American College of Physicians, April 19-21

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The American College of Physicians: Internal Medicine Meeting

The annual meeting of the American College of Physicians (ACP) was held from April 19 to 21 in New Orleans and attracted more than 6,000 participants from around the world, including internists, adult medicine specialists, sub-specialists, medical students, and allied health professionals. The conference highlighted recent advances in the prevention, detection, and treatment of illnesses in adults, with presentations focusing on updates in neurology, oncology, infectious diseases, endocrinology, and cardiology.

During the conference, the ACP held a panel discussion to address a new position paper outlining impacts of social determinants of health on patient outcomes. The position paper was published recently in the Annals of Internal Medicine.

"Physicians need to appreciate the importance of socioeconomic determinants of health. Zip codes, perhaps even more than genetic codes, determine life expectancy and health overall," said panel member John Ende, M.D., immediate past president of the ACP. "The more we know about socioeconomic determinants of health, the more effective we can be as internists in achieving better outcomes for our patients, particularly those who are challenged by poverty, low education, unemployment, and other factors that account for worse health outcomes in our most vulnerable populations."

In addition, according to Ende, training in socioeconomic determinants of health should be part of the medical school and resident curricula, and should also be emphasized in continuing medical education.

"Moreover, these issues really need to be addressed by policy makers at the local, state, and federal levels. The ACP calls for more funding for research in this area. Research is needed to identify the best strategies for internists to use to identify when a patient's health is impacted by socioeconomic factors," Ende added. "Equally important, research is needed to identify the most effective approaches to address these problems at the individual, patient-physician, and population levels."

Furthermore, Ende noted, an appreciation of the socioeconomic determinants of health enables physicians to understand, for example, why patients with asthma find themselves repeatedly in the emergency room with recurrent attacks of asthma, why patients with hypertension don't achieve appropriate blood pressure control, and why patients with diabetes are unable to reach recommended glycemic targets.

"Treatment failures such as these are often directly related not to biologic factors, but to socioeconomic factors," Ende said. "Physicians need to become aware of the importance of socioeconomic determinants of health and discuss them with their patients. This will enhance the bond between patients and physicians. This bond is so important for achieving positive health outcomes, particularly for our most vulnerable patients."

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Also during the meeting, the ACP provided an update regarding their Physician Well-Being & Professional Satisfaction initiative, which aims to promote physician well-being, improve practice and organizational environments for internists, cultivate local communities of well-being, and advocate for systems changes.

"The initiative is being led by the Physician Well-Being & Professional Satisfaction Task Force and includes tools and programs for individual members, their practices, and ACP Chapters, all focused on helping physicians and patients thrive," said Susan Thompson Hingle, M.D., chair of the Task Force. "We are working to foster a culture of wellness by training local well-being champions who will work with individuals, practices, and organizations to combat burnout and foster wellness. We are advocating for systems changes through our Patients Before Paperwork initiative that is working to simplify, streamline, and reduce excess administrative tasks that detract from patient care and contribute to burnout."

The ACP is collaborating with other organizations to aid in this initiative, including the National Academy of Medicine, the Collaborative for Healing and Renewal in Medicine, and the American Medical Association.

"By reducing administrative hassles and tasks and improving practice efficiency, clinical practice will become more enjoyable and effective for patients and physicians as well as the entire health care team. It will allow for more patient-centered care and allow for the return of focus on the physician-patient relationship," Hingle said. "As that returns, physicians will again be able to find meaning in medicine. As burnout turns to thriving, there should be a decrease in physicians leaving practice early, and thus we may begin to chip away at and assist with some of the workforce shortage issues."

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