Ask the question to find sexual dysfunction

This issue also covers making time for cancer screening, improving immunization rates, and health care for immigrants.

Sexual dysfunction in women might not be something that's always covered in a primary care office visit. Women's health experts, though, say that internists can address this common disorder in their patients simply by asking about it, and referring to specialist care when needed. In addition, the availability of newly approved treatments and the publicity surrounding them may help raise awareness and create more opportunities for conversation. Our story offers tips on screening for sexual dysfunction at every visit, discusses what to do if you find it, and details why lack of libido does not always indicate dysfunction. It also provides an overview of the new treatments, including their effectiveness and side effects.

Cancer screening can benefit from a kind of positive bias, with patients and even sometimes physicians tending to think that all screening must be good. But for most patients there comes a tipping point, due to age, comorbid conditions, or other considerations, where the risks begin to outweigh the potential benefits. The challenge for physicians is determining that point and working with the patient to individualize screening and provide appropriate care. Our story looks at best practices for managing cancer screening in clinical practice and offers tips on discussing the topic with patients and coming to a consensus.

Two articles focus on the vital issue of immunization, one broadly, one more specifically. On the broader side, ACP convened an Advisory Group, sponsored by Sanofi Pasteur, that met for two days in March to drill down into the barriers surrounding adult immunization, as well as develop strategies and access plans to overcome them. Two immunization experts who participated discuss what was covered at the meeting and describe ways to improve immunization rates. On the specific side, meanwhile, an article takes a look at how vaccination for herpes zoster has changed since the approval and subsequent recommendation of a new subunit vaccine two years ago.

Immigration issues have been in the news very frequently over the past two years, and two stories in this issue examine them from the physician perspective. Our story looks at New Mexico and how physicians there have been caring for patients who have recently crossed the southern U.S. border. And in a related Q&A, an internist and FACP talks about what he witnessed at border detention facilities and why he decided to take his observations public.

How do you handle cancer screening? What challenges do you face with immunization in your practice? Let us know at


Jennifer Kearney-Strouse
Executive Editor