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September 2020

Feature

COVID-19 Upends Every Aspect of Visits

(from the July/August 2020 ACP Internist)

Several months into the COVID-19 pandemic, it's still uncertain to what degree it will reshape the practice of medicine and office management in the near and long terms.


I.M. Internal Medicine

Spotlight: Stefanie Brown, MD, FACP, FAAP, Med–Peds for Life (#MP4L)

Someone once told me, “The problem with life is that it has no table of contents. You can try to write your story, but it always turns out differently than you plan it.” That was true for me, especially as it relates to my career. I entered medical school with the idea that I was certain about my future career in medicine. I wanted to be a private practice family medicine physician in New Jersey. What I am now is the Internal Medicine Residency Program Director at the University of Miami/Jackson Health System program, clinically practicing ambulatory and inpatient medicine and pediatrics; in my other administrative roles, I am the Section Chief for Med–Peds and Pediatric Hospital Medicine.


Council of Student Members (CSM) Spotlight

Addressing Implicit Bias Within the Medical Curricula

Studies have shown that a majority of medical students have a more negative perception of lesbian and gay people than they do heterosexual people. Perceived discrimination from health care providers and denial of health care altogether are common experiences among LGBTQ+ patients, which contributes to health disparities. As our social landscape changes, many medical institutions are evaluating how they can address this issue.


Medical Student Perspectives

Learning to FLI: The Need for a Community for First-Generation, Low-Income Medical Students

I recently returned to my high school for an event intended to celebrate the accomplishments of alumni who have earned a place on the school's academic wall of fame. My mother, an employee at the school, couldn't attend because she was in the cafeteria with the other food servers preparing the reception that would follow the ceremony.


Advocacy Update

ACP Leadership Day Goes Virtual: Here's What to Know

(from the July 17, 2020 ACP Advocate)

In the past, ACP members from across the country convened in Washington, D.C., for a two-day conference where they would lobby legislators and staff on key advocacy issues affecting the practice of internal medicine. While large group meetings are not currently considered safe or responsible, advocacy is more important than ever, which is why ACP is launching a newly created Virtual Advocacy Toolkit for members along with step-by-step guidance for how to best utilize the tools, said Jonni McCrann, ACP senior manager of legislative affairs.

The ACP Advocate is a bi-weekly e-newsletter that provides ACP members with news about public policy issues affecting internal medicine and patient care.


Analyzing Annals

Beyond the Guidelines – Management Options for an Older Adult With Advanced Chronic Kidney Disease and Dementia

Grand Rounds Discussion From Beth Israel Deaconess Medical Center

The Kidney Disease Outcomes Quality Initiative recommends that patients with an estimated glomerular filtration rate below 30 mL/min/1.73 m2 be educated about options for both renal replacement therapy, including dialysis or transplantation, and conservative management. Here, 2 experts—a nephrologist and a general internist–palliative care physician—reflect on the care of a patient with advanced chronic kidney disease (CKD) and mild to moderate dementia. They discuss the management options for patients with advanced CKD, the pros and cons of each method, and how to help a patient choose among them.

Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.


Winning Abstracts

Social Isolation within an Urban Safety Net Hospital Patient Population

Social isolation (SI) is a largely silent social determinant of health that has been linked to various negative health outcomes including increased rates of cardiovascular diseases, depression, hospital readmissions, and increased health care costs. Numerous studies have also found that low income populations are more likely to be socially isolated. While SI is as common as food insecurity, little is known about the prevalence and impact of SI in patients hospitalized at safety net hospitals. We aimed to measure the prevalence of SI within the inpatient population and to better understand the factors that contribute to SI in order to create a unique intervention to ameliorate SI.

Want to have your abstract featured here? ACP holds a National Abstracts Competition as part of the ACP Internal Medicine Meeting every year. Find out more at ACP Online.


Subspecialty Careers

Sports Medicine

Sports medicine focuses on physical fitness and the treatment and prevention of injuries related to sports and exercise. This frequently includes advising patients on exercise and training, injury prevention, assessment and management of acute athletic injuries, rehabilitation, and care of medical problems of the athlete.


In the Clinic

Stable Ischemic Heart Disease

Stable ischemic heart disease (SIHD) is a leading cause of death in the United States and many other countries. The defining pathobiology is an imbalance between the metabolic demands of the myocardium and its oxygen supply, which most often results from coronary artery atherosclerosis. The classic presenting symptom of SIHD is angina, but clinical presentation varies greatly among patients. Since the last In the Clinic on SIHD in 2014, several new drugs have been approved to reduce ischemic complications, such as myocardial infarction and congestive heart failure.


Medical School During COVID-19

Navigating the 2021 Match During COVID-19 Webinar Recording Now Available

On August 12, 2020 the ACP Council of Student Members, in conjunction with the Alliance for Academic Internal Medicine (AAIM), held a webinar focusing on the impact of pandemic-related changes on the residency application and Match process. If you weren't able to make it, access the webinar recording, a frequently asked questions document, and AAIM resources for the residency application process. Also note, that the College is planning a similar webinar for IMGs.


Get Involved

Council of Student Members Call for Nominations

The Council of Student Members (CSM) is currently seeking candidates to fill vacant seats for 2021-22. Nominations are due by November 1, 2020 and details for submitting are included in the CSM Call for Nominations. If you have any questions about the elections, please contact ACP staff at acpgovernance@acponline.org


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