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When oral therapy cannot be administered, patients with hypertensive urgency can have their blood pressure (BP) reduced with hydralazine, enalaprilat, metoprolol, or labetalol. Due to the scarcity of comparative trials looking at clinically significant outcomes, the medication should be chosen based on comorbidity, efficacy, toxicity, and cost.

BACKGROUND: Deficiencies in physical examination skills among medical students, housestaff, and even faculty have been reported for decades, though specifics on how to address this deficit are lacking.METHODS: Our institution has made a commitment to improving key physical examination competencies across our general medicine faculty. Development of the Merrin Bedside Teaching Program was guided by a comprehensive needs assessment and based on a learner‐centered educational model. First, selected faculty fellows achieve expertise through mentorship with a master clinician. They then develop a bedside teaching curriculum in the selected domain and conclude by delivering the curriculum to peer faculty.RESULTS: We have developed curricula in examination of the heart, shoulder, knee, and skin. Currently, curricula are being developed in the examination of the lungs, critical care bedside rounds, and motivational interviewing. Curricula are integrated with educational activities of the internal medicine residency and medical school whenever possible.CONCLUSIONS: A hospitalist‐led physical examination curriculum is an innovative way to address deficits in physical exam skills at all levels of training, engenders enthusiasm for skills development from faculty and learners, offers scholarship opportunities to general medicine faculty, encourages collaboration within and between institutions, and augments the education of residents and medical students. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine.

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Although the periodic health examination was introduced over 80 years ago, it remains a controversy in internal medicine. There have been few data from controlled studies to document the examination's efficacy for adults; nevertheless, its popularity is increasing and health screening has become a multimillion-dollar industry in the United States. Conclusions drawn from poorly designed studies 65 years ago led to the acceptance of periodic examination as a means of detecting disease and reducing mortality. First, physicians associated with life insurance companies and, later, private practitioners began offering these examinations. By promoting the periodic health examination, the medical profession created interest among the general population. The impact of health screening is still unknown today, and well-designed studies are needed to resolve the controversy.

Inadequate access to medication results in serious sequelae for recently arrested prisoners in New York City with insulin-dependent diabetes. Access to health care for recently arrested prisoners needs to be improved.

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