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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.
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1. Physicians Are Not Providers: New ACP Paper Says Names in Health Care Have Ethical Significance
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03852
Summary for Patients: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03852-PS
URL goes live when the embargo lifts
A new ethics policy paper from the American College of Physicians (ACP) says the term ‘provider’ should not be used to describe physicians, and using the blanket term undermines physicians’ ethical responsibility, clinical integrity, and professionalism. Referring to physicians as providers reduces the patient-physician relationship to a transaction and does not recognize differences in roles, responsibilities, and training among health care professionals. The paper is published in Annals of Internal Medicine.
Language in health care has ethical and practical implications and should uphold the ethics of the patient-physician relationship, which is fundamental to the practice of medicine. ACP’s view is that the words physician and provider are not interchangeable and using them synonymously also reflects the increasing commercialization of today’s practice environment. ACP says that the current use of the word provider in reference to institutions, insurers, and health care professionals lumps impersonal entities with humans and is not transparent to patients.
ACP also recommends that professionals with varied credentials who care for patients should be referred to as clinicians or health care professionals, not providers. The paper was developed by the ACP Ethics, Professionalism and Human Rights Committee.
Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To speak with someone at ACP, please contact Angela Collom at acollom@acponline.org.
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2. Experts debate optimal work‑up and management of idiopathic acute pancreatitis in a young woman
This “Beyond the Guidelines” feature is based on a discussion held at the Medical Grand Rounds conference on 18 September 2025.
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-05045
URL goes live when the embargo lifts
In a new Annals “Beyond the Guidelines” feature, two pancreatologists and coauthors of the 2024 American College of Gastroenterology (ACG) guideline on acute pancreatitis discuss diagnostic uncertainties, invasive interventions, and the role of genetic testing in the management of idiopathic acute pancreatitis (IAP). IAP accounts for approximately 18% of acute pancreatitis cases and presents clinicians with challenges around work‑up, recurrence prevention, and the selective use of cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP). Given the wide heterogeneity in available evidence and inconsistent guideline recommendations, the question “How would you manage a young patient with idiopathic acute pancreatitis?” remains an important clinical question.
They reviewed the case of Ms. P, a 29‑year‑old woman with iron deficiency anemia who experienced abdominal pain, elevated lipase, and imaging consistent with acute pancreatitis without necrosis. Ultrasounds and lab testing showed no gallstones, microlithiasis, sludge, pancreas divisum, or metabolic causes. After a short hospitalization and stabilization on a low‑fat diet, she was discharged, though questions remained about recurrence risk, the role of genetic testing, and whether preventive interventions such as cholecystectomy or ERCP should be pursued.
The first discussant, Santhi Swaroop Vege, MD, is a Professor of Medicine at Mayo Clinic College of Medicine and Science and a member of the Division of Gastroenterology and Hepatology at Mayo Clinic in Rochester, Minnesota. Dr. Vege emphasizes that thorough evaluation for biliary disease is essential before labeling a case “idiopathic,” noting that biliary disease accounts for 42% of pancreatitis worldwide and is often under‑detected with initial imaging. He highlights the role of genetic testing as a means of clarifying disease pathogenesis and determining whether invasive procedures may be useful in certain patients. Given the safety of laparoscopic cholecystectomy and studies suggesting reduced recurrence after surgery, he generally recommends cholecystectomy for IAP once genetic causes are excluded. For Ms. P, he recommends genetic testing followed by laparoscopic cholecystectomy if results are negative.
The second discussant, Sunil G. Sheth, MD, is an Associate Professor of Medicine at Harvard Medical School and a member of the Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Dr. Sheth also supports discussion of genetic testing, noting that identifying pathogenic variants can guide counseling, refine prognosis, and prevent misdiagnosis. However, he is more cautious about empirical cholecystectomy. He argues that trials supporting surgery often included patients who did not undergo the full recommended diagnostic evaluation and likely captured individuals with occult biliary disease rather than true IAP. For Ms. P, he advises genetic testing but recommends neither cholecystectomy nor ERCP without a demonstrable biliary or anatomical cause.
All “Beyond the Guidelines” features are based on selected clinical conferences at Beth Israel Deaconess Medical Center (BIDMC) and include multimedia components published in the Annals of Internal Medicine.
Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact one of the discussants, please email Kendra McKinnon at kmckinn1@bidmc.harvard.edu.
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3. ACP issues final update to its rapid practice points on antiviral treatment of COVID-19 in outpatient settings
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03766
URL goes live when the embargo lifts
The American College of Physicians’ (ACP) issued its final update of living, rapid practice points on antiviral treatment for COVID‑19 in outpatient settings. Using evidence from an updated rapid review focused on the Omicron variant, ACP reaffirms its earlier guidance for treating symptomatic, confirmed COVID‑19 in both vaccinated and unvaccinated patients. The update is published in Annals of Internal Medicine.
The recommendations emphasize that nirmatrelvir–ritonavir and molnupiravir may be used for high‑risk patients with mild to moderate COVID‑19 if started within five days of symptom onset. ACP advises against using ivermectin or sotrovimab, as evidence does not support their benefit in the outpatient setting. Because recent updates and ongoing surveillance have not produced meaningful changes to these recommendations, ACP is retiring this topic from its “living” status, meaning it will no longer be continuously updated.
Related Evidence Reviews:
Outpatient Treatment of Confirmed COVID-19: A Living Rapid Review for the American College of Physicians (Version 3)
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03691
Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To speak with someone at ACP, please contact Angela Collom at acollom@acponline.org.
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Also new this issue:
Frailty
Ariela R. Orkaby, MD, MPH; Andrea Wershof Schwartz, MD, MPH; and Kathryn E. Callahan, MD, MS
In the Clinic
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04412
END
Physicians are not providers: New ACP paper says names in health care have ethical significance
2026-02-09
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