Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.
(Separate news release on the guidelines will be released this week.)
A study of primary data from eight studies in five countries found that people who drank more than 45 grams of alcohol per day, or more than three average-size drinks, had a slightly higher risk for colorectal cancer than those who drank less or no alcohol (Article, p. 603). The study found no relationship between the type of alcoholic beverage people drank and colorectal cancer risk, or between the amount of alcohol consumed and the location of the colorectal cancers within the intestine.
In response to challenges facing general internal medicine, a task force makes eight recommendations to redefine the domain of general internal medicine (Perspective, p. 639). Among these are that the field should stay both broad (working with the basic primary care needs of adults) and deep (maintaining the traditional role as experts in care of adults with multiple, complex and chronic diseases); that general internists should usually work in teams, and that the final two years of residency training should be tailored to the type of practice the physician will enter and to his or her career goals. The task force, commissioned by the Society of General Internal Medicine, also recommended that the fee-for-service financing system be abandoned, reformed or restructured to include payment for services provided outside traditional face-to-face office visits. Six accompanying editorials respond to some of the recommendations. Respondents include an internal medicine subspecialist (a cardiologist); a professor of family medicine, the other medical discipline providing primary care to adults; and an economist and expert in health care financing.
(Review, p. 620)