March 30-April 1, 2017 Pre-Courses: March 28–29 ADVANCE PROGRAM im2017.acponline.org Plan Now to Attend Internal Medicine Meeting 2017 My Fellow Colleagues, There is a buzz in the air as we prepare for Internal Medicine Meeting 2017 in beautiful San Diego, CA. Planning began in 2015, and efforts are well under way to make this meeting one of the best that the College has ever hosted. The multidimensional program offers something for everyone—from small group sessions to classic lecture formats to hands-on learning activities—you’re sure to find a format to fit your learning style. Top national medical professionals will present the latest internal medicine clinical findings, improved practice management techniques, and topics pertaining to health care policy and reform. In addition, attendance offers the opportunity to earn CME credit and ABIM MOC points. This meeting is a highlight for me each year. I look forward to learning new ways to improve my techniques and enhance patient care. Having the opportunity to share knowledge, discuss current topics, and exchange ideas with my internal medicine colleagues is an integral part of why I enjoy attending. Please join me at Internal Medicine Meeting 2017 and be part of the conversation. Lisa Ellis, MD, FACP Chair, Internal Medicine Meeting 2017, Scientific Program Committee Keynote Speaker Anthony S. Fauci, MD, MACP Director, National Institute of Allergy and Infectious Diseases National Institutes of Health Keynote Address:From AIDS to Zika: The Enduring Challenge of Emerging Infectious Diseases San Diego Harbor im2017.acponline.org Enjoy the West Coast Vibe San Diego is often referred to as “America’s Finest City” and for good reason. San Diego, CA, has fabulous beaches, year-round warm temperatures, and clear skies. San Diego’s vibrant communities each have unique characters that will win your heart. Come and enjoy the best of both worlds— outstanding education in a location that offers countless opportunities for recreation, including world-class resorts, amusement parks, golf courses, deep-sea fishing, sailing, surfing, windsurfing, and kayaking. San Diego has something for everyone! Balboa Park Bell Tower and Museum Table of Contents Pre-Courses..................................................................2 Special Events............................................................38 CME Information.......................................................10 Exhibit Hall and Additional Learning Opportunities ...........................................................40 Maintenance of Certification....................................11 Guest Activities Program..........................................42 Scientific Program Sessions.....................................12 Advance Registration Information...........................43 Hospital Medicine Track...........................................20 Travel Information......................................................45 Schedule Planner......................................................22 Housing Information.................................................48 Fulfill State CME Requirements...............................31 Registration Forms....................................................49 Herbert S. Waxman Clinical Skills Center...............................................................33 Shuttle Bus Schedule................................................52 Clinical Skills Workshops..........................................37 im2017.acponline.org | 1 Pre-Courses (March 28-29) Learning Objectives: Tuesday PRE 1701 Diabetes for the Internist2017 1. Discuss the management of patients with PRE 1702 Perioperative Medicine 2017 prediabetes and whether metformin is the best treatment. PRE 1703 Dermatology for the Internist Wednesday 2. Identify patients with fatty liver disease and PRE 1704 Advances in Therapy how to diagnose and manage the patient PRE 1705 Cardiology for the Internist: The Key Points with type 2 diabetes. PRE 1706 Hospital Medicine: A Day on Service 3. Review guideline-based medical options PRE 1707 Neurology for the Internist for the management of patients with type 1 QI Champion Training to Save Time, Money, Patients, and or type 2 diabetes. PRE 1708 Peace of Mind 4. Discuss new insulin products and the indica- Tuesday and Wednesday tions and contraindications for their use in PRE 1709 Critical Care Medicine 2017 patients with type 2 diabetes. PRE 1710 The Art of Leadership: A Laboratory for Change 5. Discuss personalized care of the patient with PRE 1711 Maintenance of Certification Exam Preparation diabetes and how to make the correct diag- PRE 1712 Point-of-Care Ultrasound for Internists and Hospitalists nosis of the type of diabetes in confusing clinical presentations. For information about MOC points see page 11. Perioperative Medicine 2017 Diabetes for the Internist 2017 PRE 1702Tuesday, 8:00 a.m.-5:00 p.m. PRE 1701Tuesday, 8:00 a.m.-5:00 p.m. Geno J. Merli, MD, MACP, FHM, FSVM Diana B. McNeill, MD, FACP Professor of Medicine and Surgery, Senior Vice President, Professor of Medicine, Department of Internal Medicine, Associate CMO, Department of Hospital Administration, Division of Endocrinology and Metabolism, Duke Thomas Jefferson University Hospital, Philadelphia, PA University Medical Center, Durham, NC This Pre-Course will provide the opportunity to The management of patients with diabetes can understand the assessment and management be complicated. There are many new therapies of patients with medical comorbidities under- available for the management of diabetes, in- going surgical procedures. Particular attention cluding new medications, technologies, and will be placed on preoperative validated risk- surgical options for the appropriate patient. assessment tools, modification strategies for This Pre-Course will discuss the diagnosis and identified comorbidities, and management of management of diabetes in different clinical postoperative complications. Topics will in- settings, including issues related to nutrition, clude perioperative medication management; exercise, and risk factor modification. New cardiac, pulmonary, and frailty risk indices with therapies for the management of type 2 dia- modification strategies; postoperative cardiac betes and new insulin preparations for type 1 complications; venous thromboembolism pre- diabetes and insulin-requiring type 2 diabetes vention; managing the target-specific antico- will be presented. Participants will learn to agulants; treating postoperative delirium; and identify the patient with fatty liver disease and challenging perioperative cases. learn strategies for evaluation and manage- ment of this increasingly common complica- Learning Objectives: tion of the metabolic syndrome. 1. Understand the principles of postanesthesia care. 2 | im2017.acponline.org Pre-Courses (March 28–29) 2. Discuss guidelines and best practice man- Advances in Therapy agement of perioperative medication. PRE 1704Wednesday, 8:00 a.m.-5:00 p.m. 3. Evaluate risk-assessment tools and modifica- Douglas S. Paauw, MD, MACP tion strategies for cardiac, pulmonary, and Professor of Medicine, Rathmann Family Foundation frail elderly patients. Endowed Chair for Patient-Centered Clinical Education, Department of Medicine, University of Washington 4. Review venous thromboembolism prophy- School of Medicine, Seattle, WA laxis in the postoperative period—both acute This Pre-Course will focus on pearls to help the and extended prevention. practicing internist use drug therapies in the 5. Evaluate approaches to identification and most effective manner. Newer medications and management of postoperative delirium. new uses for older medications will be covered. Current recommendations for “best therapy” for different diseases will also be covered. Com- Dermatology for the Internist mon side effects of medications will be empha- PRE 1703Tuesday, 8:00 a.m.-5:00 p.m. sized. Faculty will provide practical information on therapy for psychiatric disease, diabetes, and Elizabeth Magill Billingsley, MD infectious diseases; safe use of medications in Professor of Dermatology, Director of Mohs Micrographic Surgery, Department of Dermatology, Penn State Hershey the elderly; and drug interactions. Medical Center, Hershey, PA Learning Objectives: Patients often present to their internist with skin 1. Prescribe appropriate drug therapies for dis- concerns. Many of these concerns are common eases commonly seen in the office. conditions that, once identified, can be easily addressed without a referral to a dermatolo- 2. Understand the current uses of older drugs gist. With the aid of an audience-response sys- and newly released drugs. tem, faculty will engage participants in 3. Understand the use and appropriate place identifying many of these common dermato- of new diabetes therapies. logic conditions and will review appropriate steps for diagnosis and management of these 4. Gain a better understanding of drug reac- conditions in the primary care setting. Practical tions and interactions. approaches, including biopsy techniques, will be reviewed. Cardiology for the Internist 2017: Learning Objectives: The Key Points 1. Identify common dermatologic problems PRE 1705Wednesday, 8:00 a.m.-5:00 p.m. that present in the primary care setting, and David L. Fischman, MD, FACP initiate appropriate treatment. Professor of Medicine, Department of Medicine, Thomas 2. Understand and develop treatment strate- Jefferson University Hospital, Philadelphia, PA gies for patients with acne and rosacea. Howard H. Weitz, MD, FACC, MACP 3. Review biopsy techniques and know when to Professor of Medicine, Director, Division of Cardiology, Sidney Kimmel Medical College at Thomas Jefferson apply each technique. University Hospital, Philadelphia, PA 4. Recognize common skin cancers and under- This Pre-Course will provide a focused update stand indications for various approaches to of the diagnostic, preventive, and therapeutic management. approaches to the patient at risk for, or with im2017.acponline.org | 3 Pre-Courses (March 28-29) known, cardiovascular disease. Expert clini- 9. Learn the role of atrial fibrillation ablation for cian–educators will focus on the cardiovascular the patient with atrial fibrillation. disease issues that internists most frequently encounter and will provide “key points” to up- date the audience and foster patient care. Sub- Hospital Medicine: A Day on Service jects covered will include identification and PRE 1706Wednesday, 8:00 a.m.-5:00 p.m. management of acute and chronic coronary ar- Jamie Newman, MD, FACP tery disease, optimal treatment of acute and Assistant Professor, Department of Internal Medicine, chronic heart failure, update in the treatment of Mayo Clinic, Rochester, MN hypertension, risk assessment and risk reduc- Roger Yu, MD, Member tion for the patient with cardiac disease who Department of Medicine, Division of Hospital Medicine, undergoes noncardiac surgery, approach to Scripps Green Hospital, La Jolla, CA the patient with valvular heart disease, atrial fibrillation update, approach to the treatment It's Monday morning and you are picking up an of acute and chronic venous disease, and chal- inpatient service. You will be managing these lenging cases in antithrombotic and anticoagu- patients, working with a physician assistant. In lant management. this 1-day Pre-Course, we will review the chal- lenges of assuming care for a service, transi- Learning Objectives: tions of care and handoffs, clinical conundrums 1. Develop diagnostic, treatment, and preven- of common and uncommon scenarios, admin- tion strategies for patients with coronary istrative hurdles, and bureaucratic barriers. The artery disease (acute and chronic). faculty of experienced hospitalists and special- ists from across the United States will discuss 2. Understand the approach to the evaluation ideal medical management. First and foremost and treatment of both new-onset and is the consideration of the needs of the patient. chronic heart failure. Individual lectures will involve review of up-to- 3. Become familiar with the various guideline date medical care using a case-based format approaches to the treatment of hypertension. and an audience-response system. Framing these clinical issues will be a secondary discus- 4. Become familiar with the ACC/AHA guide- sion of the other key issues in managing hospi- line on valvular heart disease and its applica- tal patients, including utilization management, tions to patient evaluation and treatment. documentation, supervision, safety, and quality. 5. Become familiar with the guidelines for the This Pre-Course will present an advanced per- evaluation and care of the patient with spective of hospital medicine. cardiovascular disease who undergoes Learning Objectives: noncardiac surgery. 1. Review inpatient management of complex 6. Become familiar with the prevention and patients in case-based presentations. treatment of acute deep vein thrombosis. 2. Recognize and rescue the deteriorating pa- 7. Become familiar with the treatment of tient. chronic venous disease. 3. Explore practical considerations in transi- 8. Become familiar with the treatment of the tions-of-care and handoffs. complex patient who requires treatment with anticoagulants as well as antiplatelet agents. 4. Succeed at adapting to new rules and regu- lations to better advocate for patients. 4 | im2017.acponline.org Pre-Courses (March 28–29) Neurology for the Internist QI Champion Training to Save Time, Money, Patients, and Peace of Mind PRE 1707Wednesday, 8:00 a.m.-5:00 p.m. Martin A. Samuels, MD, DSc (Hon), MACP, PRE 1708Wednesday, 8:00 a.m.-5:00 p.m. FAAN, FRCP, FANA Marie T. Brown, MD, FACP Miriam Sydney Joseph Professor of Neurology, Harvard Associate Professor, Department of Internal Medicine, Medical School; Department of Neurology, Brigham and Rush University, Chicago, IL Women's Hospital, Boston, MA Doron Schneider, MD, FACP Neurologic complaints comprise an important Chief Safety and Quality Officer, Abington Hospital, part of the practice of internal medicine, but Jefferson Health, Abington, PA over the years the exposure to formal neuro- Performance reporting requirements are ever-in- logic training as part of internal medicine train- creasing, costing overburdened physicians and ing has waned. This Pre-Course is designed to their team time, money, and joy in practice and help internists approach the common neuro- ultimately robbing from patient care. ACP has logic problems seen in their patients and to developed a program that trains physicians to update them in this rapidly changing field of improve care for patients with chronic pain and medicine. A broad view of the spectrum of diabetes, increase revenue through adult immu- neurologic disorders seen in the practice of in- nizations, and promote safe opioid prescribing ternal medicine will be discussed, including through better use of the care team and technol- the neurologic history and examination, stroke, ogy. Already, hundreds of ACP members and dizziness, topics in neuro-ophthalmology, care teams from 19 states have become ACP QI seizures, and movement disorders. champions and are increasingly enjoying patient Learning Objectives: care through greater efficiency and peer-to-peer learning, all the while growing revenue through 1. Take a neurologic history, and perform a better performance in value-based reimburse- competent neurologic examination. ment models. This full-day course will launch you 2. Recognize the major types of seizures and on the journey of becoming an ACP QI cham- how to treat them. pion, whether you are a solo practitioner, are 3. Understand the spectrum of dizziness, and working among underserved patient popula- be able to make the likely diagnosis. tions, or are in a training program or a large health system. Do it for the relief, requirements, 4. Recognize and treat the major movement or revenue. Regardless of the reason, realize the disorders. benefits of better care of your patients while 5. Examine the eyes, and recognize the major reinvigorating your practice of medicine. neuro-ophthalmology problems. Learning Objectives: 6. Identify the major stroke emergencies, and 1. Better understand the strategies that can en- initiate appropriate therapy. hance team-based care through QI, leading 7. Recognize the major headache syndromes, to significant practice efficiencies. and initiate therapy. 2. Develop a QI project outline with the input 8. Identify the common disorders of the of national experts and peers. peripheral nervous system and initiate 3. Practice communicating QI goals to your treatment. team, colleagues, patients, and organization leadership. im2017.acponline.org | 5 Pre-Courses (March 28-29) 4. Apply QI-based strategies to promote safe Learning Objectives: opioid prescribing, chronic pain and dia- 1. Update the internist on common disorders betes management, and increased revenue and diseases encountered in the intensive through immunizing adults through team- care unit. based approaches. 2. Review the diagnostic techniques used in 5. Understand the strategies and resources the management of the critically ill adult. for easing performance reporting available from ACP. 3. Discuss recommendations for the manage- ment of common critical illnesses encoun- 6. Become an ACP QI champion, serving as a tered in the intensive care unit and leader in your practice, region, system, and prevention of complications of critical illness. the ACP. The Art of Leadership: A Laboratory Critical Care Medicine 2017 for Change PRE 1709Tuesday and Wednesday, 8:00 a.m.-5:00 p.m. Presented by the American Association for Robert A. Balk, MD, MACP Physician Leadership J. Bailey Carter, MD Professor of Medicine, Director, PRE 1710Tuesday and Wednesday, 8:00 a.m.-5:00 p.m. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Rush Medical College, Rush This Pre-Course is a primer on the “need-to- University Medical Center, Chicago, IL know” leadership skills and your tool belt for This Pre-Course will provide the opportunity to success in today’s rapidly changing health care understand the principles of diagnosis and environment. In this interactive, content-rich, management of common clinical problems and skills-oriented two-day course, participants and conditions encountered in the intensive are given an intimate view of what makes care unit. Particular attention will be placed on today’s physician leaders unique and effective. the recognition of disease process, acute man- Learn effective leadership and communication agement of critical illness, and prevention of skills, how to become both an effective team complications of critical illness in the critically member and team leader, and how to build ill adult patient. work teams that make a difference. Topics include acute coronary syndromes and You’ll leave this course ready to lead effective myocardial infarction, acute congestive heart change. Through short lectures, small-group failure, atrial arrhythmia management, acute discussions and facilitated teams, faculty mem- stroke management, acute respiratory distress ber Kevin O’Connor and experienced ACP facil- syndrome, pulmonary embolism, drug over- itators will help you tackle challenges that dose, sepsis and septic shock, and severe you’re experiencing today at your organization. pneumonia. Also discussed will be the man- You’ll go home with a purpose and a plan of ac- agement of patients with a wide variety of in- tion to achieve results and solve real problems. fectious diseases, approaches to mental status Learning Objectives: evaluation, fever in the ICU, blood product uti- lization, mechanical ventilatory support of the 1. Identify leadership goals as it relates to each critically ill patient, care of the cancer patient in participants own case study. the ICU, and methods for preventing common 2. Assess the communication style of others in complications in the critically ill patient. order to influence them for effective change. 6 | im2017.acponline.org Pre-Courses (March 28–29) 3. Demonstrate the connections between the tion Examination in Internal Medicine. Taught by bedside, the boardroom and everything in a faculty of clinician–educators, each an expert in between. his or her subspecialty, this highly interactive course focuses on content likely to be ques- 4. Transform a group of individuals into a highly tioned on the exam. With the aid of an audience- motivated, high-performing team. response system, faculty engage participants in 5. Determine how to handle difficult issues, dif- clinical problem solving that reflects priority ficult people, and even the difficult parts of areas identified on the recently revised ABIM ex- ourselves! amination blueprint. The question-based format serves as a springboard for discussion of impor- This Pre-Course is organized and presented by tant developments across the spectrum of inter- the American Association for Physician Leader- nal medicine. ACP’s MOC Prep Course is an ship. Category 1 CME credit will be provided by efficient and effective way to refresh your knowl- American Association for Physician Leadership edge and get ready for the exam. and not the American College of Physicians. Instructions for claiming credit through the Learning Objectives: American Association for Physician Leadership 1. Increase and refresh knowledge of core top- will be provided at the end of the Pre-Course. ics in internal medicine through presenta- The American Association for Physician Leader- tions of common and not-so-common ship® is accredited by the Accreditation Council clinical problems. for Continuing Medical Education (ACCME) to 2. Become adept working through difficult test provide continuing medical education for questions logically and successfully. physicians. 3. Implement changes in clinical practice in ac- The American Association for Physician Leader- cordance with recent advances and clinical ship® designates this live activity for a maximum guidelines. of 14 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Point-of-Care Ultrasound for Internists and Hospitalists Maintenance of Certification Exam PRE 1712Tuesday and Wednesday, 8:00 a.m.-5:00 p.m. Preparation Michael Blaivas, MD, MBA, FAIUM, FACEP PRE 1711Tuesday and Wednesday, 8:00 a.m.-5:00 p.m. Professor of Medicine, University of South Carolina, Department of Emergency Medicine, Piedmont Newnan, Marc J. Kahn, MD, MBA, FACP Columbia, SC Peterman-Prosser Professor, Senior Associate Dean, Keith Boniface, MD Department of Medicine, Tulane University School of Medicine, New Orleans, LA Professor of Emergency Medicine, Chief, Emergency Medicine, George Washington University, Washington, DC Fred A. Lopez, MD, MACP This Pre-Course will introduce the internist to Richard Vial Professor and Vice Chair, Department of Medicine, Louisiana State University School of Medicine, point-of-care ultrasound skills and applications New Orleans, LA that may be applied from the office to any hos- This Pre-Course is designed to help physicians pital setting to provide answers to specific clini- prepare for the ABIM Maintenance of Certifica- cal questions in real time. Ultrasound allows im2017.acponline.org | 7 Pre-Courses (March 28-29) the clinician a focused diagnostic modality di- Learning Objectives: rectly at the patient’s bedside. Could this be a 1. Describe the principles of ultrasound opera- deep vein thrombosis (DVT), or is there some tion, use of artifacts, and optimization of im- other cause for this swollen leg? Point-of-care ages. ultrasound is proven by multiple studies as a rapid and accurate evaluation and diagnosis of 2. List indications and rationale for focused di- DVT at the time of the evaluation. agnostic ultrasound applications for cardiac, lung, and abdominal applications. Point-of-care echo is a quick way to estimate ejection fraction and volume status, assess for 3. Perform and interpret focused diagnostic severe structural changes, and rule out a peri- ultrasound for cardiac, lung, and abdominal cardial effusion. Point-of-care abdominal applications. ultrasound is a rapid way to detect free air, 4. Explain the rationale for using ultrasound gallbladder disease, and aortic disease. Addi- guidance for thoracentesis, paracentesis, tional clinical questions ultrasound may help and vascular access. you answer are: Is that a simple cellulitis or one 5. Perform ultrasound-guided thoracentesis, complicated by an underlying abscess that paracentesis, and vascular access using needs drainage? How deep is the abscess? simulators. Can it be drained safely in the office/bedside or the operating room? Is that lump you pal- 6. Understand point-of-care ultrasound use for pate on exam solid, cystic, or vascular? focused musculoskeletal evaluation, joint injection, and arthrocentesis. 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 The afternoon of the second day of this use ultrasound in their practices on a daily course will be divided into two tracks, basis, will be augmented by simulation experi- Hospital- and Office-based applications. ence, including procedure practice on phan- The Hospital track will focus on thoracen- toms, as well as amazing computer-based tesis, paracentesis, and CVC. The Office simulation presenting actual patient pathology track will focus on common ambulatory and allowing attendees to learn from real applications for point-of-care ultrasound, clinical scenarios. including lower-extremity MSK, upper- extremity MSK, and soft tissue/abscess. If you have heard of other fields embracing ultrasound and how it improves their practice To ensure that you receive the optimal ed- and are interested in increasing efficiency and ucational experience, you will be required safety in your own practice, this course is a to select one of these two tracks at the great place to start. time of registration. Changes cannot be made to your track selection after initial registration. 8 | im2017.acponline.org