April 2009

Allan L Crimm ACP Member at left reviews lab results and self-management goals with a patient as one aspect of services provided in a patient-centered medical home

Patients find medical home in Pennsylvania

A group of physicians in southeastern Pennsylvania are among the lucky and proactive few practicing in some of the first payer-supported patient-centered medical homes (PCMH) in the country.

Do placebos have a place in clinical practice?

Placebo use is common in internal medicine. But is it ethical? Experts examine the disconnect between the standards of medicine, and how it's actually practiced in the office.

Twitter: a medical help, hindrance or hype?

Imagine a future where you can with a click of the mouse see what your patients and colleagues read on the Internet this morning, what they ate for lunch, and what they're working on right now. Whether that sounds to you like a potential practice innovation or a disaster of oversharing probably indicates whether you'll have any use for Twitter, the most hyped Internet innovation of the year.

The timing is right, and possibly expandable, for giving tPA

Tissue plasminogen activator (tPA) was the star of the show at this year's International Stroke Conference 2009, with much discussion of expanding its treatment window, and several studies presented on gender differences in tPA treatment.

Help from afar: telemedicine vs. telephone advice for stroke

Experts sparred over whether telephone advice or telemedicine is best during a session at February's International Stroke Conference 2009 in San Diego.

Boxed warning for metoclopramide, alert for zonisamide

A summary of approvals, recalls, warnings and alerts.

National Trends

People under the age of 65 who had been uninsured for more than 12 months or were uninsured for any time up to 12 months previously were much more likely to have forgone needed medical care than those insured continuously for the whole 12 months.

In the News

New opioid therapy guidelines released; PFO closure may help migraines.

Internist searches for answers when test results go missing

An internist is surprised by a patient's previous blood work, which shows a dramatic rise in PSA levels. There is no evidence in the medical record that the patient was informed of, or that the internist acted upon, the prior abnormal PSA result. However, the internist is certain she never saw it. What should she do next?.

Unraveling autism's many causes, spread across the genome

Despite the 90% heritability of autism, suggesting a very strong genetic component to its etiology, zeroing in on the genetic underpinnings of this disorder has been very challenging.

Social networking is a hit but will it change practice?

There's been a lot of talk in the media lately about physicians' enthusiasm for social networking. But how will it impact on the way they practice medicine?.

What's new in other College publications

ACP Hospitalist, ACPNet, ACP Press, Annals of Internal Medicine, and others.

Unresolved health care reform issues mask real progress

ACP's outgoing president reflects on the past year with confidence that within the turbulent environment of primary care lies great opportunity.

Stimulus package part of down payment on health reform

Stimulus legislation enacted in the first two months of President Obama's administration show that the White House is serious about health care reform.

Expensive vaccines may wipe out wrong target—the doctor

New and expensive vaccines added to the schedule for adolescents, adults and children over the last several years have created a crisis in the delivery system that threatens to reduce or eliminate the private provider's role, say experts following the issue.

PQRI improvements based on physician feedback, says CMS

Medicare's pay-for-reporting program, the Physician Quality Reporting Initiative provides more and different options for physicians to report on quality measures, and staying current on the rules and requirements can be a challenge.

RVUs—the common denominator in financial management

In today's economy, tight financial management is more important than ever. Relative Value Units can be used as a powerful tool for financial management in medical practices.

Regents, Treasurer nominations

The Nominations Committee has begun the process of seeking candidates to fill Regent positions on the Board that will become vacant in 2010. The position of Treasurer will also open in 2010.

New Executive Committee for Board of Governors

ACP announces those who will officially take office as Class Representatives at the close of the upcoming Annual Business Meeting and serve in that capacity for one year.


Truman G. Schnabel, Jr., MACP; Maurice L. Kelley, Jr., FACP; and Maurice M. Burkholder, FACP.

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.

MKSAP Quiz: Cardioversion to restore normal sinus rhythm?

A 71-year-old man presents for a routine visit. He has a history of hypertension and atrial fibrillation.