For four decades, leading physicians have called patients the most under-used resource in healthcare, a sentiment amplified by statements like "Nothing about me without me." But slogans alone don’t cause change, and the time has come to teach clinicians (and patients/caregivers) to evolve healthcare in the internet age and to seek the evidence, rationale, and theoretical basis for these practices. While many patients are not yet "e-patients" (empowered and engaged), new care models are emerging and real. When new methods are understood and developed, the workload can be rebalanced, and the results can be more fulfilling for all. This unconventional keynote will be shared, fittingly, by the best-known exemplars of this new model: stage IV cancer survivor "e-Patient Dave" deBronkart and his physician, Dr. Danny Sands. They are two of the co-founders of the Society for Participatory Medicine and co-authors of "Let Patients Help: A Patient Engagement Handbook." Participants will learn about the transformative and potentially disruptive movement of participatory medicine, and they will leave informed -- even empowered -- to take effective new actions on behalf of their patients.

The speaker will describe the most common foot pathology and offer appropriate treatments. Learners will observe the differential diagnosis for many of the foot problems and walk away with clinical pearls.

Whether we realize it or not, the stories we witness and the narratives we are privileged to co-author give meaning to our work as clinicians. However, stress and burnout prevent many from connecting with these stories. This session will provide the unique perspectives of three different speakers who will discuss storytelling, the “4Rs” (reflection, relationships, resourcefulness, and resilience), and fiscal health. From them, you will learn preemptive approaches for managing stress and promoting resilience as well as strategies to obtain non-medical income streams that could put you in position for a more optimal work-life balance. With these tools, you may find more bandwidth to engage with the stories of your patients and restore satisfaction in your work.

This talk will provide an evidence-based approach to the detection, treatment, and monitoring of osteoporosis. Important, recently published studies will be referenced. You will walk away more informed about controversies on how long to treat and current estimates of the rates of adverse effects of therapy.

Growth is a fundamental process of childhood that is followed longitudinally by primary care. Poor growth velocity warrants an evaluation to identify an underlying pathology, whether endocrine or non-endocrine, whereas short stature refers to height below the normal spectrum of the population. You will learn more about common pathologies that may present with poor growth and contrast them with genetic mechanisms that contribute to variation in the population. Growth hormone—which was traditionally restricted to use in those with growth hormone deficiency—is the main intervention available to increase final adult height. As it commonly has efficacy to increase stature outside of the setting of growth hormone deficiency, the number of FDA-approved indications for its use have expanded over the past decades. The faculty in this lecture will also discuss considerations by pediatric endocrinologists in the prescription of growth hormone.

Unlike HIV with rates of mortality that decline yearly, TB remains the leading infectious cause of death worldwide, accounting for 1.3 million deaths in 2016. Approximately 2 billion people in the world and 10 to 15 million Americans have latent TB infection (LTBI). Although they are not infectious, up to 10% each year are at risk of progression to active disease, depending on their risk factors and co-morbidities. This presentation will compare modalities to diagnose LTBI: the tuberculin skin test (or PPD) and the interferon gamma release assay (e.g., the quantiferon gold blood test). The faculty will discuss which patients are at high risk for progression to TB disease and the role of preventive chemotherapy. Finally, you will learn more about the emerging global storm that awaits us as diabetes becomes epidemic and merges with TB, as there is a 2-4-fold increased risk for TB in patients with diabetes.

In an increasingly litigious era of medicine, it becomes easy to over-test, over-treat, and generally over-do some basic urgent issues in the outpatient setting. This course will review some of the most common urgent outpatient complaints and evidence-based diagnostics and therapeutics that can let both you and your patient rest well without breaking the bank. We will focus on pearls for high-value care and reinforce the importance of thorough history-taking and physical exams, as they are the most valuable and least expensive tools in the clinician’s toolkit. After this review of evidence-based criteria that will allow you to proceed confidently when further management is indicated, you can reassure your patients that more isn’t always better.

In this activity, learners will receive an overview of an ambulatory approach to the evaluation and medical management of urinary incontinence through identifying the steps involved in performing a basic evaluation of a patient with (UI). The speaker will discuss and provide strategies for treatment and explain how treatment can be optimized for each individual patient.

More than half of all mental health treatment takes place in primary care, a major burden (though also an opportunity) for providers who are expected to do so many things at once. How can psychiatry help given their limited availability across the country? Enter the Collaborative Care Model, with multiple randomized trials showing feasibility and improved outcomes from adding two main ingredients in primary care clinics: an in-house Behavioral Health Consultant who serves as liaison, data-gatherer/recorder and manager of a registry of patients who receive “treat to target” follow-up; and a remote consulting psychiatrist in regular communication with the BHC and the primary care team. This presentation will briefly describe the 5 principles which drive this Collaborative Care Model and will also focus on implementation: what steps need to be taken to incorporate such a program in a primary care practice? And how does setting and geography play a role? General guidelines from experience implementing this model in 12 different clinics will help your planning (from pre-contemplation to preparation to action!)

In this activity, Dr. Eslami will give an overview of an ambulatory approach to the evaluation and medical management of urinary incontinence by identifying the steps involved for performing a basic evaluation of a patient with urinary incontinence. She will discuss and provide strategies for treatment and explain how treatment can be optimized for each individual patient.