Certain high-yield diagnostic physical exam maneuvers are superior to the best available technology-one reason why medical students still need to be able to master the bedside exam Photo by iStock

Bringing medicine back to the bedside

The physical exam itself is widely considered to be underutilized, but many of the country's medical educators and master clinicians are determined to bring it back to prominence.

Pick six

Six core competencies in medical education have stood the test of time. Six more could help physicians understand what it means to be a competent internist.

Preserving the Affordable Care Act despite the headwinds

Despite a treacherous political environment that posed a direct threat to ACP's efforts to preserve the historic gains in coverage from the Affordable Care Act (ACA), a group of six medical societies was able to preserve key components of the program.

ACP Internist Weekly

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Whether patients who have already received a previous herpes zoster vaccine will object to additional vaccination with the new vaccine remains to be seen especially considering the latters two injec

New herpes zoster vaccine brings familiar challenges

A new vaccine should be considered the preferred option for prevention of shingles in adults and should be given in place of the existing one, but it brings with it familiar considerations: efficacy, insurance, and patient communication.

To identify patients at higher risk of developing severe pancreatitis physicians should rely upon their clinical judgment watching out for the presence of systemic inflammatory response syndrome alo

Pinpointing pancreatitis difficult, but key to good outcomes

Several review papers help internists identify patients with pancreatitis who are most likely to progress to severe disease and how to best manage their care.

Treating urinary tract infections with antibiotics is often unneeded but can be indicated if a patient is medically unstable with signs of infection especially signs of sepsis regardless of urinary

‘UTI’ an overused diagnosis in the era of the microbiome

An evolving understanding of urinary tract infections has led one expert to describe them as an “ambiguous, expansive, overused diagnosis” that can lead to the myriad harms of antibiotic overtreatment.

QI project helps raise vaccination rates

With patients likely to decline all vaccinations, of any kind, due mainly to concerns about safety or adverse effects, physicians opted to work with ACP's “I Raise the Rates” initiative as a quality improvement project.

Gout drug concerns; monthly buprenorphine injection OK'd

This column reviews details on recent recalls, warnings, and approvals.

Options vary for acute pain management

This issue covers guidelines on chronic pain, the utility of the bedside exam, and a new shingles vaccination.

MKSAP Quiz: 5-day history of a lesion

A 31-year-old woman is evaluated for a 5-day history of a nonpainful cutaneous lesion on the back of her left hand. She works as a packer in a parcel distribution center. She does not recall injury to this area and reports no unusual employment or recreational exposures. She has not had fever, cough, shortness of breath, headache, chest discomfort, or gastrointestinal symptoms. Yesterday, two coworkers were evaluated for similar lesions. Her husband has recently been prescribed an antibiotic after being diagnosed with a “boil” from which methicillin-resistant Staphylococcus aureus was cultured. Her only medication is an oral contraceptive pill. What is the most appropriate management?

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MKSAP 17

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February 13, 2018   

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