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Am Fam Physician. 2009;79(10):839-840

AAFP Urges Physicians to Stay Up-to-Date on Guidelines for Swine Flu Outbreak

The American Academy of Family Physicians (AAFP) is encouraging members to take steps to limit the impact of the recent swine flu outbreak. In particular, the AAFP recommends that physicians follow the clinical guidance issued by the Centers for Disease Control and Prevention (CDC). If physicians suspect swine flu in patients with febrile respiratory illness, they should obtain a respiratory swab for testing, refrigerate it, and promptly contact their state or local health department. This will help facilitate transport and a timely diagnosis. A patient with a positive rapid test for influenza A may meet criteria for a probable case of swine flu; however, negative and positive tests should be confirmed with real-time polymerase chain reaction (PCR) assay testing at a state health department laboratory. Physicians may stay updated on the rapidly changing situation by monitoring the CDC's swine flu Web site (; the federal pandemic flu Web site (; and the World Health Organization Web site ( The CDC has issued treatment and prophylaxis guidance for patients with suspected swine influenza A (H1N1). Antiviral treatment with zanamivir alone, or with a combination of oseltamivir and either amantadine or rimantadine, should be initiated as soon as possible after symptom onset. For more information, visit

Cost of Diabetes Care, Number of Americans with Diabetes Increases

The annual economic burden of diabetes in the United States is growing steadily, according to a study in the Archives of Internal Medicine. In 2002, the economic impact of diabetes was estimated at $132 billion, with more than 10 percent of all U.S. health care expenditures that year attributed to the disease. As of 2000, more than 11 million Americans had been diagnosed with diabetes. This number is expected to reach 29 million by 2050. The study researchers also estimate that the annual number of patient visits to treat diabetes rose from 25 million in 1994 to 36 million in 2007. During the same period, the average number of medications prescribed per treated patient increased from 1.14 to 1.63. Additionally, a November 2008 study from the CDC and the National Institutes of Health found that nearly 13 percent of U.S. adults have diabetes, and 30 percent of the overall population is at risk of diabetes. The study also showed that the prevalence of diabetes is higher in non-Hispanic blacks and Mexican Americans than in the white population. For more information, visit

Medical Groups Endorse Review of Georgia Supreme Court Ruling on Vaccine Injury

The AAFP has joined with several medical organizations to endorse a brief supporting a review of a recent Georgia Supreme Court ruling. The American Academy of Pediatrics filed the brief with the U.S. Supreme Court in support of a petition for a judicial review from vaccine manufacturers Wyeth and GlaxoSmithKline. In October 2008, the Georgia Supreme Court ruled in American Home Products Corp. v. Ferrari that a family's civil lawsuit against the vaccine manufacturers is not barred by the terms of the National Childhood Vaccine Injury Act. This federal law was created in 1986 to ensure a stable and adequate national vaccine supply, and to provide fair and timely compensation to children injured by vaccines. Federal and state judges have consistently ruled that civil suits are pre-empted by the vaccine injury act and the associated compensation program. If the Georgia ruling stands, vaccine manufacturers could be required to defend their products on a case-by-case basis in state courts. Various news outlets speculate that the case, which alleges strict liability and negligence on the part of the vaccine makers, will be considered by the U.S. Supreme Court. For more information, visit

AARP Report Shows Patient Dissatisfaction with Chronic Illness Care Coordination

Patients 50 years and older are dissatisfied with their chronic illness care, according to survey results and a subsequent report from the AARP Public Policy Institute. Patients who participated in the survey had at least one chronic illness and had received at least one episode of care at a hospital or other care setting during the previous three years. Several complaints about poor communication and care coordination were noted. Nearly one in four patients reported experiencing a medical error during this time, with 61 percent of this subgroup experiencing a major problem as a result. One in five patients did not think their health care professionals communicated well with each other. Almost one in seven patients did not receive a follow-up appointment after being discharged, and almost one in five said their transitional care was not well coordinated. For more information, visit or the AARP report at

AAFP Provides Online Resource to Help Members Comply with Red Flags Rule

As of May 1, 2009, physicians are expected to comply with a federal rule aimed at safeguarding consumers' personal identifying information. The Identity Theft Red Flags Rule requires physicians to identify possible red flags of identity theft and create a plan for responding to them. All financial institutions and creditors must develop and implement written identity theft prevention programs as part of the Fair and Accurate Credit Transactions Act of 2003. The AAFP's Practice Support Division has created a PowerPoint presentation for members that provides information on compliance with the rule, responses to frequently asked questions, and a list of online resources. For more information, visit or the AAFP Identity Theft Red Flags Rule Web page at

MedPAC Debates Pros and Cons of Integrated Health Care Delivery Model

A new health care delivery model known as an accountable care organization (ACO) may provide a path to health care reform. Analysts from the Medicare Payment Advisory Commission (MedPAC) have defined the ACO as an integrated system that relies on a network of primary care physicians, one or more hospitals, and subspecialists to provide care to a defined patient population. Each component would be responsible for the quality of care delivered to patients. Payments would be tied to care quality and resource use based on a common set of incentives. A voluntary and a mandatory ACO model are under consideration. Under the voluntary model, hospitals and physicians would volunteer to participate in the ACO. The mandatory model would require participation from hospitals and physicians that accept Medicare patients. For more information, visit

National Infant Immunization Week Promotes Childhood Vaccinations

From April 25 to May 2, 2009, health departments and organizations throughout the country participated in National Infant Immunization Week to promote the benefits of childhood immunizations. Paul Offit, MD, chief of the Division of Infectious Diseases and professor of vaccinology at the Children's Hospital of Philadelphia, pointed to the recent outbreaks of Haemophilus influenzae type b (Hib) infection as evidence of the importance of infant immunization. Offit also underscored the dangers of delaying or altering the recommended vaccination schedule. Because the current schedule calls for children to receive 26 inoculations by two years of age with as many as five injections at one visit, some parents are concerned about the amount and frequency of shots. Offit said it is the physician's job to explain to parents that delaying vaccinations increases the period of time during which their child is susceptible to infection without providing any benefit. For more information, visit

AHRQ Campaign Encourages Patients to Ask Physicians About Their Health Care

The Agency for Healthcare Research and Quality (AHRQ) has launched a series of national public service advertisements to encourage patients to become more involved in their health care. The campaign urges patients to ask appropriate health care questions when visiting their physician. AHRQ has created a comprehensive Web site that suggests 10 questions patients should ask their physician during an office visit. According to AHRQ Director Carolyn M. Clancy, MD, asking questions about the benefits and risks of medical tests or medications will help patients make appropriate medical decisions. For more information, visit or

New E-mail Service Notifies Physicians About FDA-Mandated Patient Safety Alerts

The AAFP has reached a partnership agreement with the Health Care Notification Network (HCNN), a free online service that e-mails physicians when the U.S. Food and Drug Administration (FDA) issues a patient safety alert. Electronic receipt of an alert is verified when a physician logs into the HCNN system to view the alert. If an alert is not viewed within 72 hours, the physician will receive a paper copy in the mail. All safety alerts are specialty-specific, targeted to appropriate prescribers, and contain no advertising or extraneous information. For more information, visit or


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