First, many physical examination maneuvers (tests) have well-established sensitivities and specificities, as useful to the clinician as those for laboratory tests. ... Second, the practice of predicting what a laboratory test might demonstrate based on
Reader comments on the role of ancillary services in an internal medicine practice, and on the need for attention to nutrition and lifestyle in caring for rheumatoid arthritis. ... As for the comment by ACP's senior associate Ms. Williams that these are
23 edition] is similar to that of the AP report on the excellent New England Journal of Medicine article on malpractice claims in the U.S. ... This is an extreme disservice to practicing physicians. James E. Ramage Jr., MD, FACP.
I've always believed that patients should have the right to make medical decisions about their own lives. ... But 2 major concerns have combined to change my opinion about remaining the doctor for patients who refuse to follow my advice.
Second, I would venture to say that much of the research on hypertension was conducted using readings taken by physicians and nurses wearing white coats. ... To what extent is“ white coat hypertension” baked into the studies upon which we depend?
I could not find any symptoms or signs relating to the head or the nervous system. ... I suffered three more days of agony on ineffective proton pump inhibitors until readmission to the hospital and a hepatobiliary iminodiacetic acid scan revealed a
to point out until late in the piece the easiest and least expensive way to diagnose it—examine the patient. ... As a matter of fact, if the patient has good-quality pedal pulses it is unlikely that those above will be impaired; they need to be
By Janet Colwell, Editor. ... College members pushed for approval of $500 million to fund a Medicare pilot of the patient-centered medical home but it was a tough sell.
But concepts such as bundled payments, comparative effectiveness and the patient-centered medical home seem certain to remain center stage. ... In an era when primary care physicians have less and less time to spend with their patients, the annual
The principles of anchoring and availability are ones to guard against in all areas of medicine. ... I made notes as I read, listing the differential diagnoses and trying to keep the list as short as possible.