Journal of general internal medicine
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Guideline
Policy statement for general internal medicine fellowships. Society of General Internal Medicine.
Fellowship programs in general internal medicine should be designed to train outstanding academic internists to serve as future faculty and leaders in the field. Although programs may vary widely in their specific components, all should share a number of characteristics and goals. In this document, the Society of General Internal Medicine outlines basic principles and guidelines for fellowship training, states that its own PCIM Directory will explicitly require that programs indicate how they conform to them, and indicates its interest in considering a formal fellowship accreditation process in the future.
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To determine 1) whether young adult black patients in an emergency department (ED) are familiar with sickle-cell anemia and 2) how many of these patients know their own sickle-cell trait status. ⋯ Most black patients of childbearing age presenting to the ED have heard of sickle-cell anemia and know that it runs in families, but few know their own trait status. Until access to primary care providers is improved, ED physicians who care for patients at risk for sickle-cell trait have an obligation to ask them about prior screening and either screen them or refer them for screening.
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To assess the numbers of high-risk adult patients presenting to the emergency department (ED) who have not been vaccinated against influenza or pneumococcal disease and whether emergency physicians are willing or able to routinely provide vaccination. ⋯ Significant numbers of high-risk patients who are unimmunized against influenza and pneumococcal pneumonia present to the ED. There is hesitancy among ED physicians about assuming the primary care task of providing such immunizations. Any attempt to institute a large-scale vaccination program in an ED setting needs to be carefully planned in a way to involve primary care providers and to decrease ED physician concerns and reluctance.
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Since inordinately long or short lengths of stay at hospice can create problems for patients, providers, and payers, the author sought to identify predictors of timing of patient referral. ⋯ Inappropriately early or late referral occurs in a substantial minority of patients referred to the hospice under study. Closer attention to accurate prognostication in different types of terminally ill patients and more timely referral to hospice might help to optimize the use of this health care resource from both patient and societal perspectives.