Darren B. Taichman, MD, PhD
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From the Editors of Annals of Internal Medicine and Education Guest Editor, Gretchen Diemer, MD, FACP, Associate Dean of Graduate Medical Education and Affiliations, Thomas Jefferson University.
Ask your learners why SCT is so common.
Ask a hematologist to review the blood smears of patients with sickle cell anemia and SCT with your team.
How does SCT come to the attention of medical providers? In what clinical situations is the finding of SCT relevant?
Ask your learners what risks of SCT are. What does this review find?
How would your learners counsel a patient with SCT who inquires about the importance of this trait for her or his health? Should it alter his or her care or behavior?
Ask your learners when buprenorphine therapy is indicated. When is it contraindicated?
When indicated, how should it be started?
Read each of the “Previous approach” statements to your learners. How do they respond to each? Then, review what the authors say current practice and recommendations should be.
The authors note that a requirement for traditional counseling is ill advised. Why? Use the accompanying editorial to help frame your discussion.
Ask your learners who may prescribe buprenorphine. Who provides buprenorphine care at your institution, and how should your learners arrange for the care of a patient in need? Invite a specialist in opioid use disorder treatment to join your discussion.
Start a teaching session with a multiple-choice question. We've provided one below!
Ask your learners to list the possible symptoms of menopause.
Which are more common? Which might be overlooked? Use the information in DynaMed Plus: Menopause, a benefit of your ACP membership.
Do your learners ask patients about menopausal symptoms?
Is testing required to diagnose menopause?
What options are available for treatment of vasomotor symptoms?
How do menopausal symptoms affect a patient's quality of life? What do your learners tell their patients about the likely duration of menopausal symptoms?
Ask your learners how NAFLD is defined. How does it differ from nonalcoholic steatohepatitis, and why is the distinction important? Use Table 1 to help.
Who is at risk for NAFLD? How is the diagnosis made? Are there symptoms? What is the differential diagnosis? What testing should be considered, and why? Use Table 2.
When should liver biopsy be considered?
How should patients with NAFLD be managed?
When should a gastroenterologist be consulted?
Log on to answer the multiple-choice questions and earn CME/MOC credit for yourself! Use the questions to help introduce topics for teaching.
Ask your learners whether they believe women and men receive equal pay for equal work in fields other than medicine. What about physicians who practice internal medicine and its subspecialties?
What did this study find? Are your learners surprised?
What do your learners think are the potential reasons for the lower median compensations to women than men?
What barriers continue to impede remedying the long-recognized discrepancy in pay? What remedies do your learners think are needed? Use the accompanying editorial to help frame your discussion.
How will these issues affect your learners when they apply for and accept positions following their training? How should they approach the issue when discussing payment with potential employers? To whom may your learners turn for advice?
Ask your learners what factors contribute to over- and underdiagnosis.
Why is each potentially harmful?
The authors emphasize that we need to accept uncertainty as part of the diagnostic and caring process. Why?
In what way must we “rethink symptoms”? Do your learners agree?
How might the approach advocated by the authors help to improve diagnostic approaches and patient care?
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Taichman DB. Annals for Educators - 6 November 2018. Ann Intern Med. ;169:ED9. doi: 10.7326/AFED201811060
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Published: Ann Intern Med. 2018;169(9):ED9.
Endocrine and Metabolism, Gastroenterology/Hepatology, Hematology/Oncology, Liver Disease, Red Cell Disorders.
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