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A survey of internists-physicians practicing internal medicine-whose board certification was up for renewal in December 2002 found that the most common reasons for participating in recertification were to maintain professional image and update knowledge (Improving Patient Care, p. 29). Ninety-one percent of the internists surveyed were still working in internal medicine, with the proportion lower among generalist physicians (79 percent) than subspecialists (96 percent). In an accompanying editorial, the Annals editor considers the issue of the physicians who left the practice of internal medicine (Editorial, p. 57). The editor says that the survey provides three lessons for those involved in medical workforce planning: 1) The number of primary care physicians is probably declining faster than realized; 2) Migration between medical specialties is important; 3) Some entity must track career changes of practicing physicians, including the rates of physicians leaving medicine and moving between specialties within medicine.
(Review, p. 37.)
Patients with peripheral arterial disease (PAD), leg pain caused by impaired blood flow in the arteries, who walked at least three times per week had less decline in walking distance and speed than PAD patients who walked less often (Article, p. 10). It is known that a supervised treadmill walking program improves walking performance and slows progression of PAD, but many older people with PAD are not able to participate in outpatient exercise programs because of cost or transportation problems. In this study, the walking sessions were unsupervised. Authors conclude that simple, unsupervised walking at home can reap many benefits for patients with PAD.