July/August 2012

Baby boomers' health isn't what they expect

The normal aspects of aging will place extraordinary demands on the health care system as the baby boomers enter their retirement years. Sheer numbers, coupled with high expectations of this population, pose a problem for primary care.

Disease Management

Better treatment, low awareness for hepatitis C

Amid rising rates of long-term hepatitis C infection, particularly among older populations, better treatments are able to treat the condition. But first, patients have to know they have it, and internists have to be able to recognize the diagnosis.

Lipid Management

Assess statin-associated myalgia on a patient-by-patient basis

Statin-associated muscle pain is controversial and poorly understood. But the consequence of stopping cholesterol drugs has a much clearer downside. Counsel patients on potential side effects, and let them know that switching is preferable to stopping.

Practice Rx

Chronic disease model helps improve smoking cessation efforts

Smoking cessation programs are traditionally treated as discrete, standalone attempts. One program applied dedicated counselors who could form a relationship with the patient over long stretches of time, resulting in better success.

Q and A

Risk of financial abuse in elders should draw internists' attention

An expert counsels internists to consider screening their elderly patients for financial abuses, from investment scams to pressure from family members. Doctors can partner with financial experts to prevent financial exploitation.

FDA Update

Cautions about mixing HIV, HCV drugs

This regulatory update covers a warning about giving boceprevir with some ritonavir-boosted HIV protease inhibitors, as well as approval of a new erectile dysfunction drug.

Gray Matters

Advance directives are the beginning of care, not the end

Despite the best planning, patients may change their minds at the end of life once they recognize their unique situations and their sometimes surprising decisions.

Practical Genomics

Determining actionability of genetic findings in clinical practice

Just as radiology screenings can return results of incidentalomas, genetic scans can also return inadvertent findings. But some guidance can be taken from criteria developed in 1968 for adopting any screening test.

President's Message

Team performance defines practice success

An entire team of clinicians is responsible for good patient care, and it is time to consider practice models and medical society memberships that reflect this necessity in the modern era.

Washington Perspective

Positions on health care reform aren't all black and white

ACP's health care positions can't be neatly labeled as coming from one political perspective or another. A wide array of issues requires consideration.

Practice Rx

Learn proper coding for modifiers 59 and 25

Learn how to properly use two similar evaluation and management codes to avoid later denials and challenges.

Practice Tips

Why job descriptions matter

Job descriptions not only help practices hire and retain the right employees, they can also have a positive effect on productivity and profitability.

Editor's Note

Meeting baby boomers' high expectations

Baby boomers may seek a level of health care that isn't always realistic. Learn how to address their needs while carefully transitioning them into their golden years.

Test Yourself

MKSAP Quiz: History of diffuse headache, fatigue

A 27-year-old woman is evaluated in the emergency department for a 2-day history of diffuse headache, fatigue, and gingival bleeding on brushing her teeth. She is otherwise healthy. She is alert and oriented but reports having a headache. Petechiae that had gone unnoticed by the patient are visible on the lower extremities. What is the most appropriate next step in management?.

Political Advocacy