April 2013

Chest radiograph showing right ventricular hypertrophy in a patient with pulmonary hypertension Photo c American College of Physicians

Learn to see signs of an often fatal disease

Pulmonary arterial hypertension can be recognized and treated. But it remains a diagnosis that is often missed, and the delay can lead to a rapidly progressing and fatal outcome. Learn the signs beyond a patient who reports “being out of breath.”.

Work-life balance easily upset, tough to restore

Doctors sometimes struggle with their own poor health choices, as busy days in the office are carried home. Burnout, depression and stress can lead to smoking, drinking and weight gain. Find a balance that works.

Probiotics have potential, though definitive evidence is lacking

Probiotics are gaining some rationale for use##mdash;not for everything, but for preventing anti-biotic-associated diarrhea and Clostridium difficile infections in hospitals. But many products on the market don't live up to their own hype.

Patients with diabetes facing vision loss at ever-earlier ages

Just as diabetes is affecting younger populations, so are its consequences. Childhood obesity can translate into diabetic retinopathy in patients in their 20s, which requires a response from the primary care community.

‘Discontinued’ medications a problem when using EHRs

Physicians who wonder why a patient is still taking a discontinued medication might look to their EHRs for the answer. Unlike with new prescriptions, a doctor's orders to stop a drug usually aren't automatically transmitted to pharmacies. This widespread problem requires an old-fashioned solution: talking to patients to ensure they know what medications they are meant to be taking.

‘Sic’ing primary care physicians on sickle cell disease

Sickle cell patients who survive into adulthood are falling into a gap in care as they leave a pediatric practice and don't enter an adult one. A pilot program is offering medical education to patients and to clinicians.

Zolpidem dose for women lowered, diabetes drug approved

This regulatory update covers warnings to lower zolpidem doses in women and approvals for a new drug to improve blood glucose control in adults with type 2 diabetes.

Reflecting on a busy year and on returning home

ACP's outgoing president reflects on his year serving the College's membership and the joys of rededicating himself full-time to his patients.

Transparency needed for successful health care reform

With fewer than 10 months left until the Affordable Care Act's coverage guarantees take effect, how prepared are federal agencies and state governments to make the law work?.

Unique aspect of internship involves learning to meet needs

An intern learns to balance patient needs with his own, following the guidance of senior residents and mentors.

Letters to the Editor

Readers react to ACP Internist's coverage, offering more resources for alcohol screening and ways to rethink first-line treatment for hypertension.

Don't overlook pulmonary hypertension

Learn how doctors can best spot pulmonary hypertension, a disease for which treatments have improved dramatically but inclusion in the typical internist's differential hasn't.

Avoid the most common claims errors in Medicare billing

Learn the most common reasons why Medicare Administrative Contractors reject claims, and how to avoid such pitfalls in the future.

Gain efficiency, not overload, through electronic communication

Use digital communications' strengths to streamline its glut of information instead of being carried away.

Start with the basics for disaster preparedness

Doctors' offices are just as vulnerable as any business after a natural disaster. But patients won't rely on their favorite restaurant as much as they will their regular physicians in the aftermath. Learn ways to keep your doors open even when your building has been closed.

ACP to conduct Annual Business Meeting

All members are encouraged to attend ACP's Annual Business Meeting, to be held during Internal Medicine 2013 in San Francisco.

MKSAP Quiz: Management after a routine exam

A 35-year-old woman undergoes routine evaluation. She has no current medical problems or history of bleeding symptoms. Her medical history is significant only for iron deficiency 3 years ago that was thought to be diet related. She takes only oral contraceptive pills. A peripheral blood smear is shown. Following a physical exam and lab results, what is the most appropriate management?.