Readers respond to ACP Internist's coverage. Regarding the article “Bringing Medicine to the Streets” in the July/August 2019 ACP Internist, I had the opportunity to know James S. ... I did have the opportunity on several cold winter nights to travel
First, many physical examination maneuvers (tests) have well-established sensitivities and specificities, as useful to the clinician as those for laboratory tests. ... Second, the practice of predicting what a laboratory test might demonstrate based on
Reader comments on the role of ancillary services in an internal medicine practice, and on the need for attention to nutrition and lifestyle in caring for rheumatoid arthritis. ... As for the comment by ACP's senior associate Ms. Williams that these are
A different approach to pain. I read the article “Seeking clarity for opioid prescribing” in the April ACP Internist, and I believe it is time for the medical community to scale ... Overzealous efforts must be replaced by research-proven methods to
to go to the hospital to care for the patient with sudden critical illness. ... That illness, and the doctor's struggle to help, is not caused by global warming at all.
I could not find any symptoms or signs relating to the head or the nervous system. ... I suffered three more days of agony on ineffective proton pump inhibitors until readmission to the hospital and a hepatobiliary iminodiacetic acid scan revealed a
The principles of anchoring and availability are ones to guard against in all areas of medicine. ... I made notes as I read, listing the differential diagnoses and trying to keep the list as short as possible.
to point out until late in the piece the easiest and least expensive way to diagnose it—examine the patient. ... As a matter of fact, if the patient has good-quality pedal pulses it is unlikely that those above will be impaired; they need to be
It is usually appropriate for consultants to explain to the patient what they have found and what recommendations they will make to the referring physician. ... If consultants have not yet discussed their findings with the patient, it's appropriate to do
By Janet Colwell, Editor. ... College members pushed for approval of $500 million to fund a Medicare pilot of the patient-centered medical home but it was a tough sell.