Clinician's Roundtable

Host: Bruce Japsen Guest: Roland Goertz, MD If patients take advantage of flexible spending accounts to help pay for their medical care, the health reform law is triggering some changes for them and doctor practices. Most notably, over the counter items like pain relievers and allergy meds will require a prescription. Host Bruce Japsen talks with Dr. Roland Goertz, president of the American Academy of Family Physicians about how patients and their doctors can prepare for these health reform law changes.

Host: Bruce Japsen Guest: Barbara Levy, MD As health reform brings a focus on the budget for Medicare, a little-known but influential group with links to the AMA and specialty societies is getting a closer look. It's called the Relative Value Scale Update Committee and it is at the center of a debate over whether doctors have too much control over the flow of taxpayer dollars in the Medicare program. Dr. Barbara Levy, chair of the RUC tells Bruce Japsen about how this group works and the importance of what it does. In a previous segment, he spoke with Tom Scully, senior counsel in Alston & Bird, LLP, in Washington, DC, and former head of the Centers for Medicare & Medicaid Services, about the other side of this debate.

Host: Bruce Japsen Guest: Mark Chassin, MD, MPP, MPH An estimated 4 out of 5 serious medical errors involve miscommunication that occurs when care is 'handed off' from one care provider to another. Dr. Mark Chassin, president of the Joint Commission, the organization that's studied handwashing and potentially dangerous acronyms and abreviations, tells host Bruce Japsen about how the Commission's Center for Transforming Health Care and 10 hospitals and health systems across the country are working to improve patient care by improving communication between 'senders' and 'receivers.'

Host: Bruce Japsen Guest: Thomas Scully, JD In a two-part series, as health reform brings a focus on the budget for Medicare, we look from two sides at a little known but influential group convened by the American Medical Association. It's called the Relative Value Scale Update Committee and some critics say it has too much control over the flow of taxpayer dollars in the Medicare program. Tom Scully, senior counsel in Alston & Bird, LLP, in Washington, DC, and former head of the Centers for Medicare & Medicaid Services, tells host Bruce Japsen about problems with the AMA's role in the so-called RUC. In an upcoming program, Bruce Japsen talks with Dr. Barbara Levy, chair of the Relative Value Scale Update Committee.

Host: Bruce Japsen Guest: Eric Whitaker, MD An initiative sprouting on the South Side of Chicago that was once led by First Lady Michelle Obama aims to become a national model for re-educating communities on everything from appropriate emergency department usage to outpatient care and healthy life choices. Dr. Eric Whitaker, executive vice president of strategic affiliations and associate dean of community-based research at the University of Chicago Medical Center, tells host Bruce Japsen about the Urban Health Initiative and what it aims to achieve.

Host: Michael Greenberg, MD Guest: Susan Bachrach, PhD Guest: Richard Hirschhaut Physicians and scientists played an integral role in implementing the racial eugenics program in Nazi Germany, which culminated in the murder of six million European Jews. How can a better understanding of physician involvement in what ultimately led to the Holocaust help us frame issues being debated in medicine today? Susan Bachrach, curator of special exhibitions at the United States Holocaust Memorial Museum in Washington, D.C., and Richard Hirschhaut, executive director of the Illinois Holocaust Museum and Education Center in Skokie, Illinois, discuss the ideas behind the traveling exhibit, Deadly Medicine: Creating the Master Race. How did the idea of eugenics originate, and eventually turn into the racial eugenic ideas of the Nazis? How do we define science and pseudo-science, in the context of the roots of the Holocaust? Hosted by Dr. Michael Greenberg.

Host: Bruce Japsen Guest: John Adams, PhD Health insurance companies are pushing physician ratings to steer more patients to what they see as less expensive but higher quality medical care. But doctors are finding these new measurements aren't always accurate. John Adams, a senior statistician at RAND Health in the Statistical Research and Consulting Group, tells host Bruce Japsen how doctor ratings are being used, their limitations, and their potetial impact as future quality measures.

Host: Bruce Japsen Guest: George Korch, PhD The federal government has acknowledged the United States needs to overhaul its effort to develop better measures to counter pandemic flus and bioterrorist threats. So with nearly $2 billion committed, Dr. George Korch, secretary of preparedness and response at the US Department of Health and Human Services, tells host Bruce Japsen about how this new initiative should improve the system of developing and manufacturing drugs and vaccines to prepare for public health crises.

Host: Bruce Japsen Guest: Karen DeSalvo, MD Five years after Hurricane Katrina, the horrific memories of disaster and devastation remain, but the healthcare system has created a legacy of resilience for the city's safety net and a potential national model beyond the primary care medical home. Dr. Karen DeSalvo, professor of medicine at the Tulane School of Medicine and a leader in the health system's post-Katrina recovery, tells host Bruce Japsen about the new community-based effort that has since been created to improve medical care delivery in New Orleans.

Host: Maurice Pickard, MD Guest: Matthew Wynia, MD, MPH One of the most horrific disasters in modern history, the Holocaust, is being illuminated through a lens that is of particular interest to medical professionals, through a traveling exhibit called Deadly Medicine: Creating the Master Race. Nazism's roots in biology and genetics interlinked medical professionals with its advocacy of a eugenic program that ultimately led to the murder of European Jews in the Holocaust. What ethical lessons can we learn from examining physician involvement with the Nazi regime and what they called "racial hygiene for the greater good"? Dr. Matthew Wynia, director of the Institute for Ethics at the American Medical Association, stresses the importance for all medical professionals of understanding the role physicians played in implementing Nazi racial eugenics, and frames the ethical issues in the historical context of the early 20th century. How did German physicians succumb to the pseudo-science that formed t

Host: Michael Greenberg, MD Guest: Rebecca Thomley, PhD Five years after Katrina, some mental health issues linger. Dr. Michael Greenberg talks with Rebecca Thomley, a psychologist and CEO of Orion Associates, based in Minneapolis, about the mental health situtation in New Orleans and her group's walk-in mental health clinic in New Orleans' Lower Ninth Ward, opened post-Katrina.

Host: Bruce Japsen Guest: Angela Gardner, MD As healthcare reforms take place, changes are also in the offing in the emergency department amid demands that EDs be able to turn attention from treatment of routine conditions to disasters and other true emergencies. Dr. Angela Gardner, president of the American College of Emergency Physicians, tells host Bruce Japsen about tomorrow's needs for the emergency department, which will have a greater role as health reform is implemented and patients seek primary care.

Host: Maurice Pickard, MD Guest: Maureen Lichtveld, MD, MPH Long after the clean-up process from the Deepwater Horizon oil spill is complete along the Gulf of Mexico, we'll still be examining the health effects of this catastrophe. While there is a wealth of information on the health effects of specific contaminants, the effects are less known regarding mixtures of contaminants. What are some of the immediate and potential long-term health risks (both mental and physical) of this disaster? Dr. Maureen Lichtveld, professor and chair of the department of environmental health sciences at the Tulane University, School of Public Health and Tropical Medicine in New Orleans, Louisiana, discusses the role of physicians in this type of public health disaster. How are we identifying the populations most at risk of experiencing health effects from the oil spill, and what are some of the most effective risk communication strategies for these populations? What types of surveillance methods are being used? Wh

Host: Bruce Japsen Guest: Patrick Hagan As doctors and hospitals enter an era of healthcare that will demand high quality at a competitive price, factory-style efficiency is an answer that's working, at Seattle Children's Hospital. The hospital's president, Patrick Hagan, tells host Bruce Japsen about how doctors and hospitals can replicate the kind of factory efficiency used at companies like Toyota and Boeing to improve medical care service for their patients, and perhaps even boost their productivity and profits.

Host: Bruce Japsen Guest: Max Brown Though tort reform has been an elusive goal for some state lawmakers and Congress, health reform will bring grants to come up with alternative medical liability reform initiatives. But meanwhile, some medical providers have developed their own answers. Max Brown, Vice President and General Counsel to Rush University Medical Center in Chicago tells host Bruce Japsen about the hospital's mediation program that has dramatically lowered the academic medical center's liability costs and has become a national model followed by others.

Host: Bruce Japsen Guest: Daniel Carlat, MD Is there a psychiatrist in the house? There is often attention to a shortage of doctors, particularly in primary care, but the specialty of psychiatry is also in crisis. Dr. Daniel Carlat, professor of psychiatry at Tufts University School of Medicine in Boston and editor-in-chief of The Carlat Psychiatry Report, tells host Bruce Japsen about how medical professionals and the healthcare system can cope with and address the crisis facing psychiatry.

Host: Bruce Bloom, DDS, JD Guest: Berish Rubin, PhD Only a few years ago familial dysautonomia (FD) was a fatal disease, but some "Rediscovery Research" from the FD lab at Fordham University in Bronx, New York, is turning this killer into a chronic manageable disease. What have we learned from familial dysautonomia research, and how might this help patients with other diseases? Joining host Dr. Bruce Bloom to provide an update on current FD research and treatment is Dr. Berish Rubin, professor in the department of biological sciences and head of the laboratory for familial dysautonomia research at Fordham University.

Host: Bruce Japsen Guest: Peter Carmel, MD Healthcare reform will bring health insurance benefits to more than 30 million uninsured Americans but the nation's largest doctor group and its new-president elect see more work to be done. Dr. Peter Carmel, elected in June as president-elect of the American Medical Association, tells host Bruce Japsen how he plans to lead the nation's doctors group into a post-health reform era and what additional improvements need to be made by Congress.

Host: Bruce Japsen Guest: J. Lyle Bootman, PhD Pharmaceutical sales representatives can have great impact on patient care but until now have not always been subject to rigorous certification standards. Dr. Lyle Bootman, chairman of the Medical Representatives Certification Commission and dean of the University of Arizona College of Pharmacy, tells host Bruce Japsen about a new initiative that will prepare drug, device and other medical sales representatives to deal with the complex regulator, legal and political environment they face when selling health care products to physicians.

Host: Bruce Japsen Guest: Mark Frohlich, MD The cancer treatment Provenge, known as a "therapeutic vaccine," was approved by the Food and Drug Administration in April, 2010 as a novel way to attack prostate tumors. But this is more than the story of a new treatment. Host Bruce Japsen learns about the long path to FDA approval for this unique therapy that some see as a watershed development in oncology, from Dr. Mark Frohlich, senior vice president of clinical affairs and chief medical officer of Dendreon Corporation, the Seattle-based biotech company that manufactures Provenge.