October 2010

Justen Rudolph ACP Member left Maria Stewart RN BSN center and Patricia McCormick RN CDE right evaluate a glucose monitor and results at St Vincent Healthcare in Billings Mont Photo b

Monitoring glucose minute by minute

Continuous glucose monitoring presents challenges not only to patients, but to internists learning how best to teach their patients how to use them. But with a lack of enough endocrinologists to care for the 1 million patients with type 1 diabetes, internists have to pick up the slack.

House calls becoming a viable practice model

Think of it as the patient-centered medical home's ultimate evolution##mdash;care inside the patient's own home. More doctors are making house calls, either to patients who don't travel easily, or to improve the quality of care they could deliver in an office.

Expressive writing could help erase irritable bowel syndrome

A pilot study may have found a new use for an established treatment. Expressive writing, used for other illnesses with a known psychological component, is now being studied to control the symptoms of irritable bowel syndrome.

Learning to learn: Simulators are easy, inexpensive to make

There's no need to spend hundreds of dollars on learning simulators when they can be made with supplies that cost pocket change and a few hours of time. Examples from the Herbert S. Waxman Clinical Skills Center provide step-by-step instructions for learning to drain an abscess.

Guidelines getting tougher on industry, but physicians are not

A survey of physicians found that respondents were comfortable with industry-sponsored lunches and other gifts, despite their institutions' prohibition against such practices. One physician discusses how to align medicine's ethical goals with physicians' attitudes.

Emergency contraception drug, flu vaccines approved

Recalls, warnings, approvals and other regulatory news.

Continuous glucose monitoring—a good fit for primary care?

Continuous glucose monitoring is a complex task, even for physicians. Internists will have to step in to help endocrinologists manage the rising population of type 1 diabetics.

When patients don't tell all: The diagnostic challenge

Patients don't always disclose aspects of their history that may be shameful or stigmatizing, posing a challenge of attribution errors for physicians.

Change for the future and a look at the past

A look back at where internal medicine has been provides insight into the future of what health care might become.

Health care reform, PCMHs forge a new path for primary care

A new focus by health care reform advocates on the patient-centered medical home will forge a path toward financing and delivering primary care.

Annual ICD-9 diagnosis code revisions take effect in October

A review of the annual updates to ICD-9 code set finds that there are more codes affecting internists than in years past. ACP digests these, as well as category headings and exclusion notes.

Another security risk: The copy machine

Your office photocopier stores permanently every image it's ever scanned, copied or faxed. Those images stay with the machine after it's re-sold, and the images can be easily hacked. Learn how to maintain security over medical records, taxes, bank statements##mdash;or any other document that's ever been copied.

Chapter Awardees

In recognition of their outstanding service, individuals received chapter awards in September and October 2010.

MKSAP Quiz: Assessment of exertional dyspnea

A 70-year-old man with a history of a systolic murmur presents for further assessment of exertional dyspnea. He has had dyspnea his entire life, but has noted a recent deterioration in his exercise capacity. What is the most likely diagnosis?.