July/August 2014

Art by Lorraine Lostracco and Barry Moshinski

DME requests pose practice problems

Documentation requirements for some types of durable medical equipment (DME) are increasing, but DME requests can also be time-consuming in other ways for physician practices.

Seeking common ground on CKD screening

ACP's 2013 guideline on screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease (CKD) raised an immediate response from leaders of the American Society of Nephrology, which felt the College missed the big picture of CKD prevention when developing the guideline. Learn where the two organizations agree and disagree about screening for CKD.

Changes coming for colon cancer screening

Colonoscopies are an obvious target in the current push to decrease health care costs, given their expense and utilization, said experts at Digestive Disease Week in Chicago in May.

Tackling tPA and stroke outcomes through telemedicine

Thirteen “spoke” hospitals across the U.S. without on-site stroke experts used telemedicine to increased their use of recombinant tissue plasminogen activator (tPA) to treat acute ischemic stroke.

Expert offers advice on moving fast and mastering meningitis

The traditional 3 symptoms of bacterial meningitis are well known: fever, headache, and neck stiffness. But altered mental status should be on that list, too.

College Fellow's foundation helps support health care workers

For many people, retirement means a chance to improve one's golf handicap and vacation in Europe. For Larry Crook, MD, FACP, it meant setting up a nonprofit to help people halfway around the world.

Understand patient expectations as part of a negotiation

Both physicians and patients have a role in developing good communication.

Leadership Day attendees push legislators to finish SGR fix

Physicians and medical students representing ACP took to Capitol Hill to discuss the sustainable growth rate formula, workforce issues, and liability reform.

A doctor seeks out a concrete diagnosis

In medicine, a single diagnosis is preferred when possible as opposed to seeking multiple diagnoses to explain symptoms. But it isn't always correct.

Are internists ready to respond, or asleep at the concert?

ACP's president argues the importance of ensuring the graduation of lifelong learners and internists who are prepared for the profession not only in knowledge and skill, but also in wisdom.

When will Medicaid begin to get the respect it deserves?

Medicaid is the largest provider of government-funded health coverage in the United States, based on number of people enrolled, yet it doesn't get as much attention as Medicare. That may soon change.

Memories offer lessons in going from mentee to mentor

What a mentor does will always speak louder than what he or she says. In both positive and negative ways, mentors transmit “lessons” to their mentees through their everyday actions, conversations, and decisions.

Devil can be in the details for DME requests

This issue covers topics including requests for durable medical equipment (DME), screening for stages 1 to 3 chronic kidney disease, and diagnosis of meningitis.

Practice Tips: Review reporting of industry relationships

What should physicians look for when reviewing their Open Payments information online?.

New drugs for diabetes, secondary prevention of CV events

This update covers approval of a new drug to treat type 2 diabetes mellitus, along with diet and exercise, and of a drug to reduce risk of heart attack, stroke, cardiovascular death, and need for revascularization in patients with a previous heart attack or peripheral artery disease.

MKSAP Quiz: 6-month history of exertional dyspnea

A 49-year-old woman is evaluated for a 6- month history of exertional dyspnea and nonproductive cough that had an insidious onset. She has not noticed any particular triggers for her cough. She has no history of asthma, airway disease, reflux, or aspiration. She has never smoked. She has had no chemical or industrial exposures, has not been in contact with birds, has not been in a hot tub recently, and has not had recent travel. She has no family history of atopy or asthma, and she takes no medications. Lung volumes and spirometry are normal; DLCO is mildly reduced at 75% of predicted. Based on physical exam and chest radiographs, what is the most likely diagnosis?.

Barking up the right tree

ACP Internist's puzzle feature challenges readers to find clues placed horizontally in rows to reveal an answer written vertically.

Chapter awards

Chapters honor Members, Fellows, and Masters of ACP who have demonstrated by their example and conduct an abiding commitment to excellence in medical care, education, research, or service to their community, their chapter, and the organization.