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ACP addresses challenges internal medicine faces

The American College of Physicians called attention to three problems internists currently face — defining their roles in health care, satisfaction with their careers and controlling health care costs — in a paper published in the Annals of Internal Medicine.

“I highlight what I consider to be three leading issues for internal medicine and for ACP as it enters its second century and strives to continue to meet the goals of its recently updated motto, ‘Leading Internal Medicine, Improving Lives,” Steven E. Weinberger, MD, of the American College of Physicians, wrote.

Defining the role of internal medicine

Weinberger stressed that non-subspecialist internists face competition for the role of primary care clinician with internal medicine subspecialists, family physicians and nurse practitioners.

The ACP decided to unify the profession with this definition: “specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness.”

Primary care internists are unique in their ability to diagnose patients with complicated or undifferentiated presentations and coordinate acute and continuing care for patients, Weinberger wrote.

Addressing professional satisfaction concerns

The ACP addressed the unhappiness of primary care physicians with their careers and professional activities with its Practice Enjoyment Initiative, which it considers to be one of its highest priorities.

A component of this initiative, Patients before Paperwork, focuses on the issue of time-consuming administrative work creating a burden, such as prior authorizations, documentation requirements and learning complicated electronic health record systems.

The ACP also acknowledged primary care physicians’ unhappiness with their professional isolation in small or rural practices and the subsequent loss of intellectual stimulation and collegiality. 

Responsibility to control health care costs

The ACP also announced efforts to prevent overuse and misuse of care such as unnecessary diagnostic tests or treatments. The college vowed to identify low or no-value care and educate the medical community of such practices. 

“Over time, however, the effort to reduce staggering health care costs needs to be expanded to additional areas, including decreasing unnecessary hospitalizations and emergency department visits,” Weinberger wrote.

Disclosure: Weinberger reports no relevant financial disclosures.