AIDS, Risk Management and State Requirements CME Review Courses

Aids Topics

ANESTHESIOLOGY: HIV and AIDS: What Do We Know Mark H. Katz and Jeffrey T. Kirchner Encourage testing for HIV infection as a continuing priority in AIDS prevention; Counsel HIV-infected patients on avoiding high-risk behaviors responsible for current unacceptable level of HIV transmission; Participate in new strategies to encourage AIDS prevention, including voluntary routine HIV testing among at-risk groups, testing outside medical facilities, and prevention of perinatal transmission. (A94)

INTERNAL MEDICINE: Advances in Managing HIV and AIDS Diane V. Havlir, M.D. and Arthur Ammann, M.D. Discuss the benefits associated with early initiation of antiretroviral therapy. Implement evidence-based guidelines for initiating treatment in patients with HIV and AIDS-related complica¬tions. Detail the treatment options for treatment-naive and treatment-experienced patients with HIV infection. Identify patients at increased risk of transmitting HIV and initiate interventions that decrease that risk. Summarize the progress and remaining challenges related to the global AIDS epidemic. (A96)

FAMILY PRACTICE: HIV: A Primary Care Update Monica Gandhi, M.D., M.P.H. and Gail Bolan, M.D. Incorporate routine HIV screening into health care maintenance. Describe current and newer methods for reducing HIV transmission. Counsel patients about when to start HIV treatment. Review screening options for syphilis. Select the best treatments of gonorrhea. (A100)

OBSTETRICS/GYNECOLOGY: Clinical Challenges in Contraception and HIV Daniel R. Mishell, Jr., M.D. and Deborah Cohan, M.D. Discuss the efficacy, benefits, and drawbacks of different methods of contraception. Recognize contraindications for the use of combination oral contraceptives. Prescribe appropriate contraceptive methods for women with medical conditions. Determine the appropriate cervical cancer screening interval for women with HIV infection. Implement preconception and obstetric care in HIV-positive women. (A101)

Dermatology

FAMILY PRACTICE: Dermatologic Dilemmas John R. T. Reeves and Julie A. Letsinger Describe and identify common as well as unusual causes of itching; Discuss the appropriate use of topical steroids, antihistamines, tricyclic antidepressants, and other agents in the treatment of pruritic skin conditions; Diagnose and treat onycholysis and other disorders of the nails; Manage patients with common skin conditions such as tinea capitis, scabies, impetigo, and psoriasis; and Review appropriate treatment of basal cell carcinoma, squamous cell carcinoma, and pigmented lesions such as nevi and melanomas. (DERM2)

EMERGENCY MEDICINE: Wound and Infection Loren Crown and Frederick Abrahamian Summarize the principles of wound care; Utilize appropriate techniques for wound closure; Distinguish between cellulitis and erysipelas; Prescribe appropriate antibiotic therapy for skin and soft tissue infections; and Recognize colonization with methicillin-resistant Staphyloccus aureus. (DERM3)

Diabetes

INTERNAL MEDICINE: Cardiovascular Management of Patients with Diabetes Jan N. Basile Manage hyperglycemia in patients with diabetes and CVD; Control blood pressure in patients with diabetes and CVD; Treat lipid abnormalities in patients with diabetes and CVD; Treat lipid abnormalities in patients with diabetes and CVD; Diagnose diabetes in patients whose fasting blood glucose is within normal range; and Adopt a multi-factorial approach in managing patients with diabetes and CVD. (D1)

PEDIATRICS: Sickle Cell Disease/Diabetes John J. Strouse and David W. Cooke Cooke Describe the possible genotypic representations of sickle cell disease; Identify patients with sickle cell disease who are at high risk for severe disease; Describe effective therapies for managing sickle cell disease in children; Choose appropriate medication and delivery devices for patients with type 1 diabetes; and Evaluate the efficacy of glucose monitoring devices. (D2)

OPHTHALMOLOGY: Diabetic Retinopathy Carol Schwartz, Lloyd P. Aiello, and Michael J. Cooney Describe current methods for managing diabetic retinopathy; Discuss new and proposed approaches to treatment of diabetic retinopathy; Evaluate the efficacy of intrvitreal bevacizumab for diabetic retinopathy; Describe the role of nutritional therapy in preventing progression of age-related macular degeneration; and Discuss the role of nutrition in managing diabetic retinopathy. (D3)

Domestic Violence

PSYCHIATRY: Sex Offenders Charles L. Scott Supply medical and legal definitions for several categories of sex offenders; Provide an overview of people with paraphilias and estimate the risk for their engaging in more than one form of paraphilia; Discuss past and present trends in legislation dealing with sex offenders; Evaluate sex offenders in terms of their risk for recidivism; and Describe treatments available for sex offenders. (DV23)

Ethics

EMERGENCY MEDICINE: Ethical Considerations in Emergency Medicine Peter Rosen Explain the importance of having a well worked-out system of ethics in place before practicing in the emergency department (ED); Define ethics and law, and describe the difference in these principles of conduct; Explore the current concept of an ethical relationship between the physician and the patient; List some of the general ethical problems that may be encountered in the ED; and Describe the recommended approach to resolving ethical dilemmas presented in case examples. (E21)

INTERNAL MEDICINE: Trust Cycle: Saving Lives, Changing Lives from the Bedside to the Boardroom Brian D. Wong, M.D., M.P.H. Discuss the importance of trust in health care settings. Identify barriers to cooperation and teamwork. Recognize one’s personal role in suboptimal workplace dynamics. List the qualities of a TRUSTED colleague. Apply TRUSTED concept to facilitate positive change and effective solutions in the workplace. (E23)

OTOLARYNGOLOGY: Ethical Issues in Medicine Peter Rosen, M.D. Explain the importance of having a well worked-out system of ethics in place. Define ethics and law, and describe the difference in these principles of conduct. Explore the current concept of an ethical relationship between the physician and the patient. List some of the general ethical problems that may be encountered in medical practice. Describe the recommended approach to resolving ethical dilemmas presented in case examples. (E24)

OPHTHALMOLOGY: Ethical Issues in Medicine Peter Rosen, M.D. Explain the importance of having a well worked-out system of ethics in place. Define ethics and law, and describe the difference in these principles of conduct. Explore the current concept of an ethical relationship between the physician and the patient. List some of the general ethical problems that may be encountered in practice. Describe the recommended approach to resolving ethical dilemmas presented in case examples. (E25)

GASTROENTEROLOGY: GI Ethical Issues David T. Rubin, M.D. and Carol Burke, M.D. Discuss some of the ethical dilemmas associated with genetic testing for IBD. Describe the influence of environmental factors on IBD. List the genes involved in IBD. Recognize the genetic features of familial adenomatous polyposis and Lynch syndrome. Explain the importance of informed consent for genetic testing in IBD and colorectal cancer. (E26)

FAMILY PRACTICE: Issues in the "Not so Golden Years" Daniel Pound, M.D. and William M. Simpson Jr, M.D. Describe legal statutes that govern treatment decisions. Counsel patients and family members about advance directive decisions. Incorporate values history and effective communication into advance planning. Select appropriate medications to reduce risk for adverse drug effects in elderly patients. Provide measures to improve adherence to appropriate medication use. (E27)

Infectious Disease

INTERNAL MEDICINE: Preventing and Treating Infectious Disease Lisa G. Winston and Jonathan M. Zenilman List the essential qualities of preventive vaccines; State the latest recommendations for vaccinating health care workers against mumps; Describe the differences (eg, contraindications, side effects) between the injectable and intranasal influenza vaccines; Discuss the controversies about the human papillomavirus vaccine; and Identify atypical presentations of respiratory infections, including psittacosis and non-tuberculous mycobacterial infections. (ID1)

FAMILY PRACTICE: Curbing Infectious Disease B. Joseph Guglielmo and Bradley A. Sharpe Select appropriate antibiotic therapy for common respiratory tract infections; Identify patients with acute otitis media who should benefit from antibiotic therapy; Educate patients about the lack of benefit of antibiotics in some disease settings; Diagnose and treat patients with community-acquired pneumonia (CAP); and Describe patterns of resistance to the management of CAP. (ID2)

FAMILY PRACTICE: Infectious Disease Update Lisa Winston and Bradley A. Sharpe Describe the vaccines available for protection against pneumococcal and meningococcal disease, influenza, varicella, and human papillomavirus (including their components, efficacy, indications, and contraindications); Cite and follow current vaccination recommendations and guidelines; Employ the Pneumonia Severity index (PSI)/ Pneumonia Outcomes Research Team (PORT) score to determine whether a patient diagnosed with CAP requires admission; Initiate appropriate antibiotic treatment in the outpatient with CAP; and Describe some of the preventative treatments and strategies for CAP and their benefits. (ID3)

EMERGENCY MEDICINE: Infectious Diseases at Home and Abroad Explain potential downsides to antibiotic therapy. Cite and follow the recommended treatment algorithm when bacterial meningitis is strongly suspected. Describe antibiotic options for treating outpatient and serious methicillin-resistant Staphylococcus aureus infections and current recommended timing of antibiotics for community-acquired pneumonia. Evaluate patients with travel-related illness.Diagnose and manage diarrheal illness, dermatologic problems, and malaria acquired abroad. (ID4)

FAMILY PRACTICE: Infectious Diseases Sharon Adler, M.D., M.P.H. and David Asmuth, M.D. Implement evidence-based recommendations for screening men and women for STDs. Diagnose and treat patients with STDs. Educate patients about risk, risk reduction, and the prevention of transmission of STDs. Identify pitfalls in the management of TB. Adequately treat patients with multidrug-resistant TB. (ID6)

EMERGENCY MEDICINE: Infectious Disease Update 2009 Gregory J. Moran, MD Choose appropriate antibiotics for specific infections, including sepsis, septic shock, bacterial meningitis, and pneumonia. Recognize when antibiotics are not necessary or when a short course of antibiotics is appropriate. Discuss the differences between community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and hospital-acquired MRSA and the treatment of CA-MRSA infections of differing severity. Explain the epidemiology of West Nile virus infections and the treatment of Clostridium difficile infections. Describe the problems expected to be encountered in an influenza epiedemic and the challenges in preparing for one. (ID7)

PEDIATRICS: Infectious Disease Challenges Ravi Jhaveri, M.D. and Coleen K. Cunningham, M.D. Evaluate the efficacy of cold-inactivated and thermally inactivated influenza vaccines, and identify patients who should receive the nasal vaccine. Interpret the data on evolution and diversity among isolates of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), and recognize factors that contribute to its virulence. Analyze reports on the incidence of Streptococcus pneumoniae serotype 19A and the optimal use of vaccination and antibiotics for diseases caused by this organism. Describe the appropriate use of blood culture for identification of pathogens in febrile children. Diagnose diseases caused by emerging respiratory viruses, and discriminate between new human pathogens and those recently identified. (ID9)

PEDIATRICS: Infectious Disease Dilemmas Stephen C. Eppes, M.D. and Jason (Jay) H. Homme, M.D. Describe the host response to EBV infection. Recognize the key symptoms (clinical triad) and physical examination findings of infectious mononucleosis (IM). Utilize the appropriate laboratory tests to diagnose IM. Recognize the importance of analgesia and education in the treatment of AOM. Determine when observation is appropriate for AOM. (ID10)

PEDIATRICS: Infectious Disease Consult John S. Bradley, M.D. and Ravi Jhaveri, M.D. List the most common causes of CAP in children. Describe factors that vary with the etiology of CAP and that may provide clues when diagnosing a child’s CAP. Utilize the patient’s age, clinical presentation, physical examination, and laboratory tests to focus anti-infective therapy against the most likely disease-causing pathogens. Discuss recent studies documenting the impact of PCV7 on pneumococcal pneumonia and meningitis. Recognize indicators for switching from intravenous to oral antibiotics in the treatment of osteomyelitis. (ID11)

PEDIATRICS: ENT Infections/Travel Medicine S. Michael Marcy, MD Discuss the difficulty of using clinical criteria alone to diagnose acute otitis media (AOM). Describe the latest guidelines for antimicrobial therapy for AOM and treatment recommendations for the peni­cillin-allergic child. Explain methods that can be used to diagnose group A b-hemolytic streptococcal (GABHS) pharyngitis, and describe antibiotic agents available for its treatment. Cite recent data on observation vs antibacterial therapy for treatment of pediatric acute bacterial sinusitis. Describe safety and health precautions and recommended preparations for international travel with children. (ID12)

OTOLARYNGOLOGY: Update on Prevention and Management Andrew T. Kroger, M.D. and Sandro K. Cinti, M.D. Describe risk factors and give immunization recommendations for infectious diseases ranging from human papillomavirus to influenza. Assess the need for immunizations in individual health care providers. Explain the molecular mechanisms behind treatment resistance in Staphylcoccus aureus. Distinguish resistance patterns of hospital-acquired MRSA from those of community-acquired MRSA. Manage MRSA infections of varying severity using the appropriate antibiotics and strategies. (ID13)

GASTROENTEROLOGY: Infectious Diseases David A. Peura, M.D. and C. Bradley Hare, M.D. Assess patients with gastritis and dyspepsia for H pylori infections. Compare various treatment regimens for H pylori infection. Predict gastric cancer risks among patients with H pylori. Determine which early antiretroviral drug intervention is best for treatment-naive HIV-positive patients. Discuss findings of recent clinical trials on use of antiretroviral agents in the ongoing management of HIV-positive patients. (ID14)

EMERGENCY MEDICINE: Infectious Diseases Lisa Winston, M.D. and Sam Torbati, M.D. Explain the difference between antigenic drift and antigenic shift. Utilize the appropriate influenza antiviral drug in a timely way. Review the indications for and contraindications to influenza vaccine. Distinguish between sepsis, severe sepsis, and septic shock. Apply early goal-directed therapy for sepsis. (ID15)

OBSTETRICS/GYNECOLOGY: Issues in Communicable Diseases Patricia J. Sulak, M.D. and Katherine K. Hsu, M.D., M.P.H. Identify the most common STDs by incidence, prevalence, most reportable, and age group. Counsel patients about the modes of transmission of STDs. Discuss the asymptomatic carrier state associated with STDs. List the 3 vaccines that make up the adolescent vaccine platform. Implement an appropriate vaccination program for an adolescent patient. (ID16)

Medical Errors

EMERGENCY MEDICINE: Risk Management Today Paul A. Silka, M.D.and David B. Hoyt, M.D. Describe the characteristics that make the ED an error-prone environment. Recognize some of the common heuristics that can lead to errors in diagnosis. Apply methods that can create a culture based on teamwork and communication in the ED. Utilize appropriate screening tests and algorithms to avoid missed injuries. Avoid secondary injury when 2 competing injuries are present. Avoid secondary injury when 2 competing injuries are present. (ME3)

ANESTHESIOLOGY: Patient Safety Kenneth F. Kuchta, M.D. and John J. Nance, J.D. Describe common anesthetic medication errors. List the likely contributing factors resulting in anesthetic medication errors. Provide recommendations to minimize anesthetic medication errors. Consider how culture change can be brought about in health care. Evaluate the roles of perception, assumption, and communication in medical errors. (ME4)

OTOLARYNGOLOGY: Strategies for Improving Your Surgical Practice John J. Nance, J.D. and Peter A. Adamson, M.D. Consider how culture change can be brought about in health care. Evaluate the roles of perception, assumption, and communication in medical errors. Describe unique ability and how it affects surgical practice. Apply delegation and growth strategies to a surgical practice. Discuss the frontstage/backstage model of surgical practice. (ME5)

Pain Management

FAMILY PRACTICE: Patients in Pain Elliott B. Sterenfeld, Steven N. Berney, and William R. Vollmar Perform a rational clinical evaluation for patients complaining of back pain; Offer reasonable treatment options for back patients, and know when to refer patients; Workup the patient suspected of having fibromyalgia; Consider options for treating patients with fibromyalgia; and Evaluate and treat patients with hip and pelvic pain due to trauma. (PM59)

ANESTHESIOLOGY: Chronic Pain/CPR Update Mark S. Wallace and Benjamin S. Abella Review the diagnosis of neuropathic pain; Examine the components of pain management; Compare treatments approved by the Food and Drug Administration for neuropathic pain; List the interventional therapies for neuropathic pain; and Examine the latest changes in cardiopulmonary resuscitation guidelines, drug recommendations, and post-resuscitation care. (PM61)

PSYCHIATRY: Pain Management Mark S. Wallace and James U. Adelman Describe treatment options for chronic pain; Participate in a pain-management team; Discuss the latest definition of migraine; Prevent or stop individual migraine attacks in patients who are headache-free most days; and Reduce the frequency of migraine attacks in patients who have a headache most days. (PM63)

FAMILY PRACTICE: Oh Doctor, I Hurt Louis Kuritzky and Donald R. Taylor Diagnose and treat diabetic peripheral neuropathic pain; Recognize the importance of treating pain in patients with depression; Prescribe appropriate drugs to treat pain comorbid with depression; Review the different classes of drugs used to treat chronic pain and their mechanisms of action; and Utilize the appropriate drugs in patients with chronic pain. (PM64)

FAMILY PRACTICE: Pain and Behavioral Dilemmas Mark S. Wallace, M.D. and Lloyd A. Darlow, M.D. Recognize fibromyalgia in patients who present with musculoskeletal pain. Address other features of fibromyalgia, such as sleep disturbances. Select effective therapy for fibromyalgia, based on clinical evidence. Select effective therapy for children with attention-deficit/hyperactivity disorder (ADHD). Differentiate ADHD from oppositional defiant disorder. (PM66)

FAMILY PRACTICE: Pearls in Pain Management Nathan J. Rudin, M.D. and James W. Leonard, D.O. Describe risks and benefits associated with use of nonsteroidal anti-inflammatory drugs. Target specific pain conditions such as diabetic neuropathy and fibromyalgia with appropriate medications. List risks and benefits of common adjuvant analgesics.Identify effective uses of ultrasonography and transcutaneous electrical nerve stimulation for pain. Counsel patients about rehabilitating with exercise and strength training. (PM67)

FAMILY PRACTICE: Pain Management: A Primary Care Perspective Richard C. Timming, M.D. and Edward C. Covington, M.D. Distinguish chronic pain from acute pain. Identify candidates for opioid use. Establish a care plan for patients experiencing chronic pain, based on clinical findings. Describe the effect of cognition and perceptions on chronic pain. Outline behavior modification techniques for comorbid pain and psychiatric disorders. (PM68)

OBSTETRICS/GYNECOLOGY: Pain Issues in Women Dawn A. Marcus, M.D. and Jan Lewis Brandes, M.D. Recognize hormonal influence on migraine headache. Individualize therapy for women with migraine headache during the perimenopausal period. Cite diagnostic criteria for fibromyalgia. Discuss the role of central sensitization in symptoms associated with fibromyalgia. Recognize and care for patients with fibromyalgia. (PM69)

PSYCHIATRY: The Psychiatrist/Psychologist as Pain Manager Barry Eliot Cole, M.D., M.P.A. and Robert Lynn Horne, M.D. State the contributions psychiatrists and psychologists can make to the field of pain management. Describe the pathophysiology of chronic pain. Discuss methods for managing chronic pain. Define fibromyalgia using the American College of Rheumatology criteria. Diagnose and treat fibromyalgia. (PM70)

ORTHOPEDICS: Upper Extremity Update James L. Mahoney, M.D., Terry S. Axelrod, M.D. and Robin R. Richards, M.D. Diagnose and treat patients with carpal tunnel syndrome (CTS). Identify patients with CTS who are likely to benefit from surgery. Optimize outcomes of metacarpophalangeal (MP) surgery in patients with rheumatoid arthritis (RA). Discuss the advantages and disadvantages of silicone and pyrocarbon MP implants in patients with RA. Assess patients with work-related injuries of the upper extremities. (PM72)

PEDIATRICS: Pediatric Orthopedics T. Desmond Brown, M.D. and Jennifer M. Weiss, M.D. Recognize red flags in the child with back pain that may indicate serious pathology. Choose appropriate imaging studies for pediatric back pain and sports injuries. Explain the role of exercise and stretching in treatment of pediatric back pain. List the most common sports injuries in pediatric patients. Identify pediatric sports injuries that require surgical intervention. (PM73)

ANESTHESIOLOGY: Control of Chronic Pain and Acute Pain/Hemoglobinopathies Teresa Dews, M.D., John E. Tetzlaff, M.D. and Stacy Ritzman, M.D. Describe the action and effects of opiates. Recognize the differences between addiction, dependence, and tolerance. Develop a treatment plan for prescribing opiates, including mutually agreed upon treatment goals and regular monitoring of the patient for compliance and side effects. Discuss the advantages of using peripheral nerve catheters for management of acute pain . List the most common hemoglobinopathies and coagulopathies, including sickle-cell disease and von Wille­brand’s disease. (PM74)

OTOLARYNGOLOGY: Trends in Treatment J. Stephen Huff, M.D., Frederick G. Freitag, D.O. and Stewart J. Tepper, M.. Recognize common and serious causes for headache in the emergency department. Distinguish clinical features of cluster headache from those of migraine. Treat cluster headache using abortive agents and long- and short-term preventive agents. Explain the autonomic system pathogenesis of cluster headache. Describe mechanisms and outcomes of sphenopalatine ganglion stimulation in patients with chronic refractory cluster and migraine headaches. (PM75)

Risk Management

OB/GYN: Cancer Screening/ Risk Management Identify candidates for early breast cancer screening; Enumerate ways of minimizing false-negative mammography findings; Analyze the meaning of abnormal imaging findings and give patients a realistic idea of their risk for breast cancer; Anticipate the issues that are most likely to arise in malpractice litigation involving failure to diagnose breast or gynecologic cancers; and Establish standard cancer screening protocol (R104)

ANESTHESIOLOGY: Quality Metrics/Malpractice Daniel R. Brown and Joseph A. Camarra Distinguish which current reportable metrics are pertinent to the practice of anesthesiology; Analyze metrics used in perioperative medicine; Determine the impact of nonanesthesiologists on anesthetic care; Discuss limitations of quality and outcome metrics; Recognize the importance of communication, charting, delegation and supervision, and flexibility when the unanticipated occurs in avoiding malpractice lawsuits. (R105)

PSYCHIATRY: Risk Management: Part I Seclusion and Restraint Kim J. Masters, M.D. Examine the historical roots of seclusion and restraint procedures. Describe 3 elements of coercive treatment in a psychiatric service or child and adolescent residential treatment facility. Explain why institutions are never completely free of coercion, but should always strive toward collaboration. Discuss patients’ views of seclusion and restraint. Improve the safety of restraint by using pulse oximetry to monitor patients being restrained. (R106)

OPHTHALMOLOGY: Medicolegal Issues in Ophthalmology Howard A. Slavin, J.D. and Tamara R. Fountain, M.D. Identify elements of a well-documented patient record. Enumerate elements of the informed consent for procedures. Recognize the 2 classes of medication that most commonly contribute to lawsuits. Avoid common mistakes when acting as an expert witness. Follow ethical guidelines when providing expert witness testimony. (R107)

OTOLARYNGOLOGY: Improving Control of Health Care-Associated Infections Dennis G. Maki, M.D. and Ovid O. Meyer, Professor of Medicine Explain why the risk for HCAIs is higher in intensive care units (ICUs). Discuss possible reasons for failure of hospital to reduce the incidence of HCAIs. Describe how HCAIs are transmitted in the hospital, particularly in the ICU. Adopt evidence-based preventive measures, (eg, hand hygiene), barrier precautions, and chlorhexidine sponge baths). Utilize innovative technologies to prevent HCAIs. (R108)

EMERGENCY MEDICINE: Paul A. Silka, M.D. and David B. Hoyt, M.D.. Describe the characteristics that make the ED an error-prone environment. Recognize some of the common heuristics that can lead to errors in diagnosis. Apply methods that can create a culture based on teamwork and communication in the ED. Utilize appropriate screening tests and algorithms to avoid missed injuries. Avoid secondary injury when 2 competing injuries are present. (R110)

INTERNAL MEDICINE: Rules and Laws in Medical Malpractice Part I Marvin C. Mengel, M.D., J.D. & Michael R. Lowe, Esq. Describe physician behaviors, practices, and attitudes that optimize patient care and minimize the risk of being sued. Recognize the link between patients’ anger, complaints, and the risk of being sued. Practice standards of medicine that reduce the chances of patients’ having a bad outcome, becoming angry, and initiating a lawsuit against the physician. Document procedures and interactions with patients and hospital staff to protect against future legal actions. Respond to patients’ concerns about drug side effects and explain the physician’s and patient’s roles and responsibilities in making decisions about medication and care. Respond to patients’ concerns about drug side effects and explain the physician’s and patient’s roles and responsibilities in making decisions about medication and care. (R111)

INTERNAL MEDICINE: Rules and Laws in Medical Malpractice Part II Michael R. Lowe, Esq. and Marvin C. Mengel, M.D., J.D. Cite the reasons for the increase in medical spas and retail medicine clinics. Describe some of the rules pertaining to licensure and proper supervision of physician extenders; medical records and privacy; the treatment of Medicare patients and the use of advance beneficiary notices (ABNs). Explain the regulatory and legal consequences of the improper off-label use of drugs, medications, and medical devices. Describe key considerations when selling a physician practice, or entering physician employment, physician recruitment, medical director, call coverage, joint venture, or gainsharing agreements. Avoid violations of the Stark Law and federal antikickback statute. (R112)

ANESTHESIOLOGY: Professional Liability Karen B. Domino, M.D., M.P.H. and Robert A. Caplan, M,D., et al Explain how experts evaluate standard of care. Review the role of informed consent in medical malpractice. Describe how malpractice attorneys evaluate liability and settle a claim. Analyze causation and burden of proof in medical malpractice and predict the outcome of a jury award exceeding the malpractice insurance cap. Inform medical staff of essential steps to take before informing a family about an adverse outcome. (R113)

EMERGENCY MEDICINE: High Risk Emergencies Robert Vissers, M.D. and Ron M. Walls, M.D. Determine the cause of abdominal pain, based on history, physical examination, laboratory tests, and imaging. Compare the efficacy of computed tomography and ultrasonography in the diagnosis of abdominal pain. Use symptoms, laboratory tests, and imaging to establish the diagnosis of appendicitis. Explain the decision-making process in managing difficult airways. Summarize the medicolegal responsibilities of emergency physicians, attending physicians, and consultants in the management of patients with difficult airways. (R114)

EMERGENCY MEDICINE: Malprictice Prophylaxis Gary F. Pollock, M.D. and Michael J. Bresler, M.D. Recognize the importance of excellent care and of the physician’s attitude and leadership in the emergency depart­ment (ED) in avoiding a malpractice lawsuit. Interact with patients in an effective and respectful manner in various situations. Record relevant information in the patient’s chart. Recognize the importance of timing physicians’ orders. Manage combative and difficult patients in the ED. (R115)

ANESTHESIOLOGY: Lynn D. Martin, M.D. and Avery Tung, M.D. Explain how the principles of the Toyota company can be applied to anesthesiology and the operating room. Summarize the differences between classical and lean process improvement. Describe typical challenges encountered when using lean process improvement methodology in anesthesiology and operative services. Provide examples of disagreement between clinical experience and clinical trials, and compare human vs analytic decision-making strategies. Discuss unique characteristics of human decision making when risk and uncertainty are involved, and identify potential strategies to improve decision making in ambiguous or uncertain environments. (R116)

Substance Abuse

PSYCHIATRY: Nicotine and Alcohol Dependence Stuart Gitlow Explain the dopamine hypothesis of nicotine dependence; Use the “5 As” )Ask, advise, assess, assist, and arrange) to help people stop smoking; Assess the use of pharmacotherapy as an adjunct to behavioral therapy for smoking cessation; Describe how conflicting definitions affect the research on treating alcoholism and alcohol dependence; and Discuss the uncertain efficacy of pharmacotherapy for treating alcoholism and alcohol dependence. (SA42)

INTERNAL MEDICINE: Brief Interventions: Targeting Substance Use and Abuse Richard L. Brown, M.D. and Douglas E. Jorenby, P.h.D. Explain the effect of substance use on the reward center of the brain and its clinical implications. Screen all patients for substance use and identify patients who may benefit from brief interventions. Appropriately prescribe pharmacotherapeutic agents to aid patients in stopping use of alcohol or opioids. Discuss the importance of targeted personal advice, specific quit plans, and follow-up for patients attempting to quit smoking. Compare mechanism of action and outcome of approved pharmacotherapies for smoking cessation. (SA43)

PSYCHIATRY: Substance Abuse David A. Fiellin, M.D. and Dorothy Hatsukami, P.h.D. Identify patients at risk for dependence on prescription opioids, heroin, and alcohol. Describe treatment strategies for opioid dependence. Compare and contrast traditional and newer treatment strategies for alcohol abuse and dependence. Explain some of the mechanisms, such as environmental cues, that contribute to nicotine addiction. Discuss pharmacotherapy for nicotine addiction. (SA44)

FAMILY PRACTICE: Confronting Addiction John D. Patz, D.O. and Steven M. Juergens, M.D. Recommend appropriate levels of care for detoxification. Recognize substances and conditions that warrant inpatient detoxification. Manage symptoms, such as insomnia and hypertension, during alcohol and opioid withdrawal. Discuss pharmacokinetic differences of commonly used benzodiazepines. Describe symptoms of benzodiazepine withdrawal, and effects of benzodiazepines on cognition and psycho­motor performance. (SA45)

PSYCHIATRY: Addiction David B. Rosengren, P.h.D. and Richard Saitz, M.D., M.P.H. Describe the advantages and disadvantages of using motivational interviewing (MI) in treatment of addictions. Define MI and discuss some of the changes that have occurred in its philosophy. State some of the principles involved in learning and practicing MI. Explain why addictions may be better served by treating them as chronic conditions that require long-term management. Describe a model for chronic disease management of addictions in an integrated care setting. (SA47)

Various Other Topics

GENERAL SURGERY: People Skills Gregory J. Jurkovich, M.D. and Rasjad K. Lints, M.D. Recognize elements of the conversation most important to recipients when a clinician relates bad news. Describe behaviors that help family members understand and accept bad news. Appreciate the value of good communication with patients and family members and its impact on the success of the physician. Create cultural expectations of high performance among physicians’ clinical departments. Effectively manage behavioral problems and implement work improvement plans for poor performers. Effectively manage behavioral problems and implement work improvement plans for poor performers. (CD2)