In a growing number of states, 14 at last count, it's now legal for patients to use medical marijuana, as long as they have a doctor's written authorization. Supporters hail such measures as boons for patients with intractable pain and similar conditions. Critics say they're just a roundabout way of legitimizing a dangerous gateway drug. But for physicians approached by patients looking for “permission” to use marijuana, the answer isn't always a simple one. Our cover story looks at how to handle these requests.
Evidence on the pros and cons of statins for primary prevention of cardiovascular events seems to change daily. Some advocate statins for almost everyone, while others urge caution and warn of the risk of serious adverse effects. Recent studies have pointed to more widespread use, while others have shown no benefit. How should internists sort through the recommendations and evidence to provide appropriate care? Paula S. Katz talks to experts in the field about how and when they initiate statin treatment and where the current evidence seems to be headed.
Primary care physicians looking for more information on meaningful use of electronic health records should read the perspective of David Blumenthal, FACP, the White House's national coordinator for health information technology. In a webinar in August, excerpted in this issue, Dr. Blumenthal addressed such topics as the specifics of the incentive program, the timeline for implementation, and how to sign up.
Finally, what do you think would happen if you phased out your waiting room and had patients proceed directly to exam rooms as soon as they arrived at your office? One practice in Wisconsin tried this method of “self-rooming” and found that it decreased waiting time, increased patient and staff satisfaction and heightened patients' privacy.
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