Pre-courses require pre-registration.
- Dermatology for the Internist (PRE 1801)
- Diabetes for the Internist (PRE 1802)
- Perioperative Medicine 2018 (PRE 1803)
- Advances in Therapy (PRE 1804)
- Cardiology for the Internist 2018: The “Key Points” (PRE 1805)
- Hospital Medicine: From Admission to Discharge (PRE 1806)
- Neurology for the Internist (PRE 1807)
- MACRA, MIPS, and APMs: Strategies for Success Within the Quality Payment Program (PRE 1808)
- QI Champion Training: Transforming Your Practice to Improve Patient Outcomes, Increase Efficiency, Maximize Reimbursement, and Increase Joy in Practice (PRE 1809)
- Critical Care Medicine 2018 (PRE 1810)
- Update in General Internal Medicine and MOC Exam Prep (PRE 1811)
- Point-of-Care Ultrasound for Internists and Hospitalists (PRE 1812)
- Boost Your Well-Being and Professional Satisfaction at Home and Work: Practical Skills for Positive Results (PRE 1813)
Dermatology for the Internist
PRE 1801 Tuesday, 8:00 a.m.–5:00 p.m.
Elizabeth Magill Billingsley, MD
Professor of Dermatology, Director, Mohs Micrographic Surgery, Department of Dermatology, Penn State Hershey Medical Center, Hershey, PA
Patients often present to their internist with skin concerns. Many of these concerns are common
conditions that, once identified, can be easily addressed without a referral to a dermatologist.
With the aid of an audience-response system, faculty will engage participants in identifying
many of these common dermatologic conditions and will review appropriate steps for their diagnosis
and management in the primary care setting. Practical approaches, including biopsy techniques, will be reviewed.
1. Identify common dermatologic problems that present in the primary care setting, and initiate
2. Understand and develop treatment strategies for patients with acne and rosacea.
3. Identify and develop management approaches for both common and complicated dermatoses, such as psoriasis.
4. Recognize common skin cancers and understand indications for various approaches to management.
Diabetes for the Internist
PRE 1802 Tuesday, 8:00 a.m.–5:00 p.m.
Tracy L. Setji, MD, MHS
Assistant Professor of Medicine, Medical Director, Inpatient Endocrinology Consultation, Department of Medicine, Division of Endocrinology, Duke University, Durham, NC
The management of patients with diabetes can be complicated. Many new medications, technologies, and surgical options for the appropriate patient are available. This Pre-Course will discuss the diagnosis and management of diabetes in different clinical settings, including issues related to nutrition, exercise, and risk factor modification. The appropriate indications and practical utilization of weight loss medications in overweight/obese patients will be discussed. New therapies for the management of type 2 diabetes and new insulin preparations for type 1 diabetes and insulin-requiring type 2 diabetes will be presented. Participants will learn to identify the patient with fatty liver disease as well as strategies for evaluation and management of this increasingly common complication of the metabolic syndrome.
1. Discuss the management of patients with prediabetes and whether metformin is the best treatment.
2. Identify patients with fatty liver disease, and how to diagnose and manage the patient with type 2 diabetes.
3. Review guideline-based medical options for the management of patients with type 1 or type 2 diabetes.
4. Discuss new insulin products and the indications and contraindications for use in patients with type 2 diabetes.
5. Review indications and dosing of medications to aid weight loss in overweight individuals with or at risk for diabetes.
Perioperative Medicine 2018
PRE 1803 Tuesday, 8:00 a.m.–5:00 p.m.
Geno J. Merli, MD, MACP, FHM, FSVM
Professor of Medicine & Surgery, Senior Vice President, Associate CMO, Co-Director, Jefferson Vascular Center, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA
This Pre-Course will review the assessment and management of patients with medical comorbidities undergoing surgical procedures. Expert faculty will discuss hypotension, delirium, and pain management in the postanesthesia care unit. Venous thromboembolism (VTE) prophylaxis in the postoperative period for patients with hereditary or acquired coagulation disorders, history recurrent VTE, and aspirin dosing for VTE prophylaxis will be reviewed. Preoperative validated risk assessment tools, modification strategies for identified comorbidities, and management of postoperative complications will be emphasized. Topics will include perioperative medication management, cardiac, pulmonary, and frailty risk indices with modification strategies, postoperative cardiac complications, diabetes management, using the target-specific anticoagulants, treating postoperative delirium, and challenging perioperative cases.
1. Understand the assessment and management of patients with medical comorbidities undergoing surgical procedures.
2. Review guidelines and best practices for preoperative assessment, perioperative medication use, and common postanesthesia care unit problems.
3. Review preoperative validated risk assessment tools, modification strategies, and management of patients with a variety of pre- and postsurgery cardiac and pulmonary problems as well as complications in the frail elderly.
4. Understand management of the new diabetic agents, insulin pumps, and direct oral anticoagulants (DOACs) in the perioperative period.
5. Assess key management strategies for neurologic and neurosurgery patients taking antiplatelet therapy requiring emergent surgery, postoperative pain management, and timing of surgery after acute stroke.
Advances in Therapy
PRE 1804 Wednesday, 8:00 a.m.–5:00 p.m.
Douglas S. Paauw, MD, MACP
Professor of Medicine, Rathmann Family Foundation Endowed Chair in Patient-Centered Clinical Education, Department of Medicine, University of Washington School of Medicine, Seattle, WA
This Pre-Course will focus on pearls to help the practicing internist to maximize the utility of drug therapies. Newer medications and new uses for older medications will be covered. Current recommendations for “best therapy” for different diseases will also be covered. Common side effects of medications will be emphasized. Faculty will provide practical information on therapy for psychiatric disease, diabetes, and infectious diseases; safe use of medications in the elderly; and drug interactions.
1. Prescribe appropriate drug therapies for diseases commonly seen in the office.
2. Understand safe drug prescribing in the elderly.
3. Understand the use and appropriate place of new diabetes therapies.
4. Gain a better understanding of drug reactions and interactions.
Cardiology for the Internist 2018: The “Key Points”
PRE 1805 Wednesday, 8:00 a.m.–5:00 p.m.
Howard H. Weitz, MD, MACP, FACC
Bernard L. Segal Professor of Medicine, Director, Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA
David L. Fischman, MD, FACP
Professor of Medicine, Department of Medicine, Division of Cardiology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
This Pre-Course will provide a focused update on the diagnostic, preventive, and therapeutic approaches to the patient at risk for, or with known, cardiovascular disease. Expert clinician-educators will focus on the cardiovascular disease issues that internists most frequently encounter and will provide “key points” to update the audience and foster patient care. Subjects covered will include identification and management of acute and chronic coronary artery disease, optimal treatment of acute and chronic heart failure, update in the treatment of hypertension, risk assessment and risk reduction for the patient with cardiac disease who undergoes noncardiac surgery, approach to the patient with valvular heart disease, atrial fibrillation update, approach to the treatment of peripheral arterial disease, and discussion of selected cases.
1. Update the internist on the diagnostic and therapeutic approaches to the patient with known cardiovascular disease.
2. Become familiar with the guidelines and recent studies regarding hypertension, valvular heart disease, optimal blood pressure control, and care of the patient with cardiovascular disease having noncardiac surgery.
3. Understand approaches for decreasing the risk for complications and decreasing hospital readmissions for patients with a variety of cardiovascular issues.
4. Become familiar with optimal surgical and pharmacologic treatments for the care of patients with acute coronary syndrome, heart failure, valvular heart disease, and atrial fibrillation.
5. Become familiar with the transition of care following hospital discharge for patients with a variety of cardiac issues.
Hospital Medicine: From Admission to Discharge
PRE 1806 Wednesday, 8:00 a.m.–5:00 p.m.
Steven B. Deitelzweig, MD, MMM, FACP, SFHM
Associate Professor of Medicine, Department of Hospital Medicine, Business Development, Ochsner Health System, New Orleans, LA
Jamie Newman, MD, MHA, FACP
Associate Professor, Internal Medicine, Assistant Professor, Health Care Management, Department of Hospital Medicine, Mayo Clinic, Rochester, MN
Roger Yu, MD, Member
Department of Medicine, Division of Hospital Medicine, Scripps Green Hospital, La Jolla, CA
The hospital is a complex environment. Navigating it on behalf of our patients requires a broad and constantly growing body of clinical knowledge combined with an understanding of the systems that support them. This Pre-Course will review the challenges of transitions of care and handoffs, clinical conundrums of common and uncommon scenarios, and administrative hurdles. The faculty of experienced hospitalists and specialists from across the United States will discuss ideal medical management. First and foremost is the consideration of the needs of the patient. Individual lectures will involve review of up-to-date medical care using a case-based format and an audience-response system. This Pre-Course will present an advanced perspective of hospital medicine.
1. Review inpatient management of complex patients in case-based presentations.
2. Explore practical considerations in transitions-of-care and handoffs.
3. Succeed at adapting to new rules and regulations to better advocate for patients.
4. Highlight best practice for hospital safety.
Neurology for the Internist
PRE 1807 Wednesday, 8:00 a.m.–5:00 p.m.
Martin A. Samuels, MD, MACP, DSc (Hon), FAAN, FRCP, FANA
Miriam Sydney Joseph Professor of Neurology, Harvard Medical School; Department of Neurology, Brigham and Women's Hospital, Boston, MA
Neurologic symptoms comprise an important part of the practice of internal medicine, but over the years exposure to formal neurologic training as part of internal medicine training has waned. This Pre-Course is designed to help internists approach the common neurologic problems seen in their patients and to update them in this rapidly changing field of medicine. A broad view of the spectrum of neurologic disorders seen in the practice of internal medicine will be discussed, including the neurologic history and examination, stroke, dizziness, topics in neuro-ophthalmology, seizures, and movement disorders.
1. Take a neurologic history, and perform a competent neurologic examination.
2. Recognize the major types of seizures and how to treat them.
3. Understand the spectrum of dizziness, and be able to make the likely diagnosis.
4. Recognize and treat the major movement disorders.
5. Examine the eyes, and recognize the major neuro-ophthalmology problems.
6. Identify the major stroke emergencies, and initiate appropriate therapy.
7. Recognize the major headache syndromes, and initiate therapy.
8. Identify the common disorders of the peripheral nervous system, and initiate treatment.
MACRA, MIPS, and APMs: Strategies for Success Within the Quality Payment Program
PRE 1808 Wednesday, 8:00 a.m.–5:00 p.m.
Peter Basch, MD, MACP
Department of Quality & Safety, Research, Medical Affairs, MedStar Health, Washington, DC
Robert M. McLean, MD, FACP
Associate Clinical Professor, Yale School of Medicine, Medical Director of Clinical Quality, Northeast Medical Group of the Yale New Haven Health System, New Haven, CT
Beginning in 2019 the Medicare payment system will change. Physicians and practices need to prepare now in order to be successful within the Quality Payment Program. With the elimination of the Sustainable Growth Rate (SGR), the new value-based payment program for Medicare was designed with the goal of replacing volume-based fee-for-service payment over time. Private payers also have moved in the direction of incentivizing higher quality rather than only the volume of services. Without a clear understanding of how care will be measured and paid for, physicians risk losing revenue and reputation. This course will help practices of all sizes understand this paradigm shift and how to succeed in the new environment.
Attendees will take a deep dive into understanding the Quality Payment Program, including how practices will be scored and paid in both the advanced Alternative Payment Models (APMs) and Merit-Based Incentive Payment System (MIPS) pathways. The agenda will discuss options and opportunities for current and future APMs, including an understanding of MIPS APMs. On the MIPS side, attendees will learn practical strategies on how to select and implement measures and activities best for their practices in order to maximize scores in each category. The agenda will address strategies for all four MIPS categories – quality, improvement activities, advancing care information, and cost.
Who should attend: clinicians, medical directors, CMOs, CMIOs, quality managers, administrators, and any staff who administers the Quality Payment Program for a practice.
1. Understand the components of the new Medicare Quality Payment Program, as well as the rules for participation.
2. Identify strategies for your practice to be successful under this new program.
3. Utilize available tools and resources from ACP, including the Quality Payment Advisor, Genesis Registry, ACP Practice Advisor, and the ACP Physician & Practice Timeline to establish best practices and lead to successful outcomes within the Medicare Quality Payment Program.
QI Champion Training: Transforming Your Practice to Improve Patient Outcomes, Increase Efficiency, Maximize Reimbursement, and Increase Joy in Practice
PRE 1809 Wednesday, 8:00 a.m.–5:00 p.m.
Doron Schneider, MD, FACP
Assistant Professor of Medicine, Drexel University; Department of Medicine, Abington Hospital, Jefferson Health, Abington, PA
ACP's quality improvement champion training program aims to facilitate practice transformation to improve health and patient experience, reduce costs, and increase efficiency. Participants will be provided with proven and practical tools to improve care for patients, promote patient engagement and partnerships, apply practice redesign strategies to maximize skills of all team members, reduce administrative complexity and increase joy in practice, maximize reimbursement under new value-based payment models, and promote health equity among diverse patient populations. At the conclusion of this Pre-Course, champions will be able to apply QI strategies to tackle challenging issues, such as caring for patients with chronic illnesses, increasing adult immunizations, and promoting safe opioid prescribing. Hundreds of ACP members and care teams from 21 states have become ACP QI champions and have established an engaging peer-to-peer learning network and are experiencing significant improvements. This full-day course will launch you on the journey of becoming an ACP QI champion and will provide the skills you will need throughout your career to lead the way through the changing tides of health care.
1. Understand the rationale for practice transformation.
2. Understand how to identify performance gaps and opportunities for improvement while taking into account health disparities.
3. Understand how to create change and improvement using plan-do-study-act (PDSA) and other basic QI tools.
4. Understand how to partner with patients and families in QI activities.
5. Understand how to develop a focused QI workplan in an area of interest, such as adult immunization, safe opioid prescribing, diabetes, or atrial fibrillation.
6. Understand how to best communicate your QI plan needs and goals with stakeholders at the practice and leadership levels.
7. Understand how to effectively use ACP tools to drive QI and measure reporting, such as the Genesis Registry, ACP Practice Advisor, Patient Education Resources, and Quality Payment Advisor.
Critical Care Medicine 2018
PRE 1810 Tuesday and Wednesday, 8:00 a.m.–5:00 p.m.
Robert A. Balk, MD, MACP, MCCM, FCCP
J. Bailey Carter, MD Professor of Medicine, Director, Division of Pulmonary, Critical Care, and Sleep Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL
This Pre-Course will provide the opportunity to understand the principles of diagnosis and management of common clinical problems and conditions encountered in the intensive care unit. Particular attention will be placed on the recognition of disease process, acute management of critical illness, and prevention of complications of critical illness in the critically ill adult patient.
Topics discussed include acute coronary syndromes and myocardial infarction, acute congestive heart failure, atrial arrhythmia management, acute stroke management, acute respiratory distress syndrome, pulmonary embolism, drug overdose, sepsis and septic shock, ischemic bowel and abdominal compartment syndrome, obstructive lung disease, and severe pneumonia. Also discussed will be the management of patients with a wide variety of infectious diseases, approaches to mental status evaluation, blood product utilization, mechanical ventilatory support of the critically ill patient, surgical issues in the ICU, care of the cancer patient in the ICU, and methods for preventing common complications in the critically ill patient.
1. Update the internist on common disorders and diseases encountered in the intensive care unit.
2. Review the diagnostic techniques used in the management of the critically ill adult.
3. Discuss recommendations for the management of common critical illnesses encountered in the intensive care unit and strategies for the prevention of complications of critical illness.
Update in General Internal Medicine and MOC Exam Prep
PRE 1811 Tuesday and Wednesday, 8:00 a.m.–5:00 p.m.
Marc J. Kahn, MD, MBA, FACP
Peterman-Prosser Professor, Senior Associate Dean, Department of Medicine, Section of Hematology/ Medical Oncology, Tulane University School of Medicine, New Orleans, LA
Fred A. Lopez, MD, MACP
Richard Vial Professor and Vice Chair, Department of Medicine, Louisiana State University School of Medicine, New Orleans, LA
This Pre-Course provides an update in internal medicine and preparation for an MOC exam. Taught by a faculty of clinician-educators, each an expert in his/her subspecialty, the course uses a highly interactive format to engage participants. Clinical scenarios and challenging multiple-choice questions are springboards for discussion of recent advances across the spectrum of internal medicine. With the use of an audience-response system, participants can compare their clinical judgement with that of their peers. This course is an effective way to update your knowledge and/or prepare for an ABIM exam.
1. Increase and refresh knowledge of internal medicine through discussion of challenging cases frequently seen in practice.
2. Become adept at working through difficult exam-type questions logically and successfully.
3. Implement changes in clinical practice in accordance with recent advances and guidelines.
Point-of-Care Ultrasound for Internists and Hospitalists
PRE 1812 Tuesday and Wednesday, 8:00 a.m.–5:00 p.m.
Michael Blaivas, MD, MBA, FAIUM, FACEP
Professor of Medicine, University of South Carolina, Department of Emergency Medicine, Piedmont Newnan, Columbia, SC
Keith Boniface, MD
Professor of Emergency Medicine, Department of Emergency Medicine, George Washington University, Washington, DC
This Pre-Course will introduce the internist to point-of-care ultrasound skills and applications that may be applied from the office to any hospital setting to provide answers to specific clinical questions in real time. Ultrasound allows the clinician a focused diagnostic modality directly at the patient’s bedside and directs the performance of procedures. Could this be a deep vein thrombosis (DVT), or is there some other cause for this swollen leg? Point-of-care ultrasound is proven by multiple studies as a rapid and accurate evaluation and diagnosis of DVT at the time of the evaluation. Multiple procedures such as peripheral and central line placement, joint and tendon aspiration and injection, thora/paracentesis and pericardiocentesis along with others benefit from ultrasound guidance.
Point-of-care echo is a quick way to estimate ejection fraction and volume status, assess for severe structural changes, and rule out a pericardial effusion. Point-of-care abdominal ultrasound is a rapid way to detect free air, gallbladder disease, and aortic disease. Additional clinical questions ultrasound may help you answer are: Is that a simple cellulitis or one complicated by an underlying abscess that needs drainage? How deep is the abscess? Can it be drained safely in the office/bedside or the operating room? Is that lump you palpate on exam solid, cystic, or vascular?
Hear lectures from national experts on point-of-care ultrasound and learn evidence-based approaches and techniques. Ample hands-on learning, guided by seasoned clinicians who use ultrasound in their practices on a daily basis, will be augmented by simulation experience, including procedure practice on phantoms, as well as amazing computer-based simulation presenting actual patient pathology and allowing attendees to learn from real clinical scenarios.
If you have heard of other fields embracing ultrasound and how it improves their practice and are interested in increasing efficiency and safety in your own practice, this course is a great place to start.
This 2-day course will offer topics of interest on both hospital- and office-based applications.
1. Describe the principles of ultrasound operation, use of artifacts, and optimization of images.
2. List indications and rationale for focused diagnostic ultrasound applications for cardiac, lung, and abdominal applications.
3. Perform and interpret focused diagnostic ultrasound for cardiac, lung, and abdominal applications.
4. Explain the rationale for using ultrasound guidance for thoracentesis, paracentesis, and vascular access.
5. Perform ultrasound-guided thoracentesis, paracentesis, and vascular access using simulators.
6. Understand point-of-care ultrasound use for focused musculoskeletal evaluation, joint injection, and arthrocentesis.
Boost Your Well-Being and Professional Satisfaction at Home and Work: Practical Skills for Positive Results
PRE 1813 Wednesday 8:00 a.m.-5:00 p.m.
Charlene M. Dewey, MD, MEd, FACP
Professor of Medical Education and Administration, Professor of Medicine and Public Health, Assistant Dean for Educator Development, Co-Director, Center for Professional Health, Chair, Faculty Wellness Committee, Vanderbilt University School of Medicine/Medical Center, Nashville, TN
This Pre-Course will provide participants with the knowledge and practical skills to help them improve their own well-being and professional satisfaction and those of their colleagues by helping to create a supportive and fun work environment. Participants will discuss the epidemic of physician burnout and evidence-based solutions to improve both individual well-being and organizational culture. Participants will practice skills to manage their own stress and positive psychology coaching to help colleagues and staff. The end of the day will focus on an appreciative inquiry process for addressing and improving resiliency for the individual in a variety of different practice settings and best practices for positively influencing change within the work environment.
1. Discuss stressors, risks, and symptoms of physician burnout.
2. Compare and contrast measures for assessing burnout, resilience, and culture within
health care environments.
3. Apply aspects of positive psychology and resilience in addressing physician well-being and professional satisfaction and reducing burnout.
4. List several systematic approaches to reduce burnout and promote well-being.
5. Develop and write intents to change for both individual and organizational approaches to
promoting physician well-being and professional satisfaction.