Tip sheet Annals of Internal Medicine, Nov. 21, 2...( of life for both caregivers and patient...),Health

of life for both caregivers and patients and improve patient care (Editorial, p. 780). If these interventions were drugs, they would be on the fast track for approval, the writers say. In fact, "the magnitude of benefit and quality of evidence supporting these interventions considerably exceed those of currently approved pharmacologic therapies for dementia."

Unfortunately, few clinicians will be able to implement the programs for their patients because 1) Medicare and other providers do not reimburse for most caregiver support services, despite that fact that caregivers save these systems millions of dollars by keeping patients out of hospitals and caring for them at home; and 2) Medicare does not pay for team-based case management service for elderly persons with dementia, even though "this approach clearly improves the quality of care."

Since dementia patients and their burdened caregivers are not likely to form the vocal lobby needed to work for these changes to Medicare law, the editorial writers call upon the medical profession "to advocate on their behalf."

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ALSO IN THE NOV. 21, 2006, ISSUE OF ANNALS OF INTERNAL MEDICINE:

4. Changes in Career Decision of Internal Medicine Residents during Training," (Academia and Clinic, p. 774) with "Career Changes in Medicine: Part II" (Editorial, p. 782).

5. "Insurance Coverage and Care of Patients with Non-ST-Segment Elevation Acute Coronary Syndromes" (Article, p. 739).

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Contact: Susan Anderson
sanderson@acponline.org
215-351-2653
American College of Physicians
20-Nov-2006

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