The American College of Physicians: Internal Medicine 2014
The annual meeting of the American College of Physicians (ACP) was held from April 10 to 12 in Orlando, Fla., and attracted more than 6,000 participants from around the world, including internists, adult medicine specialists, sub-specialists, medical students, and allied health professionals. The conference highlighted recent advances in the prevention, detection, and treatment of illnesses in adults, with presentations focusing on updates in neurology, oncology, infectious diseases, endocrinology, and cardiology.
During the conference, the ACP announced the launch of the High Value Care Coordination Toolkit, which is designed to improve communication between primary care physicians, specialists, and patients.
"The problem the ACP identified with care coordination is multi-faceted. In part, it has to do with medical sub-specialists, in part with internal medicine specialists in primary care settings, and in part with the confusion the health care system places on our patients," said Charles Cutler, M.D., of the ACP and the University of Pennsylvania in Philadelphia. "Therefore, we established a helpful toolkit to improve communication. We felt that care coordination needs to clearly define in advance the roles and expectations for the physician and patient. Medical information needs to be transferred in a timely manner between doctors caring for a patient. And expectations for ongoing care should be established early and in a mutually agreed upon manner. The development of the High Value Care Coordination Toolkit, I believe, accomplishes all of these goals."
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The ACP also released a policy paper addressing issues surrounding medical liability and their impact on clinical practice patterns.
"ACP has been working on this issue for a while now and feels that the current liability system is really broken with respect to how it treats patients and physicians," said Thomas G. Tape, M.D., of the ACP and the University of Nebraska College of Medicine in Omaha. "For example, the system spends an enormous amount of money to compensate a small percentage of patients, distributing large awards to the 2 percent of injured patients who bring a suit to court following an unintended medical episode. However, there are many more patients who are never compensated for their injury."
Another issue addressed in this policy paper relates to defensive medicine. Many physicians fear liability. This fear is not unfounded as it is more likely than not that during the course of an internal medicine career a physician will face liability action of some sort. As a result, excess medical costs are often incurred.
"This paper proposes a number of ideas to develop alternatives to the existing court system of addressing medical liability," said Tape. "Some of the ideas we have proposed will hopefully help resolve the long-standing impasse in medical liability reform in this country. A solution to the broken medical liability system in the United States should include a multi-faceted approach since no single program or law by itself is likely to achieve the goals of improving patient safety, ensuring fair compensation to patients when they are harmed by a medical error, and strengthening the patient-physician relationship."
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Another policy paper released at the meeting provided physicians with recommendations for reducing gun-related injuries and death in the United States. The policy paper provides insight into how physicians can help protect patients and offer recommendations for firearm safety. Firearms are a public health problem and, therefore, the ACP advises physicians to think about their role in that context.
"We concluded that firearm violence is not just a criminal justice issue, but also a public health threat that requires the nation's immediate attention," Tape said in a statement. "As an organization representing physicians who have firsthand experience with the devastating impact of firearm-related violence, ACP has a responsibility to participate in efforts to mitigate needless tragedies."
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The ACP highlighted the most important 2013 medical studies that were published in the Annals of Internal Medicine, including research in the areas of women's health; hematology and oncology; endocrinology; hospital medicine; rheumatology; cardiology; geriatrics; gastroenterology and hepatology; and pulmonary, sleep, and critical care medicine.
"The 10 'Update' articles published in Annals of Internal Medicine are based on presentations at the annual meeting of the American College of Physicians. In each, a clinician with expertise in that field summarizes 10 to 12 articles published in the previous calendar year that they think should most influence practice in that specialty," said Christine Laine, M.D., M.P.H., editor-in-chief of the Annals of Internal Medicine. "Taken together, the 'Updates' summarize over 100 articles published in 2013. I encourage physicians to look at the articles as an efficient way to see what they might have missed in the overwhelming amount of new medical information that becomes available over the course of a year."
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As part of the meeting, the ACP launched a series of educational materials for patients and physicians directed at addressing care for rheumatoid arthritis, chronic pain, irritable bowel syndrome, and exocrine pancreatic insufficiency.
"The materials we developed are part of a larger library of resources for members and non-members of the ACP. The materials are aimed to support the primary care physician and other physicians managing patients with chronic illness in promoting self-management of their own conditions," said Wendy Nickel, M.P.H., the director of the Center for Patient Partnership in Healthcare at the ACP.
The rheumatoid arthritis and chronic pain guides were created to help patients learn techniques to manage pain and develop positive lifestyle skills. Some of the other resources available include a guide related to pancreatic disease and information about irritable bowel syndrome.
"These are meant to be complementary to what the physician is already providing in practice; some materials include DVDs that show patients what they can expect in terms of diagnosis, symptoms, and treatment," Nickel added.
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