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Effective Clinical Practice, March/April 2001 highlights

Following are highlights from Effective Clinical Practice, published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM) and the Alliance of Community Health Plans. These highlights do not substitute for articles as sources of information. Call 215-351-2655 for fax copies of articles, which are slated for Web site posting on 4/17/01 at acponline.org/journals/ecp/index.html.

Group visits for chronically ill; or the doctor will see you, you, and you now

Group visits may reduce the need for emergency care among chronically ill adults. Of 295 Kaiser Permanente Colorado patients participating in a study, half were randomly assigned to try group visits – a meeting involving 8-12 patients with similar conditions, a physician, nurse and pharmacist. The visits were structured, focused on topics the group chose, and included brief one-on-one doctor or nurse visits. In two years, patients receiving group visits had about half as many emergency department visits and one third as many hospitalizations as the control group (“Reducing Emergency Visits in Older Adults with Chronic Illness. A Randomized, Controlled Trial of Group Visits,” p. 49).

Emergency treatment for some musculoskeletal complaints can be deferred

Musculoskeletal problems represent the most common class of complaints among patients seeking emergency care. However, according to new guidelines written by physicians, some minor musculoskeletal complaints can safely be deferred. Using the guidelines, they found that 25 percent of 448 patients using the ER facilities of a Los Angeles VA medical clinic could safely wait for treatment. When asked, nearly 75 percent of the patients agreed to defer care for an average of three days. Almost 90 percent of the patients returned for appointments (“Deferred Care for Adults with Musculoskeletal Complaints,” p. 65).

Popular magazines misrepresent breast cancer incidence in young women

Stories about breast cancer in popular U.S. magazines misrepresent the ages of typical cancer patients, according to a study of 380 articles. The patient stories primarily involved young women. Although more than half of new breast cancer cases involve women over age 60, only three percent of the patient stories involved women in this age group. The authors conclude that such reporting may contribute to young women’s fears of breast cancer and to overestimates of personal risk (“Misleading Presentation of Breast Cancer in Popular Magazines,” p. 58).

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