Disaster Medicine in Eye of Storm at IM Meeting

Marcia Frellick

April 12, 2018

NEW ORLEANS — Medicine in the wake of disasters, including insights into how healthcare professionals cared for patients after Hurricane Maria swept through Puerto Rico last September, will be among the highlights at the upcoming American College of Physicians Internal Medicine (IM) Meeting 2018.

Jose Lozada-Costas

Care on the island was a particular challenge, in part because the Medicaid reimbursement rate in Puerto Rico is much lower than it is in the states, said Jose Lozada-Costas, MD, governor of the Puerto Rico chapter of the American College of Physicians (ACP).

Medical efforts involved gathering specialists, nurses, food, water, and medicines, and opening multispecialty sites in churches, schools, and sports arenas, sometimes with the help of military personnel, who cleared roads, he told Medscape Medical News.

Lozada-Costas will describe the strategies that mattered most and the measures that should be put in place before the next natural disaster strikes.

In addition, lessons that continue to be learned about healthcare, infrastructure, and community transformations after the devastation caused in 2005 by Hurricane Katrina will be shared by Karen DeSalvo, MD, national coordinator for health information technology and former acting assistant secretary for health at the US Department of Health and Human Services, and former health commissioner for the City of New Orleans, during her keynote address.

These sessions anchor a suite of offerings on climate change, disaster medicine, and medical volunteerism.

Davoren Chick

Speakers will also provide updates on cutting-edge research and practices related to a host of topics, such as diabetes, hypertension, pain medications, medical marijuana, wearables, and the human microbiome, said Davoren Chick, MD, senior vice president for medical education at the ACP.

The rationale for changes to hypertension guidelines will be explained by Paul Whelton, MD, who holds the Show Chwan Health System Endowed Chair in Global Public Health at Tulane University in New Orleans. The new guidelines call for treatment threshold for hypertension to be lowered with lifestyle changes and medication, as necessary, to 130/80 mm Hg instead of 140/90 mm Hg, but not all medical societies have endorsed them.

Whelton will help physicians better understand when treatment should be initiated, and why.

Another hypertension session will look specifically at the management of hypertensive emergencies.

Emerging Pathogens

Two sessions will introduce the latest emerging pathogens and update physicians on successes and remaining challenges related to Zika, dengue, and chikungunya.

One pathogens session — targeted at hospitalists — will include projections for Clostridium difficile this year.

I don't want to spoil the surprise, but there will be unexpected 'edutainment' during the course of the meeting.

New this meeting is a session on ways to talk with patients about the costs of their care. Experts will explain the most effective patient- and clinician-identified ways to present options and help patients make good choices.

"With the increase in patient enrolment in higher-deductible healthcare plans, there has been a trend toward more patient awareness of the cost of care, and an increased expectation to have those discussions," Chick told Medscape Medical News.

Physicians will also learn about the latest in wearable technology and how to respond to the data provided, she said. Because these devices fall outside of HIPAA protections, what to tell patients about the security of their data, and their rights, is a matter of concern.

Another session — Why Engaging Patients Is Today's Blockbuster Drug — will describe how partnering with patients and families can improve outcomes.

Physician wellness will also be high on the agenda, and several sessions and workshops will explore strategies that work to prevent burnout and restore the joy of practice.

This year, conference organizers have added pop-up education. And, "I don't want to spoil the surprise, but there will be unexpected 'edutainment' during the course of the meeting," said Chick.

Lozada-Costas and Chick and declare no relevant financial relationships.

Follow Medscape on Twitter @Medscape and Marcia Frellick @mfrellick


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