April 2015

As opioid prescribing has escalated so have overdoses and other adverse effects The rate of opioid-related poisoning deaths nearly quadrupled from 1999 to 2011 according to federal data Photo by I

Seeking clarity for opioid prescribing

Doctors continue to be frustrated by their patients' chronic pain problems, due to a lack of evidence on opioids' long-term effectiveness and strong evidence of potential harms.

Unmask malnutrition with careful questions

Increasing awareness of the harmful effects of under- and overnutrition can in turn increase nutritional assessments in primary care.

Helping clinicians improve care for sexual, gender minorities

The second edition of “The Fenway Guide to Lesbian, Gay, Bisexual and Transgender Health” goes several steps further than its first edition by educating physicians on how to account for a changing cultural landscape.

‘Incidentalomas' may prove challenging to manage

The medical field is still grappling with the benefits and consequences of ever more sophisticated imaging technologies and how they affect the issues of overtesting and overdiagnosis.

ACP's ‘Mission: Not Impossible’

Changes to the Maintenance of Certification process advocated by College leadership are the beginning of meaningful reform of the process, not the end.

A taxing season for Obamacare

April's tax filings may create sticker shock among the electorate, testing whether the gains in health care access made by millions of people can be sustained.

Letters to the Editor

Readers respond to ACP Internist coverage of issues surrounding the time spent with patients, ICD-10 coding changes, and physician burnout.

More research needed on long-term opioids

This issue covers topics including opioid pain management, malnutrition, and ‘incidentalomas' during imaging.

Documenting ICD-10-CM: What's new?

More specific information required in clinical documentation will lead to more efficient claims processing under the ICD-10 requirements that take effect in October.

Making patient portals patient-friendly

Patient portals can create barriers to successful use but can also offer benefits to patients. Three simple steps can improve the patient experience.

Approvals for an oral anticoagulant, generic esomeprazole

This update covers the approval of an oral medication to reduce the risk of stroke and embolism in atrial fibrillation and the first generic version of esomeprazole.

1945-1954: ACP and other organizations find their niches

ACP's fourth decade started with the restoration of pre-World War II programs that had been suspended, as well as struggles with more philosophical issues.

MKSAP Quiz: 4-day history of fever, malaise

A 24-year-old man is admitted to the hospital with a 4-day history of fever, malaise, and arthralgia of the elbows, wrists, and knees. Two days ago, he developed progressive pain and swelling of the right knee. He also has a rash on his arm. Following a physical exam and blood cultures, what is the most appropriate diagnostic test to perform?.


James A. Curtin, MD, MACP.