American College of Physicians, April 11-13, 2013
The annual meeting of the American College of Physicians (ACP) -- Internal Medicine 2013 -- was held from April 11 to 13 in San Francisco 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 and the Federation of State Medical Boards released a new policy paper, "Online Medical Professionalism: Patient and Public Relationships." The policy paper is intended to provide health care professionals and patients guidance on best practices for online communication.
"In these recommendations, the ACP addressed modern communication between physicians and patients regarding use of new forms of technology, including e-mail, instant messaging, and social media. Many physicians are using these types of technologies to get more educational information to patients and provide another way of getting in touch with physicians. However, there is an issue of how much and what kind of information should be shared between physicians and patients by these means and there are quality of care issues," said David Fleming, M.D., the chair of the ACP's Ethics, Professionalism, and Human Rights Committee. "The ACP recommends that physicians keep any professional social media pages separate from personal pages. The ACP also recommends that patients and physicians not 'friend' each other on social networks for personal reasons. There are boundaries in physician and patient relationships and these can get blurred with social networking."
In addition, the ACP recommends that physicians not use text messaging as a form of communication with patients unless they get consent to communicate with patients via text message or e-mail. Physicians should also only communicate with established patients who have given informed consent to communicate via e-mail.
"Overall, physicians should not communicate via electronic means in the absence of an established patient/physician relationship approved by both parties and consented to by the patient," said Fleming. "We view electronic communication technologies as wonderful advancements in the ability of physicians and patients to communicate with one another; however, they need to be used responsibly by both parties so they can each trust that any information shared is protected and accurate for the good of the patient."
The ACP also announced two evidence-based interventions and two videos to improve the health outcomes of patients in the first year following an initial acute coronary syndrome event. The overall goal of this initiative is to reduce readmission rates; and by informing both the patient and physician regarding patient needs, the rates of readmission will hopefully come down.
"This initiative aims to create content for patients who just experienced a heart attack or acute coronary syndrome event to help them understand what transpired and allow them to regain control of their lives. It is an aid to help in the transition process from the hospital to the home setting. In the initiative, we created content for both patients and clinicians," said Doron Schneider, M.D., the chief safety and quality officer at the Abington Health System in Pennsylvania.
The physician guide helps the physician understand what the patient will need during their first follow-up visit. It aims to make the first follow-up visit as optimal as possible. It provides a guideline on discussions with patients regarding symptoms and medications as well as lifestyle adjustments and feelings. The patient guide explains what happened to the patient and provides them with an understanding of what occurred. It also helps the patient make the correct lifestyle choices when they return home and to understand the medications they will be taking.
"It also provides some insight on how to speak to, set goals with, and ask questions of their clinician. Guidance on symptom management is presented as well as directions as to when to call the doctor as opposed to proceeding to the emergency room," said Schneider. "The guide discusses what to expect during the recovery period, including types of feelings patients may experience as well as when the patient can return to their normal routine of daily life such as work and sexual activity. The guide provides three checklists for when the patient leaves the hospital and returns home, what to expect when they are living at home, and what they will experience during their first follow-up visit."
Physician leaders at the meeting led a discussion on the status of health care reform. During the discussion, the leaders examined what the Affordable Care Act has accomplished to date. They provided insight into what will happen at the beginning of 2014 and how the country will transition to universal coverage. Other key issues these leaders touched on included the biggest challenges associated with the Affordable Care Act, physician responsibility, patient access to care, organized care, insurance coverage, and reimbursement.