Clinician's Roundtable

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Michelle Mack, PA-C You've seen forensic investigators on TV detective shows like Law and Order and CSI but what is the job really like? Physician Assistant Michelle Mack, Director of Forensic Investigation at the Office of the Chief Medical Examiner in the District of Columbia, talks with host Lisa D'Andrea Lenell about how she puts together the puzzle surrounding a death investigation. The two also discuss how her PA training plays an integral role in her job and how she deals with the emotional side of a very difficult job.

Host: Bruce Japsen Guest: Arthur Holden, MBA Two years after it was formed, the International Serious Adverse Event Consortium, working with the U.S. Food and Drug Administration, is making progress understanding why certain people are predisposed to dangerous drug interactions. Arthur Holdren, founder of the consortium, tells host Bruce Japsen about the discovery of a genetic link between liver injury and some people who received a popular antibiotic.

Host: Cathleen Margolin, PhD Guest: Yasser Aman, PhD, MPH In 1992, after the verdict was handed down in the Rodney King trial, there were six days of rioting in south Los Angeles. Thousands were injured, more than 50 people were killed, and the city saw approximately one billion dollars in property damage. One of the few bright spots during this dark time was the formation of a new health care clinic in south Los Angeles, founded by Muslim medical students to serve a community in need. Almost two decades later, the University Muslim Medical Association (UMMA) clinic continues to serve their community, demonstrating the generosity of the Muslim faith. Host Dr. Cathleen Margolin learns more about the UMMA clinic from CEO and president, Dr. Yasser Aman.

Host: Mark Nolan Hill, MD Guest: Jeffrey Klausner, MD, MPH Detection and treatment of HIV in the United States has improved dramatically since the peak of the epidemic here in the 1980s, but there is far more work to be done. HIV transmission is one area of heightened concern, particularly those cases spread by newly infected persons who remain undiagnosed. Though tests are available to diagnose HIV in the acute phase, many experts believe we must improve these tests to really make headway in reducing the incidence of HIV in the United States. Dr. Jeffrey Klausner, a deputy health officer and director of the STD Prevention and Control Services Section at the San Francisco Department of Public Health, joins host Dr. Mark Nolan Hill to lay out the path toward progress in detecting acute cases of HIV infection. Newer, more effective tests are available, but must be adopted around the United States, and as Dr. Klausner looks ahead, a point-of-care rapid exam, though still in development, could event

Host: Mark Nolan Hill, MD Guest: William Parker, MD For many years, bilateral oopherectomy has been a routine part of hysterectomy. After a certain age, we reasoned that the role of the ovaries in helping women achieve hormonal balance was outweighed by the risks for ovarian cancer, thus offering women their best odds of long-term survival. Yet new evidence on the risks of routine bilateral oopherectomy challenges this conventional wisdom. Is it time we change our practice? Host Dr. Mark Nolan Hill examines the findings with Dr. William Parker, clinical professor of obstetrics and gynecology at the University of California, Los Angeles David Geffen School of Medicine, and a faculty member of the John Wayne Cancer Institute in Santa Monica, California. The lead author of a study published in Obstetrics and Gynecology, Dr. Parker also explores the mechanisms behind the potential risks investigated by his team, ranging from specific cancers to heart disease and all-cause mortality.

Host: Bruce Japsen Guest: Linda Powers, Ms. President Obama expanded federal funding for certain embryonic stem cell research and many are excited about what it means to the entire field of discovery of new drugs and medical treatments. Linda Powers, of the Maryland Stem Cell Commission, tells host Bruce Japsen about the importance of Obama's move to, not only those interested in embryonic stem cells, but the entire field and drug discovery in general.

Host: Jennifer Shu, MD, FAAP Guest: Basil Clyman, MD Over the years, many studies have examined the ‘difficult' patient encounter. Consistently, these studies indicate that physicians deem nearly 1 in 6 outpatient appointments to be an arduous visit. These challenging episodes are often time-consuming and may also lead to adverse outcomes. Though it is unfair to look at all difficult visits in the same light, there are trends to suggest certain patients and certain physicians are more likely to be involved. What are these trends, and how might this knowledge allow us to better navigate these situations? Dr. Basil Clyman, clinical professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles, and staff physician at the VA Healthcare Center in West Los Angeles, visits with host Dr. Jennifer Shu to share his insights on turning a difficult encounter into a positive doctor-patient experience.

Host: Lee Freedman, MD Guest: Michael Hildebrand, PhD Researchers have discovered a CATSPER gene mutation that may lead to development of a male infertility treatment, as well as a male contraceptive. Are we really another step closer to developing a male contraceptive, and when might an oral contraceptive be available for men? Join host Dr. Lee Freedman as he talks with Dr. Michael Hildebrand, fellow in the department of otolaryngology at the Carver College of Medicine, University of Iowa, about this exciting new genetic discovery, and how it might lead to the development of a male contraceptive.

Host: Michael Greenberg, MD Guest: Donna Jarmusz, MA The healthcare village is a new setting for outpatient care that's similar to an upscale shopping mall. These villages may include cardiologists, primary care physicians, and ambulatory surgery centers, alongside pharmacies, restaurants, spas and health clubs. What are the advantages to this type of business model? Is the healthcare village model primarily a repackaging of existing services, or an entirely new way of delivering care? Dr. Donna Jarmusz, senior vice president for the Chicago-based company Alter+care, a real estate development firm promoting this model, discusses aspects of the healthcare village with host Dr. Michael Greenberg.

Host: Shira Johnson, MD Guest: Brendan Carr, MD Time is critical in a medical crisis, but according to new research, the nearest facility may not always be the best place for the patient. Dr. Brendan Carr, lead author of the study and assistant professor of emergency medicine and epidemiology at the University of Pennsylvania, discusses his research with host Dr. Shira Johnson. They also look at future technology that could tell doctors and paramedics the best place to take a patient using GPS and the same system used for trauma victims.

Host: Shira Johnson, MD Guest: Shan Liu, MD Patients that come into an emergency room sometimes have to wait hours even days before they are moved to a hospital floor. A new study says more than a quarter of patients who are "boarded" in the ER after being admitted to the hospital often suffer undesirable events like missing necessary treatments or medications. Dr. Shan Liu, an attending physician at Massachusetts General Hospital in Boston and an instructor at Harvard Medical School, joins Dr. Shira Johnson to discuss her study on this growing worldwide issue.

Host: Bruce Japsen Guest: David Himmelstein, MD The single payer form of health insurance for all Americans: could this be the year that the long-debated model for medical care coverage becomes a reality? Dr. David Himmelstein, associate professor of medicine at Harvard Medical School and a long-time advocate of single payer coverage, tells the Chicago Tribune's Bruce Japsen about the best chance in years for this model in the healthcare reform debate.

Host: Bruce Japsen Guest: William Hersh, MD The stimulus package approved by Congress and signed into law by President Barack Obama promises unprecedented money for health IT and electronic medical records. But if the money is enough, are there enough health informatics specialists to pull it off? Dr. Bill Hersh, chair of the Department of Medical Informatics & Clinical Epidemiology in the School of Medicine at Oregon Health & Sciences University in Portland, tells host Bruce Japsen about the healthcare system's needs from the world of health informatics.

Host: Larry Kaskel, MD Guest: Kelly Brownell, PhD It has been billed as the biggest boon to public health since tobacco taxes. And a one-cent per ounce tax on sodas could bring in as much as $400 million of annual revenue for the state of New York alone. How would a tax on sugared beverages impact our health and health care budget? Would the general public throw enough support behind this policy shift for politicians to think about putting it on the books? Host Dr. Larry Kaskel wades into the debate over soda taxes with Dr. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, where he is also a professor of epidemiology, public health and psychology. Dr. Brownell, who recently co-authored a New England Journal of Medicine article with then-New York City Health Commissioner Dr. Thomas Frieden in support of a soda tax, shares the scientific evidence that supports his position. He also considers other viewpoints in this debate: if a soda tax won't work, could

Host: Maurice Pickard, MD Guest: Robert Brzyski, MD, PhD When a mother was granted legal permission to collect her 21 year old deceased son's sperm in April 2009, questions were raised about posthumous reproductive rights. Although the mother declared that her son always wanted to have children, does this meet the criteria of informed consent, or is it an example of substituted judgment? Can this situation be compared to a spouse or girlfriend having an in depth discussion about having a posthumous child? How should we consider the welfare of the child in such a situation? Host Dr. Maurice Pickard discusses these ethical questions with guest Dr. Robert Brzyski, associate professor of obstetrics and gynecology at the University of Texas Health Science Center at San Antonio and chair of the ethics committee of the American Society for Reproductive Medicine.

Host: Mark Nolan Hill, MD Guest: Anthony Miniaci, MD Early arthritis of the knee is a frustrating and painful condition, especially for our more active patients. Some will begrudgingly accept the end of their adult sports league careers, others will be less inclined to hang up their sneakers. In this case, depending on the severity of the condition, there could be several procedural options, including a new arthroscopic resurfacing technique for those with less severe arthritis: could this be the quickest route back to the playing field? Dr. Anthony Miniaci, executive director of Cleveland Clinic Sports Health and one of the developers of this new procedure, explains why this procedure could be the answer for patients who have failed all biologic procedures, but are not yet ready for a total knee replacement. Which of your patients might be a candidate? Dr. Mark Nolan Hill hosts.

Host: Bruce Japsen Guest: Eric Elliott What if prescription costs were tied to outcomes and how patients do on their prescriptions? It's already happening. Eric Elliott, president of CignaPharmacy Management, tells the Chicago Tribune's Bruce Japsen about new ways health benefits companies are working to provide more effective treatments.

Host: Bruce Japsen Guest: Michael King The burgeoning number of emergency patients who do not speak English because our nation has become so diverse is creating a greater imperative to bridge the language gap in the hospital. Live video interpretation and translation could be the answer, says Michael King, director of business development for the Metropolitan Chicago Healthcare Council, in an interview with host Bruce Japsen of the Chicago Tribune.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Ed Lopez What's it like to be a hospitalist? Many PAs are turning to this growing field. Ed Lopez, founder and president of La Palma Medicine and Surgical Associates in Tacoma, Washington, talks with host Lisa D'Andrea Lenell about the ins and outs of working in a hospital. They cover a typical day, and the type of personality best suited for this growing specialty.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Ed Lopez With the growing shortage of healthcare professionals, the need is growing for PAs to become part of a hospitalist team. Ed Lopez founder and president of La Palma Medicine and Surgical Associates in Tacoma, Washington, joins host Lisa D'Andrea Lenell to discuss this growing field, including how to get a job in a hospital setting and the challenges and future for this specialty track within the PA profession.