Pneumonia accounts for about 1 million hospitalizations each year in the United States. It is the number one cause of death from infectious disease and eighth leading cause of death in the United States. This article reviews recent updates in best practices for diagnosing and managing pneumonia in the ED or primary care practice. Despite developments in the diagnosis of pneumonia, vital signs and chest examination findings can and should guide clinical management. Chest radiography is routinely used to diagnose pneumonia. However, a negative chest radiograph should not replace clinical impression. In immunocompetent patients with community-acquired pneumonia, the CURB-65 decision rule has a role in identifying high-risk patients, including those who will require ICU admission and a critical care intervention.

Purpose The use of certified physician assistants (PA) has increased throughout the US health care system. The purpose of this study was to objectively evaluate physicians' perceptions of PAs' mastery of specific skills. It is important to understand stakeholders' perceptions of PAs' capabilities to support future changes in policies for better utilization of PAs in our health care system. Methods From 2014 to 2015, randomly chosen “active” physicians listed with the Kentucky Board of Medical Licensure were surveyed about their perceptions of competencies of certified PAs. Six competency domains (medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning, and improvement and systems-based practice) were rated using a Likert scale. Each competency-derived skill-based question was ranked by the number of physicians giving the highest scores on the Likert scale (a score of 4 or 5) and by effect size. Cronbach's alpha for the survey was calculated. Results An overwhelming majority of the physicians perceived certified PAs to be competent (n ≥ 161, ≥ 60%) for specific skills. The survey had internal consistency with Cronbach's alpha ranging from 0.75 to 0.87 for competency domains. Effect size ranged from 0.44 to 0.98 for scores given by physicians with, versus without, experience with PAs. Conclusions For the first time, there is objective evidence of physicians' perceptions of PAs' mastery of specific competency-derived PA skill sets. This study will help guide effective utilization of PAs throughout the health care system and future PA education.

The results of a questionnaire evaluating patient's reactions to counselling for their therapeutic abortion are reported. Most considered that counselling was necessary and that it provided support throughout the abortion process. The counselling appeared to relieve anxiety for many patients, but seemed to be less effective for patients who were not of European origin.