November/December 2012

Illustration of a renal glomerulus with diabetic glomerulonephropathy Shown are changes related to diabetic renal disease hyaline degeneration of the arterioles fibrin cap formation among the tuft

‘Goldilocks' goal for diabetes and CKD

Managing kidney disease in diabetes requires meeting individualized parameters and balancing risks in nephrology and cardiology. Learn whether more aggressive treatment is warranted in this population.

Doctors don't have to dread discussing dieting

Many internists are not discussing obesity and weight loss with their patients, even though they have the best opportunity to offer counseling about diet and new drugs that are now available to help.

Spare the emergency visit for skin and soft-tissue infections

Internists can save patients the anxiety, time and expense of an emergency department visit by screening for severity of most infections, experts say. The focus should be on acuteness and the factors surrounding onset of symptoms.

Pilot program offers a road map for PCMH model of care

Internists who have attempted to convert to a patient-centered medical home model have quickly learned the process isn't always easy. But a pilot program found the results appeared worth it: fewer emergency visits and patients who take better care of their own health.

Generic pioglitazone, new HIV combination pill approved

This regulatory update covers approvals of the first generic form of pioglitazone and a combination form of emtricitabine, tonofavir and two new drugs for patients new to HIV treatment.

Expanding Medicaid is the right thing to do for public health

Expanding Medicaid will be a state-by-state effort on the part of ACP members.

Spending on physician services, take two

Reform is required in how physicians are paid, including a more rigorous analysis of the relative value of services and compensation for the cognitive work done outside of the patient encounter.

Letters to the Editor

A reader laments that changes in health care result in physicians no longer knowing their patients as well as they used to, but only as episodes of care.

New research, drugs may change care of common conditions

Developments in fields such as diabetic nephropathy and weight loss share a common theme: There is no magic bullet. The solution is to offer care tailored to the patient.

Variety of coding changes loom for 2013

A partial freeze on diagnosis coding updates has been extended one year, while new care management codes will be introduced in 2013.

Small practices prepare for ACOs

Small practices are wondering how they will fit into the larger networks of accountable care organizations that are springing up nationwide. There are three small steps practices can take as the issue sorts itself out.

Nominees named for College Officer, Treasurer and Regents

The Governance Committee of the American College of Physicians placed in nomination candidates for leadership positions.

MKSAP Quiz: Foot pain following catheterization

A 68-year-old man was admitted to the hospital 3 days ago for a non-ST-elevation myocardial infarction and underwent cardiac catheterization via the right groin. Today, the patient reports pain in his left toes and diffuse soreness in the left calf. Following a review of the medical history, physical exam and lab values, what is the most likely diagnosis?.