April 2016

Illustration by David Cutler

Facing depression in medical residency

Depression can be prevalent during medical residency, with long hours and social deprivation as contributing factors. Concerningly, the farther residents are into their training, the more depression rates rise. Some programs are delving into their trainees' psychological well-being.

Control is the key in rheumatoid arthritis

To control symptoms of rheumatoid arthritis, new guidelines are encouraging internists to act sooner and more definitively combatting the course of the disease. Also, disease-modifying anti-rheumatic drugs are playing a bigger role in controlling symptoms.

Noninvasive treatment almost always best for knee pain

Knee symptoms are the most common musculoskeletal reason why patients visit their doctors, and in most cases, except when breaks or infection is suspected, physicians should recommend the use of nonsurgical treatments first.

Debunking HIPAA myths in the digital age

Twenty years of the Health Insurance Portability and Accountability Act have not led physicians to full understanding of how to implement it in their offices. Four commons myths can be addressed more easily than is commonly thought.

Signs of progress for MOC, but more work needed

The past year's worth of advocacy to improve the Maintenance of Certification process has succeeded, in part, but the issue will remain in front of ACP leadership in coming years.

Defining value and creating quality in the patient encounter

Critical questions will arise about defining and measuring value in the patient encounter when the Medicare Access and CHIP Reauthorization Act goes into action.

There are challenges when translating research to practice

Despite convincing results for many health care interventions, translating evidence from research into clinical practice is often challenging. What works in a research environment may not function in practice.

Letters to the Editor

Readers respond to previous coverage about mergers of large insurance companies, and with concerns about our coverage of complementary care.

Educators can help with trainees' depression

This issue covers topics such as depression in medical residency, guidelines for rheumatoid arthritis, and rehabilitation for knee pain.

Patients have a right to access personal health information

Confusion exists about how and when patients can access their personal health records under the Health Information Portability and Accountability Act.

Recall of glucose test strips; approval for hepatitis C drug

This update covers a class I recall of blood glucose test strips which might cause clinicians to overlook hypoglycemia.

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 ACP.

MKSAP Quiz: Evaluation of chest pain

A 75-year-old woman is evaluated in the hospital 4 hours after onset of chest pain with findings of an ST-elevation myocardial infarction. She was taken emergently to the catheterization laboratory and underwent emergency percutaneous coronary intervention for a totally occluded vessel. Her post-intervention ventriculogram demonstrated a left ventricular ejection fraction of 30%. One hour after the procedure, she developed an acute arrhythmia. Medications are aspirin, metoprolol, atorvastatin, and clopidogrel. Following a physical exam, cardiac exam and electrocardiogram, what is the most appropriate management?.