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Educational Objectives

SEPTEMBER 7, 2013 – GENERAL INTERNAL MEDICINE
Cannot Miss Diagnosis in Primary Care - Charles Hatem, MD
Define ‘what’s cannot miss’ diagnosis in the primary care setting.
Describe type 1 and type 2 thinking.
Explain the use of Murtagh’s model as an aid in diagnostic thinking.
Discuss various clinical examples of ‘cannot miss’ diagnoses.
Use of Medical Technology at Point of Care - Kristen Goodell, MD
List three point-of-care electronic evidence-based resources and describe what kind of questions they are best for.
Explain how to quickly assess the quality of evidence.
Answer 3-4 clinical questions per day during the course of their usual practice without staying late.
Medical Management of Obesity - Jane Sillman, MD
Describe whom should we target for help with weight loss?
Discuss how can we motivate patients to lose weight?
Describe how to counsel patients about lifestyle changes.
Describe when and how to use drugs in the treatment of obesity.
Discuss what the primary care clinician needs to know about bariatric surgery.
Managing the Health of a Population: What if you were responsible?
David Battinelli, MD
Discuss current population health concerns and the role of the primary care practitioner.

OCTOBER 5, 2013 – CARDIOVASCULAR MEDICINE
Management of Common Valvular Heart Disease Issues - Eli Gelfand, MD
Review basic epidemiology and pathophysiology of common valvular lesions.
Review the evolution of thinking regarding timing of surgical intervention in valvular heart disease.
Discuss emerging treatment modalities for valvular heart disease.
Hypertension Update - Gerald Smetana, MD
Use recent research results to guide selection of antihypertensive therapy.
Use diuretics for most patients for initial antihypertensive therapy.
Discuss recent concerns raised regarding beta blockers and ARB's.
Update and Management of Carotid Artery Stenosis - Mark Wyers, MD, FACS
Discuss recent advances in carotid artery stenosis including diagnosis , therapy, surgery and stenting.
Atrial Fibrillation: Use of Newer Agents for Stroke Prevention - Kevin Monahan, MD
Discuss the pros and cons of newer oral anticoagulant agents used in stroke prevention.

OCTOBER 19, 2013 – PAIN MANAGEMENT – END OF LIFE
Case Studies in the Use of Opioids for Non-Cancer Pain - Jane Liebshutz, MD
Identify pain and functional assessments appropriate for patients with chronic pain.
Describe a risk-benefit framework for approaching treatment of chronic pain.
Describe the components of a monitoring program for patients on chronic opioid analgesia.
How to Get Patients Off of Opioids Safely - Jane Liebshutz, MD
Recognize conditions in which opioids should be discontinued.
Shared Decision Making in End of Life Care: Use of the MOLST Form
Gail Gazelle, MD
Describe how to implement advance care planning with patients.
Identify best practices within palliative care.
Describe the patient with dementia who is eligible for hospice care.
Differentiate between palliative sedation, physician-assisted suicide, and euthanasia.
Name 3 common ethical issues in end-of-life care.
The Primary Care Provider’s Role in Providing Quality End-of-Life Care
Ellen Long Middleton, PhD, RN, FNP
List the modalities of therapy within palliative and hospice care.
Describe the means by which to access palliative and hospice care services.
Discuss the importance of listening to the patient in providing end-of-life care.

NOVEMBER 16, 2013 – ORTHOPEDICS
Shoulder Pain for the Primary Care Practitioner - Sean Rockett, MD
Discuss most common causes of shoulder pain seen in primary care setting.
Describe how to diagnose and treat shoulder pain and provide a diagnosis to patient, physical therapist or referring physician.
List the pearls of the shoulder physical exam.
Knee Injuries - Ethan Healy, MD
List the most common causes of knee pain seen in primary care setting.
Describe how to diagnose and treat knee pain and be able to provide a diagnosis to patient, physical therapist or referring physician.
Describe Imaging and treatment of knee pain.
List the pearls of physical exam.
Describe common running injuries and their management.
Hand and Wrist Pain - Charles Day, MD
List the surface anatomical landmarks of the hand and wrist.
Describe how to provide a physical exam of hand and wrist.
List the common differential diagnoses of hand and wrist.
Common Foot Issues in Primary Care - Joshua Lamb, MD
Discuss common foot issues and their diagnosis and treatment presented in primary care.
Discuss when to refer the patient with foot issues in primary care.

DECEMBER 14, 2013 – NEUROLOGY-PSYCHIATRY
TIA and Stroke Update - Louis Caplan, MD
Describe current aggressive medical regimens for stroke prevention.
List the usual causes and their evaluation of cryptogenic stroke.
Describe thrombolysis and management of acute brain ischemia.
Risks for and Management of Patients with Concussions
Robert Cantu, MA, MD, FACS, FACSM
List the signs and symptoms of concussion and long term sequlae.
Describe chronic traumatic encephalopathy.
Discuss complications of mismanagement of concussion.
Describe how to diagnose and manage a concussion.
Review ongoing research in area of concussion.
Neurology Cases that the PCP Should Not Miss - Penny Greenstein, MD
Discuss cases outlining common and not so common neurological cases that present teachable moments including infectious, neoplastic, vascular and degenerative causes.
Diagnosis and Treatment of Anxiety Disorders - Mark Frankel, MD
Describe common treatments offered for anxiety disorders and when to suggest them.
Identify circumstances under which to make a referral for further evaluation and/or treatment.

JANUARY 11, 2014 – INFECTIOUS DISEASE
Vaccine Update - Howard Heller, MD, MPH
Review CDC changes in recommendations for routine vaccinations in children and adults.
Review travel vaccine recommendations: what resources should the PCP use?
PCP and Antibiotics - Thomas Treadwell, MD
Describe antibiotics used for common bacterial infections in the ambulatory setting.
Describe how to apply the principles of antibiotic stewardship in treating outpatient infections
Decide when to use newer oral antibiotics.
Decide when outpatient parenteral antibiotics will be safe and effective.
Management of Herpes Zoster and Herpes Simplex – Howard Libman, MD
Review clinical diagnosis of herpes simplex and herpes zoster.
Describe the treatment of initial herpes simplex infection, as well as recurrences.
Discuss when to consider suppressive therapy in the treatment of herpes?
Describe herpes zoster management and utility of the zoster vaccine.
Tick Borne Illnesses - Jonathon Edlow, MD
Discuss the variability in morphology of erythema migrans.
Discuss the various manifestations of early-disseminiated Lyme disease.
Describe the limitations in serological testing for Lyme.
Describe the concept of co-infections of tick-borne illnesses.

FEBRUARY 8, 2014 – ENDOCRINOLOGY
Case Based Studies in Diabetes - Martin Abrahamson, MD
Discuss several case studies illustrating the use of best practice in the diagnosis and treatment of Diabetes.
Management of Thyroid Nodules and Thyroid Cancer - James Hennessey, MD
Review the initial evaluation of the thyroid, including ultrasound and biopsy as well as the interpretation of results.
Review the recommended treatments of thyroid cancer.
Discuss the management of benign thyroid nodules.
Hypo and Hyperadrenalism and Adrenal Incidentaloma - James Hennessey, MD
List the signs and symptoms of adrenal insufficiency.
Describe the primary care approach to initial evaluation of Cushings syndrome.
Osteoporosis: What are the Recommendations for Bone Density Screening and Treatment? - Alan Malabanan, MD
Describe how to identify those patients at risk for osteoporosis and bone density assessment.
Describe how to help patients use non-pharmacologic methods to prevent bone loss and lower fracture risk.
Discuss the use of the National Osteoporosis Foundation guidelines and FRAX to identify those patients who might benefit from pharmacologic osteoporosis therapy.

MARCH 8, 2014 – HEMATOLOGY-ONCOLOGY
Hemochromatosis: When to Screen and How to Manage - Robb Friedman, MD
Describe the pathophysiology of the hereditary iron storage disorders.
Discuss the clinical evaluation of patients with hereditary hemachromatosis with laboratory and radiographic testing.
Review the optimal management of patients with hereditary hemachromatosis or predispositions to iron overload.
How to Prevent and Treat Thromboembolic Events in Cancer Patients
Jeffrey Zwicker, MD
Review current findings on the association with thromboembolic events and cancer patients.
List the recommended agents to be used to prevent and treat thromboembolic events in cancer patients.
Management of Pain in the Patient with Cancer - Lidia Schapira, MD
Provide an overview of acute and chronic pain assessment .
Review pharmacologic and non-pharmacologic interventions for pain management.
Discuss the integration of pain and symptom management into mainstream cancer care.
Which Patients Should be Screened for Genetic Causes of Cancer?
Nadine Tung, MD
Describe when to refer for BRCA1/2 and Lynch syndrome testing.
Discuss the new gene panels available for cancer susceptibility testing.
Describe the genetic testing process.
Describe how to interpret the results of genetic testing.

APRIL 12, 2014 – PULMONARY MEDICINE
Asthma Update - Christopher Fanta, MD
List the goals of well-controlled asthma.
Describe a plan for achieving well-controlled asthma.
Identify novel therapies and therapeutic approaches for the treatment of asthma.
Interpretation of Pulmonary Function Tests - Douglas Beach, MD, MPH
Discuss the American Thoracic Society consensus guidelines for interpretation of pulmonary function testing, including spirometry, lung volumes and diffusion capacity.
Identify common problems with the interpretation of pulmonary function testing, including patient difficulty with performing testing and interpretation of tests at the extremes of patient age and demographics.
Describe additional pulmonary function tests including maximal inspiratory and expiratory pressures, 6 minute walk test, and bronchoprovocation testing.
Primary Care Management of DVT and PE: Which Drugs and How Long?
James Heffernan, MD, MPH
Using clinical cases, develop a framework for diagnosing and managing common (and important uncommon) instances of venous thromboembolism seen in primary care practice.
Emphasize core treatment recommendations of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th ed. (2012)
Highlight the use of newer agents -- especially factor Xa and direct thrombin inhibitors -- in the prevention and treatment of venous thromboembolism.
Discuss when should hematology be consulted in patients with venous thromboembolic disease?
Chronic Cough: Hacking Up a Treatment Algorithm - Thomas Carroll, MD
Discuss the etiologies and proposed pathophysiologies of chronic cough (CC).
Describe the appropriate tests and consultations for the workup of CC.
Describe treatment options for chronic cough patients.

MAY 10, 2014 – UROLOGY
Cervical Cancer Screening: Update and Management of Abnormal Pap Smears - Daniela Carusi, MD, MSc.
Review updated guidelines for cervical cancer screening.
Review recommended management for abnornal pap smears and when to refer.
Discuss what to do when the pap smear is normal, but HPV is positive.
Polycystic Ovarian Syndrome - Corrine Welt, MD
Describe the diagnostic criteria for polycystic ovary syndrome and their limitations.
List the differential diagnosis for irregular menstrual cycles and hyperandrogenism.
Identify the best treatment for polycystic ovary syndrome on the basis of patient symptoms and associated findings.
The PSA Controversy: 2013 - Michael Barry, MD
Describe the results of the two main prostate cancer screening trials, the PLCO and the ERSPC, and name one major limitation for each trial.
Describe the results for the PIVOT trial comparing observation to radical prostatectomy, including the major subgroup funding.
List the key facts men should know before making an informed decision to have or not have a screening PSA test.
Male Sexual Dysfunction in the Age of the ED Pills - Abraham Morgentaler, MD
Discuss the appropriate history and physical, differential dx and work up for erectile dysfunction.
Review what pharmacologic agents are available for treatment of erectile dysfunction.
Risks and benefits of testosterone therapy for ED, as well as other agents. 
 

Contact Information

Beth Israel Deaconess Hospital-Needham
148 Chestnut Street
Needham, MA 02492
781-453-3000