May 2011

Illustration by David Cutler

Food allergies are a tough nut to crack

As public awareness of food allergies increases, identification and management into adulthood can be difficult to sort out, carrying the risk of misdiagnosis, according to specialists who are trying to improve physician education.

Internists don't need to defer treating pain

Pain is one of the most common symptoms seen by primary care physicians, but it can be the most difficult to handle. Chronic pain often requires time-intensive, complex regimens that call for careful management and monitoring, which is not easy to achieve in a busy primary care practice.

Opioid abuse potential prompts monitoring role for internists

Opioids can be used safely for pain management in most patients, but for a small but significant percentage, there is a real chance of addiction and other harms. Experts increasingly look to the prescribed drugs in a medicine cabinet as a source of concern.

New algorithm helps weed out unneeded drugs in the elderly

Geriatrician Doron Garfinkel, MD, developed the Good Palliative-Geriatric Practice algorithm for discontinuing elderly patients' unneeded medications. In a study, he showed how it led to discontinuing 58% of the drugs taken by a group of community-dwelling elderly.

Attribution error results from a positive stereotype

A 58-year-old man with type 1 diabetes at age 38, a case of latent autoimmune diabetes of adulthood, reports worsening control of his blood sugars despite increasing doses of insulin. An internist must sort through the facts of the case to find out what's responsible.

Dealing with food allergies, chronic pain

Food allergies can represent a complicated area of diagnosis and treatment for internists.

Letter to the Editor

A reader responds about physical exams for PAD.

Reclaiming who we are: Internal medicine's central role

Internists must use their admirable heritage to provide the best care for patients and reclaim internal medicine's central role in delivering health care.

Health care reform gets mixed reviews one year later

It's been a little over one year since the Affordable Care Act was signed into law by President Obama. How is it faring?.

Medicare updates affect audits, modifiers and version 5010

This month's column covers three timely yet disparate topics: a new CPT modifier, readiness for Version 5010 electronic claims transactions, and the looming expansion of the recovery audit contractors.

Tips and tricks for hiring the right people

Hiring new staff costs both time and money, and frequently a 30- to 45-minute interview is the only opportunity to determine whether a person will succeed in your practice. Here are some tips on ways to increase the odds of making a good hire.

ACP offers internists a voice in crafting performance standards

The College has a Performance Measurement Committee to represent its member physicians in national measurement programs and to ensure that nationally endorsed performance measures are based on high-quality evidence.

Governance committee seeks Regent candidates for 2011

The Governance Committee oversees the process for nominating and electing Masters and Fellows of the College to the Board of Regents (BOR) and is beginning the process of seeking Regents to join the Board in May 2012.


William C. Waters III, MACP.

MKSAP Quiz: Burning, itching on the mid-back

A 49-year-old woman is evaluated for recurrent burning and itching on her mid-back that have been present for 2 years. Physical examination discloses ill-defined hyperpigmented patches on the mid-back below the medial aspect of the scapulae, as shown. What is the most likely diagnosis?.