.

Clinical reasoning now a ‘foundational basic science’

An important and emerging need for medical students is developing the ability to apply knowledge and use it to determine the correct diagnoses for individual patients. Diagnostic reasoning has only recently begun to be specifically taught in medical school and residency.

Improving the practice environment and payment reform

Recent examples and accomplishments of ACP advocacy toward improving the practice environment include increasing payments to internists, reducing administrative burdens, promoting continuity of care and access to physicians, and reducing the costs of prescription drugs.

New warnings added on multiple diabetes drugs

This update also covers a risk evaluation and mitigation strategy for liraglutide and approval of a new PCSK9 inhibitor.

How's Obamacare doing in getting people covered?

With the Affordable Care Act in the midst of its third annual open enrollment period, more people are insured and most enrollees like their coverage. But now, it may be getting harder to sign people up.

Benefits of clearly defining value in patient care

Physicians have always been charged as agents to advocate for patients' best interests. Simultaneously, however, they are tasked with considering using resources wisely. These commitments can sometimes conflict and create tradeoffs in clinical decision making.

Cholesterol management becomes more complicated

This issue covers topics such as cholesterol management, wearable health care technology, and post-traumatic stress disorder after a life-threatening illness.

Helping Medicare patients save money on their medications

The cost of medications can be a significant barrier for many patients who are on a fixed income or who might be taking multiple, sometimes expensive drugs. Medicare Advantage and Medicare Part D plans might provide a solution for your patients, and there are tools to help with the enrollment process.

MKSAP Quiz: 1-month history of a skin ulcer

A 24-year-old woman is evaluated for a 1-month history of increasing pain and bleeding from a skin ulcer next to her stoma. The skin symptoms get worse each time she changes her appliance. She underwent proctocolectomy 4 years ago for medically refractory colonic Crohn disease. She has not had small-bowel involvement, and her ostomy output has been stable since surgery. Following a physical exam and skin findings, what is the most likely cause?.

2005-2015: ACP hits 100; still going strong

ACP pursues political goals, such as health care reform and the reduction of firearms-related deaths and injuries.

Chapter awardees

Chapters honor Members, Fellows, and Masters of ACP who have demonstrated by their example and conduct an abiding commitment to excellence in medical care, education, research, or service to their community, their chapter, and ACP.

Nominees named for College Officer and Regent positions

The Governance Committee of the American College of Physicians places in nomination candidates for President-elect, Treasurer, and other positions.

Obituary

ACP recognizes former College officials who have passed.