Traveling to CME conferences can be an amazing experience or it can end up in disaster. Here are some great tips for traveling to CME conferences in 2012.

1. If you are willing to travel away from home for CME, chances are that you are interested in visiting the location that the conference is being held. Review the conference agenda carefully and make sure that it provides you with ample time to enjoy your destination.
2. Save money by choosing an airline that provides you with at least one free checked bag.
3. Seek conferences in which the organizers have extended the group rate with the hotel beyond the conference dates.
4. If traveling with children, seek hotels that have organized kids programs available while you are attending the conference.
5. When attending CME conferences at international destinations, avoid credit card fraud by ensuring that your credit card never leaves your sight. Most international restaurants and retail shops have the ability to run your card in front of you.
6. If you are traveling with a spouse or friend,  reserve both the window and the aisle seat, leaving the middle seat empty. If the flight is not full, you will have the entire row to yourselves. If the flight is full, the person sitting in the middle will be more than willing to switch seats for a window or aisle.
7. Be sure to bring your meal with you or purchase it before getting on the plane. Always purchase additional bottled water and take with you on the plane. Most airlines don’t provide adequate beverage service for the length of the flight.
8. When in the conference, make your mobile device last longer by using the one beep mode on a low setting and disabling vibrate mode. More energy is required to make your entire device buzz.
9. To stay healthy while traveling, purchase a bottle of hand sanitizer and use it after touching the airplane bathroom door handles, trays, magazines, reading lights, or air vents.
10. As clinicians, we rarely have free time outside of our families or practices but be sure to set aside time on your trip to do something just for you!

For more information on traveling to CME conferences in 2012, click here.

Ciao and welcome to your CME adventure in the city known as the world’s biggest open air museum! If Italy is one of your dream travel destinations, then don’t miss out on the opportunity to earn CME this summer in Rome. Attend CME sessions each morning and then allow yourself to be seduced by what’s known as the “Eternal City”.

Visit the ancient Roman sights like the Colosseum, the Pantheon, and the Aqueducts.

Explore the great squares and the famous Spanish steps.

Be amazed by the Trevi Fountain and Fountain of Four Rivers.

Discover the beauty of the Vitacan City and be awed by the Sistine Chapel.

Photograph Rome’s great basilicas and churches.

Grab a slice of authentic Pizza at Remo.

Glam up for a night at the opera.

For more information on CME conferences in Rome, click here.

Many primary care clinicians believe that it is there responsibility to discuss issues of weight and obesity with patients. When the time comes however, it can be uncomfortable for both the physician and patient and many physicians feel ill equipped to deal with issue related to weight loss. In addition, many physicians don’t believe that counseling patients on weight loss actually works. Although there are many resources for discussing obesity and weight loss with patients, here are some tips that may put both physicians and their patients on the road to success.

• Do your home work and take a refresher course on nutrition exercise. The University of North Carolina offers a free on-line course called Nutrition in Medicine that covers numerous topics targeted towards the practicing physician. Or, take a CME course that offers a broader update on  obesity.
• Don’t focus on spending more time discussing weight with your patients; rather, improve the quality of discussion by utilizing some of the motivational interviewing techniques which may include treating the patient like an expert, using reflection, and avoiding confrontation and judgment.
• Patients may not recognize that they are overweight or obese so ask questions to find out how the patient views them self such as “What do you think about your weight?”
• Patient motivation is key – find out a goal that the patient is passionate about and ask questions like, “How might you better be able to participate in/improve ______ if you lose 30 or 50 lbs?”
• Avoid terms that patients consider undesirable, such as “fatness,” “excess weight,” or “large size,” and stick with terms considered  more desirable, like “weight,” “BMI,” and “unhealthy body weight.”
• For patients that don’t recognize that they have a problem, focus on sharing general information about health, diet, exercise and weight.
• Have patients start with simple things like weighing themselves every day, cut back on sweetened beverages, walk or participate in some other physical activity 3 days per week for 15-20 minutes per day, park their car further from their destination, eat in more days per week, etc. Never overestimate their knowledge of simple weight loss techniques.
• Even if the patient does not appear overweight, always ask them about the types of food they are eating and how much they are exercising – focus on the patient’s behaviors and not just the weight.
• Remember that change comes slowly and encouraging your patients on a consistent basis will eventually pay off. Remember that even broaching the topic of weight can make your patients up to twice as likely to attempt to lose weight.

Receive more education and practice these techniques with your next few overwieght patients and you’ll be putting your patients on the road to success in no time!

If spending more time with family is on your mind, here are some of the greatest family destinations to consider when planning to attend your next CME conference:

Disney’s Grand Floridian Resort, Orlando, FL

What location is more perfect for family time than Orlando? Orlando offers unlimited opportunities for fun including thrill rides (be sure to check out Universal Studio’s new ride Harry Potter and the Forbidden Journey™), resorts, shows, theme parks like Disney, Sea World, and Universal Studios, fabulous shopping,  and championship golf.

Atlantis Resort, Nassau, Bahamas

Atlantis is an amazing family destination that caters to all ages, including “big kids”! Swim with the dolphins or interact with sea lions, ride the 120 foot water slide, stroll along miles of white sand beaches, snorkel the ruins at Atlantis, swim at one of 11 pools, try your luck at the casino, golf on the ocean, or unwind with blissful pampering at Mandara Spa.

The Village at Breckenridge, Breckenridge, CO

Plan your winter family fun with a ski vacation at Breckenridge. This Colorado resort boasts 300 inches of powder per year, caters to skiers and riders at every level, and offers one of the country’s best ski and snowboard schools for kids. After a fun filled day skiing or riding, relax and enjoy the dining, shopping, nightlife, and hospitality offered by this historic mountain town. When you are ready to take a break from skiing or riding, try tubing, visiting a mountain day spa, cross country skiing, snowmobiling, or snowshoeing.

Providers of high quality education like MER are currently offering CME conferences at each of these family destinations. Click here for 2012 dates and information.

If you are searching for a New Year’s CME conference but are looking for a warm alternative to Times Square,  Miami Beach may be your perfect New Year’s destination. Stay at the beachfront Eden Roc Renaissance Hotel, earn up to 11 CME credits at MER’s Internal Medicine for Primary Care Physicians conference, and then take advantage of the warm weather, beautiful beaches and amazing places to ring in the New Year. A few Miami New Years celebration options include:

Bayfront Park Amphitheater: This free even features live performances by various bands. There’s a countdown at midnight for the dropping of the Big Orange, followed by fireworks. This is a great family outing, if you’re kids are old enough to make it until midnight.

Mansion Nightclub: This is one of Mimi’s hottest nightclubs. Ticket prices include an open bar until midnight.

SET Nightclub: Tickets include a 3-hour open bar.

Fontainebleau Poolside Celebration: If you are interested in a poolside celebration, this is the place to be!

Miami Beach New Year’s Eve Party: A free fireworks celebration offered by the City of Miami at midnight.

Click here for some additional listings and be sure to purchase your tickets early!

Due to a number of factors, such the lack of significant power of the study and an unexpected increase in HDL-C in the placebo arm, the results from the AIM-High study (click here to view article)  failed to demonstrate a 25% reduction in cardiovascular events in those patients randomized to receive niacin. This study was discontinued earlier for futility, but further results have recently been released. The purpose of AIM-high was to evaluate the benefit of adding niacin to patients with a low LDL-C value with pre-existing statin therapy. There was only a 4 mg/dL difference in HDL-C between the treatment arms. Since the study was underpowered and other confounding factors existed, the value of adding niacin to effective statin therapy is unknown and the current HPS2-Thrive study, which has enrolled 25,000 patients is underway and also investigating the benefit of niacin to statin therapy. Is this study the nail in the coffin of the HDL hypothesis (the ability to modify HDL-C to reduce cardiovascular events) or is the HDL hypothesis alive and well?

As a primary care physician, here are some things to consider:

What advice are you giving patients?

Will you modify your clinical practice and how?

Do you use fish oil in patients who are at high risk of cardiovascular events?

Will you use niacin for patient who are statin intolerant or do not achieve LDL goals?

Feedback on any of these questions  is welcome!

So far this year, 210 drugs have been added to the list of drugs in short supply and many of the drugs included on the list are considered life-saving medications.  Just days ago, acknowledging that this is a growing crisis, President Obama signed and executive orders instructed the FDA to obtain better advance warning of impending supply problems but this will not prevent future shortages. How could this current crisis be affecting patients of primary care physicians?

• Your patients may experience delays in surgeries
• Your patient may not be able to receive chemotherapy drugs, treatments for allergies, hypertension, pain medication, and drugs to treat heart conditions
• Your patients may receive less effective treatments for their condition
• Many hospitals that have been forced to utilize “gray market vendors” (companies other than their normal wholesalers) to purchase drugs in short supply at mark-ups as much as 650%. These costs will ultimately be passed on to your patients
• Drugs purchased from “gray market vendors” may not have been stored properly and may cause side effects or other problems in patients
• In some cases, hand-mixed batches of liquid nutrition given via feeding tubes are replacing unavailable sterile pre-mixed liquids. These are subject to bacterial contamination and have resulted in 9 deaths to date.

Although there is little that you primary care physicians can do to affect this drug shortage, be prepared and be aware of which drugs are in short supply in hospitals and pharmacies in your area!  You may need to determine alternative regimens for your patients with chronic conditions and spend extra time teaching them new dosage instructions and potential side effects of substitute drugs.

Ready or not, the Sunshine Act will go into effect in January, 2012. But will the Sunshine Act affect the average primary care physician? The answer is short and simple – most likely, it will! The Sunshine Act will require drug and medical device manufacturers to publicly report gifts and payments made to physicians and teaching hospitals.

This includes cash or in-kind transfers to all covered recipients including: compensation; food, entertainment or gifts; travel; consulting fees; honoraria; research funding or grants; education or conference funding; stocks or stock options; ownership or investment interest; royalties or licenses; charitable contributions; and any other transfer of value. The law exempts payments less than $10 until the aggregate annual total per company, per covered recipient, reaches $100, at which point all payments (retroactively) must be disclosed. Prescription drug and device samples are also exempt.

After the bill goes into effect, the next time your pharmaceutical representative wants to bring you lunch to tell you more about their products, if it costs more than $10, it will be reported. Your name, along with thousands of other healthcare professionals, will eventually be plugged into a government database which will be available to the general public.

Is this bill meant to expose every meal that you accept from your pharmaceutical representative? No, of course not. It’s meant to document excessive research royalties and consultant fees paid by industry to certain physicians and to expose “the bad actors” to the public.

Will the information be used to limit payments and compensation that physicians receive? Not at this time but who knows how the information may be used in the future?

This week’s clinical pearl: It is important to diagnose subclinical hypothyroidism because it may be associated with:

• Very mild impaired left ventricular diastolic function at rest
• Impaired endothelial function and increased arterial intimal medial thickness
• Insulin resistance and increased C-reactive protein
• Slightly poorer exercise capacity in younger patients
• Mild increased LDL and decreased HDL
• Subtle impairments in mood and cognition

To receive more information regarding the diagnosis and management of subclinical hypothyroidism and to learn about other Endocrine disorders relative to your primary care practice, attend the Medical Education Resources (MER) CME seminar Clinical Endocrinology for Primary Care Physicians.

This year’s remaining Clinical Endocrinology for Primary Care Physicians programs are being held at the following locations:

• Mirage, Las Vegas, NV – September 23-25, 2011
• Atlantis Resort, Nassau, Bahamas – December 2-4, 2011

Each year, MER offers more than 60 CME programs in exciting destinations like London, Maui, Orlando, San Diego, and St. Thomas.

See our full list of locations here… CME continuing medical education.

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Do you ever wish that you could make summer last a little longer? Why not extend your summer fun and sign of for a Medical Education Resources CME meeting at one of these endless summer destinations:

• Try your luck, see a show, shop til you drop, or dine at a celebrity chef restaurant in Las Vegas
• Play in the bay,  relax on the beach, , or visit Sea World or the San Diego Zoo in San Diego
• Choose a family adventure at Walt Disney World, Universal Studios, and other exciting theme parks in Orlando
• Taste the world’s finest wines, revitalize with a luxury spa treatment, or sample the seasonal cuisine of Napa
• Unwind on a private beach, hike to an amazing waterfall, spot a humpback whale, or see the sun rise over a volcano in Maui
• Dive or snorkel a spectacular reef, chill out at a beach front pool, cool down with a famous banana daiquiri, and listen to talks of pirates lore in St. Thomas

Earn up to 11 CME credits by attending presentations each morning, and then spend the rest of the day enjoying our endless summer locations with family and friends! MER seminars are developed exclusively for the busy primary care clinician.

Visit MER’s website for a current schedule of programs and destinations.