Articles related to PRACTICE PEARLS

The American Journal of Gastroenterology published the ACG clinical guideline on the management of IBS in January 2021. Lead author gastroenterologist Brian E. Lacy, MD, PhD, says that to diagnose IBS, clinicians should take a careful history, perform a careful physical exam, use Rome IV criteria, and perform limited diagnostic testing (complete blood count, C-reactive protein, and possibly celiac serologies and fecal calprotectin, depending on symptoms). Regardless of whether a patient has constipation-predominant symptoms, diarrhea-predominant symptoms, or a combination of constipation and diarrhea, the first step is to classify the patient into a mild, moderate, or severe IBS category.

One of the main explanations for an improvement in the financial standing of medical practices is the expansion of supplementary services. Ancillary services give doctors alternatives to increase revenues and create more money. However, they also help patients by making life more convenient, saving time, and enhancing treatment and results. Here is a list of the extra services offered by internal medicine and family medicine clinics in the previous calendar year.

Use of Carnett sign, greater trochanter palpation, and a simple extension to typical joint examination can reduce imaging and orthopedic referrals by primary care physicians and bring faster effective treatment to the patient.

In his discussion of the subject, Adam M. Brufsky, MD, PhD, FACP, of the University of Pittsburgh School of Medicine notes that about 50% of breast cancers categorized as HER2-negative exhibit low HER2 expression, and preliminary data suggest that new antibody-drug conjugates may be effective in treating tumors with low HER2 expression; clinical trials are currently underway. Trastuzumab should not be added to treatment plans for women with low HER2 expression, according to Dr. Brufsky, because it does not assist those with IHC 3+ or ISH-amplified breast cancer or those without those conditions. Finally, compared to triple-negative tumors, hormone receptor-positive (HR+)/HER2-negative cancers seem to have low HER2 expression more commonly.

The effectiveness of one’s dry eye disease (DED) clinic depends on staff involvement in both diagnostic testing and patient education for three reasons: (1) It enables ODs to see more DED patients and quickly prescribe the treatment(s) needed to provide symptomatic relief; (2) It emphasizes the significance of diagnosing and adhering to the prescribed DED treatment; (3) And it fosters staff loyalty to a practice because they are actively involved in patient care rather than merely checking off the boxes.

What’s expected for medical practice in 2023? Worker shortages will persist, with the biggest gaps being nonprofessional staff. Shortages will drive competition to attract even workers with entry-level skills, which will generate wage increases and turmoil as workers move to take advantage of better offers. Wage and goods inflation will continue to press on profits. The move to value-based fee structures will increase. And there will likely be a focus on better integrating merged organizations instead of the prior frenetic acquisition land grab.