Falls common, but not always inevitable, in older primary care patients

This issue covers prevention of falls in the elderly, debate over hypertension guidelines, and social media marketing for physician practices.

Elderly patients are known to be at higher risk for falling, but although falls are certainly more common with age, they don't have to be an unavoidable consequence. Luckily, there are many ways for physicians to suss out which patients are more likely to fall and begin putting prevention methods in place. Don't ask a patient whether he's fallen, for example, according to one expert; you'll get better results if you ask him about the last time he's fallen, instead. In addition, exercise plus vision assessment and correction can go a long way toward decreasing risk, and assessing a patient's home environment is key.

Meanwhile, the debate about the definition and treatment of hypertension continues, spurred recently by the publication of a new guideline from the American College of Cardiology/American Heart Association (ACC/AHA) that differs significantly from that released last year by ACP and the American Academy of Family Physicians. Proponents of the ACC/AHA guideline think that its new, broader categories will help spur earlier treatment and management, while critics contend that it risks labeling patients with a condition they may not yet have, among other downsides. Experts in the field provide a blueprint for how primary care physicians should approach hypertension in clinical practice, given the differing guidance.

Social media can be both a blessing and a curse for a physician practice, offering a way to grow your reputation and your business while at the same time inviting online criticism. Overall, though, the benefits may be greater than the risks. Other feature stories in this issue include an update on the Sunshine Act and an overview of direct-acting oral anticoagulants for venous thromboembolism. Also, read a Q&A with Edward H. “Ted” Parks, MD, the author of a new book on orthopedics in primary care.

It's almost time for one of our favorite events of the year, and we hope one of yours too: Internal Medicine Meeting 2018 will take place April 19-21 in New Orleans. In addition to premier educational content, other highlights will include a keynote speech by the national coordinator for health information technology at the U.S. Department of Health and Human Services and a new precourse focusing on physician well-being and professional satisfaction. Read more about the meeting, and let us know what sessions you're most looking forward to.


Jennifer Kearney-Strouse
Executive Editor, ACP Internist