Clinician's Roundtable

Host: Bruce Japsen Guest: Steve Miller, MD Doctors know their patients often don't take their medications, whether because they simply forget or procrastinate on obtaining refills. But the lack of compliance with prescriptions has enormous financial ramifications. Dr. Steve Miller, senior vice president & chief medical officer, research and clinical sciences for Express Scripts, one of the nation's largest managers of pharmacy benefits, tells host Bruce Japsen about Express Scripts most recent survey on patient behavior when it comes to pharmaceuticals. He also talks about how, based on this research, improved patient compliance and other factors could save the healthcare system $100 billion a year.

Host: Bruce Japsen Guest: Dennis Richling, MD Employers, insurers and providers are all increasingly focused on keeping patients healthy by encouraging prevention and wellness. Many wellness strategies revolve around behavioral issues, so what is the clinician's role in changing patient behavior, and how does the clinician become more tied to initiatives in the community? Dr. Dennis Richling, senior medical director and vice president at the Trustmark Companies, talks with host Bruce Japsen about the move in healthcare toward wellness initiatives, how the clinician's services are involved, and efforts to make those services reimbursable by insurance.

Host: Maurice Pickard, MD Guest: Andrew Dennis, MD When our guest makes a house call, it's usually because a suspected criminal has barricaded himself, with or without hostages, inside the house. Dr. Andrew Dennis is a sworn police officer and medical director of two Chicago-area SWAT teams. Dr. Dennis is also an attending surgeon in the trauma and burn units at John H. Stroger Jr. Cook County Hospital in Chicago. How is what happens in the emergency department similar to what happens in the field, and how do a surgeon's skills complement the work of law enforcement? Also, host Dr. Maurice Pickard hears how television affects the outcome of gunshot and knife injuries.

Host: Bruce Japsen Guest: Daniel Sulmasy, Dr. While much of the nation's attention has been on expanding medical benefits to millions of Americans under health care reform, President Obama has also taken steps to ensure his medical care delivery is conducted in an "ethically responsible manner." The President does this with the help of a Commission for the Study of Bioethical Issues. Dr. Daniel Sulmasy, a member of the President's Commission, tells host Bruce Japsen about this panel's role and some of the bioethical challenges the administration may face.

Host: Bruce Japsen Guest: James Heywood For over a decade, patients have been turning to the Internet for health information and support. At least one new online venture gives patients the opportunity to access data about medications and therapies and their effects and outcomes. But this isn't clinical trial data. This is detailed, highly quantified, "real-world" data that patients put on the social networking site Patients Like Me about themselves, in order to connect with others who share their disease and learn from their experiences. Co-founder and chairman Jamie Heywood, a graduate of MIT, talks to host Bruce Japsen about privacy, doctor-patient communication, conflict of interest, and the potential effect on pharmaceutical development of giving patients the opportunity to review their treatments.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: James Scheulen, PA-C In 1975, Jim Schuelen began his career working as a PA in an emergency room. Today he is the chief administrative officer for the Johns Hopkins Department of Emergency Medicine and president of Johns Hopkins Emergency Medical Services. He joins host Lisa Dandrea Lenell to discuss the skill sets, preparation and challenges that are in store for a PA who wants to transition from clinical medicine to hospital management.

Host: Bruce Japsen Guest: Michael Prislin, MD A century after Abraham Flexner recommended medical schools be located within a university, new research indicates that this may have contributed to the proliferation of medical specialties and higher costs. Dr. Michael Prislin, Professor of Clinical Medicine and Vice Chairman of the Department of Family Medicine at the University of California, Irvine, tells host Bruce Japsen about Flexner's impact on medical specialties, patients and their costs.

Host: Bruce Japsen Guest: Mark Kaplan, DrPH When talk of Canadian healthcare emerges in US political debate, the spin often turns to long lines and waits for medical care and short-changed quality. But there are also those, like Dr. Mark Kaplan, whose study indicates more equity and efficiency for our neighbors to the north than here in the US. Dr. Kaplan, professor of community health at Portland State University, tells host Bruce Japsen about advances in the Canadian health system that might surprise you.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Elisabeth Howard, PhD, CNM Guest: Edie McConaughey, CNM, MS What can a medical student or resident learn from a midwife about childbirth? Dr. Elisabeth Howard and Edie McConaughey, both certified nurse midwives at Women & Infants Hospital in Providence, Rhode Island, recently completed research on midwives as educators to medical students. They discuss with host Lisa Dandrea Lenell why it's important for these two professions to collaborate even though there may be a difference in philosophy and why midwives are good teachers for future doctors.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Eric Holden PA Eric Holden hasn't had time to eat or sleep much since arriving in Haiti. He is one of two physician assistants on the team of NYC Medics, a medical volunteer organization treating the sick and injured following the January 12th earthquake in Haiti. In their first two days on the job, he and his team of medical professionals treated more than 800 patients, traveling from makeshift tent city to tent city, providing care where it's needed. Host Lisa Dandrea Lenell talks to Mr. Holden from the front lines of the medical tent, where they have teamed up with the US Army's 82nd Airborne division to treat everything from pelvic fractures to dehydration. They discuss the difficulty of treating patients without the proper drugs and medical supplies.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Eric Holden Medical professionals across the world have joined together to help treat the injured survivors of Haiti's devastating earthquake. Physician assistants are also part of this global effort. PA Eric Holden, a volunteer with NYC Medics didn't know what to expect when he arrived in Haiti. Holden and the rest of his team have teamed up with the 82nd airborne division of the US Army to treat the most critically injured patients in Port-au-Prince. Host Lisa Dandrea Lenell talks with Holden about the types of injuries he's treating, and what it's like to work and live in a disaster zone.

Host: Bruce Japsen Guest: Robert Tennant, MA Financial incentives to implement electronic health records are a welcome payment to the nation's physicians. But the proposed rules and regulations to implement this system under the economic stimulus are creating complexities and challenges physicians may face in the coming years. Physicians might want to first listen to words of advice from Robert Tenant, senior policy advisor for the Medical Group Management Association, which represents group practices and other organizations representing some 275,000 physicians.

Host: Bruce Japsen Guest: Wright Pinson, MD Healthcare reform may bring more medical care services to patients, which means more and complex business for the nation's physicians. But are doctors prepared to be the best business people now and in the future for their patients? Dr. Wright Pinson, deputy vice chancellor for health affairs and CEO of the Hospitals and Clinics at Vanderbilt University Medical Center, tells host Bruce Japsen about master's programs in healthcare business, like Vanderbilt's Masters of Management in Health Care program.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Jack Lasoski, PA-C How do employees working in large facilities know it's safe to return to work after being injured on the job? More than likely they must get clearance from one of the 2000 physician assistants working in occupational medicine across the country. Jack Lasoski, director of health services for the United States Enrichment Corporation in Paducah Kentucky, joins host Lisa Dandrea Lenell to talk about the history of PAs in occupational medicine, the typical day of a PA in this field, and the challenges and changes taking place within the specialty.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Krystie Lennox, PA-C More than 10 million surgical and non surgical cosmetic procedures were performed in the United States in 2008. Many of those procedures were performed by physician assistants. Krystie Lennox, the co-founder of the Aesthetic Extender Symposium, talks with host Lisa Dandrea Lenell about the state-by-state rules related to PAs performing cosmetic procedures, how to become part of this expanding specialty, and how to stay informed in this fast changing area of medicine.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Roderick Hooker, PhD, PA-C How does a doctor know when it's the right time to add a physician assistant to the office staff? There are a lot of factors to take into consideration when making the decision to add new employees. Dr. Roderick Hooker, co-author of the book Physician Assistant Policy and Practice, 3rd Edition, joins host Lisa Dandrea Lenell to discuss the cost effectiveness and productivity of the PA in a primary care practice, as well as how to build a cooperative relationship between a supervising doctor and a PA.

Host: Bruce Japsen Guest: Julian Bailes, MD The National Football League has placed its strictest rules yet on managing concussions. What is the medical profession to make of such a policy and what are its broader implications for players' long-term health and for future medical research? Dr. Julian Bailes is a founding member of the Brain Injury Research Institute, which is affiliated with the Blanchette Rockefeller Neuroscience Institute at West Virginia University and possesses a brain and tissue bank that houses 20 brains for future research. He is also professor and chairman of the department of neurosurgery at West Virginia University School of Medicine. Dr. Bailes tells host Bruce Japsen about important research into the short and long-term impact of brain injuries.

Host: Bruce Japsen Guest: Michael Ong, MD In the healthcare debate, we've heard a lot about the equation between improving quality and cutting costs. But new research takes the opposite view that sometimes increased spending leads to better outcomes. Host Bruce Japsen, who also writes about healthcare for the Chicago Tribune, talks with Dr. Michael Ong, assistant professor of medicine in residence in the UCLA Division of General Internal Medicine & Health Services Research at the David Geffen School of Medicine, about his research.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Phillip Begg, PhD The physician assistant program began in the United Kingdom in 2004 with five students. Today, four universities have a PA program, with more than 200 students expected to graduate by 2012. Dr. Phillip Begg, associate dean at the University of Wolverhampton in Wolverhampton, England, talks with host Lisa Dandrea Lenell about the successes and obstacles to the beginning of this PA program, and why the program is essential to the United Kingdom's national health service.

Host: Bruce Japsen Guest: Bob Nease, PhD Why do Americans choose healthcare options that cost more but may not even do more or be in the best interest of their own health? Dr. Bob Nease, chief scientist at Express Scripts, tells host Bruce Japsen about what appears to be a troubling phenomena researchers are calling the behavioral economics of healthcare.