Among adults presenting with acute respiratory illness, a prediction rule based on clinical findings accurately discriminated patients with and without radiographic pneumonia, and was used in two other samples of patients without significant decrement in discriminatory ability. This rule can be used by physicians to develop more effective strategies for detecting pneumonia and for helping to determine the need for radiologic study among patients with acute respiratory disease.

Patient race/ethnicity did not influence physicians' predispositions to treatment plans in clinical vignettes. Even knowing that the patient had a high-prestige occupation and a primary care provider only minimally increased prescribing of opioid analgesics for conditions with few objective findings.

BACKGROUND:The American Board of Internal Medicine (ABIM) has recommended a specific number of procedures be done as a minimum standard for ensuring competence in various medical procedures. These minimum standards were determined by consensus of an expert panel and may not reflect actual procedural comfort or competence.

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Both the number and variety of procedures done by general internists have decreased considerably since 1986. As in the 1986 survey, general internists who practice in smaller cities and smaller hospitals and those who spend more hours in patient care perform more procedures. Recommendations and practices for internal medicine residency training in procedures should be reexamined in light of these changes.