Preventing migraine, managing men's health, and more stories

Migraine is a debilitating condition, affecting 16% of U.S. adults and accounting for 4.3 million office visits in 2018. While drugs can help prevent it, patients often need to try more than one, and side effects can also be a source of concern. Our story reviews recent guidelines on migraine prevention from ACP's Clinical Guidelines Committee and the American Headache Society and the pros and cons of the different medications available.

Recent research has shown that the longevity gap between men and women has been increasing, with one study from late 2023 finding the largest difference in lifespan since 1996. COVID-19, "deaths of despair," and chronic illness all take a toll, and cultural factors are likely at work, too, according to experts. Our story offers tips on helping men engage more with both their health and with the health care system.

Early career physicians, especially those in academia, are familiar with the pressure to publish and are understandably eager to have their work disseminated. But not all journals are created equal, and predatory journals have become more common in recent years. Some signs that a journal might not be legitimate include promising very quick turnaround from submission to publication and charging exorbitant "pay to publish" fees. In our I.M. Ready feature, Christina C. Wee, MD, MPH, FACP, Senior Deputy Editor of Annals of Internal Medicine and secretary for the International Committee of Medical Journal Editors, offers more tips and tricks for making sure you're submitting your work to publications that will polish your CV rather than unintentionally tarnish it.

It can take just one medical crisis for an older adult to become what the American Geriatrics Society (AGS) terms "unrepresented," defined as lacking the decisional capacity to provide informed consent for a particular medical treatment, a relevant advance directive or the capacity to create one, and representation from a surrogate decision-maker. In a recent position statement, the AGS described best practices for medical decision making in these situations and ways to prevent older adults from becoming unrepresented in the first place.

Also in this issue, experts explain why primary care physicians are often the first to hear about stress in their patients and outline some strategies you can use to help them cope, while in our Pearls from I.M. Peers column, Paul B. Aronowitz, MD, MACP, gives advice on becoming a great teacher rather than a good one. Finally, our Senior Advocacy Officer discusses a recent ACP position paper on collective action and Jason M. Goldman, MD, FACP, ACP's new President for 2025-2026, describes advocacy as a core aspect of patient care.

Have you received a solicitation from a predatory journal? What do you prescribe for migraine? Let us know.

Sincerely,

Jennifer Kearney-Strouse
Executive Editor