Acute mesenteric ischemia in an African American patient with heterozygous factor V Leiden deficiency.

It is well documented that factor V Leiden mutation (FVL) is a common hypercoagulable risk factor in the Caucasian population. Patients with homozygous FVL mutation have an increased risk for venous thromboembolism. However, there have been few cases of heterozygous FVL mutation associated with arterial thrombosis described in the literature.

A Model for Catalyzing Educational and Clinical Transformation in Primary Care: Outcomes From a Partnership Among Family Medicine, Internal Medicine, and Pediatrics.

Purpose: To report findings from a national effort initiated by three primary care certifying boards to catalyze change in primary care training.

Method: In this mixed-method pilot study (2012-2014), 36 faculty in 12 primary care residencies (family medicine, internal medicine, pediatrics) from four institutions participated in a professional development program designed to prepare faculty to accelerate change in primary care residency training by uniting them in a common mission to create effective ambulatory clinical learning environments. Surveys administered at baseline and 12 months after initial training measured changes in faculty members' confidence and skills, continuity clinics, and residency training programs.

Transforming primary care residency training: a collaborative faculty development initiative among family medicine, internal medicine, and pediatric residencies.

Problem: The scope and scale of developments in health care redesign have not been sufficiently adopted in primary care residency programs.

Approach: The interdisciplinary Primary Care Faculty Development Initiative was created to teach faculty how to accelerate revisions in primary care residency training. The program focused on skill development in teamwork, change management, leadership, population management, clinical microsystems, and competency assessment.

Viewpoint: envisioning the successful integration of EBM and humanism in the clinical encounter: fantasy or fallacy?

Some authors challenge the dominance of evidence-based medicine (EBM) in current medical practice because of its tendency to disregard the patient in the clinical process and thus distort the clinician's view of the patient as the primary focus. This tendency to "scientize" the clinician-patient encounter threatens to seriously reduce the role of humanistic elements in medicine. Although the pendulum shift toward the epistemology of EBM is worrisome, it is only one aspect of the problems facing modern medicine in the process of discovering-or rediscovering-the human dimension in medical care.