Clinician's Roundtable

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Andrew Faucett How does a PA handle a patient who comes in following genetic testing, and how do they counsel that patient on their results? PA educators are realizing this scenario is becoming commonplace. Since 2008, genetics is now a required course for all PA students. Andrew Faucett, an assistant professor in the department of human genetics at Emory University School of Medicine in Atlanta joins host Lisa D'Andrea Lenell to discuss the importance of genetic medicine in your daily practice.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Ann Davis Guest: Beth Grivett Each state has its own laws and regulations on what physician assistants may and may not do within their practice. Host Lisa D'Andrea Lenell is joined by two guests for her discussion on state law. PA Ann Davis, director of state government advocacy and outreach with the American Academy of Physician Assistants discusses six key elements that help determine good state law for the PA practice. PA Beth Grivett, legislative chair for the California Academy of Physician Assistants, talks about how she lobbied and succeeded in removing restrictions on PAs when it comes to performing and signing physicals for the division of motor vehicles in California.

Host: Larry Kaskel, MD Guest: Owen J. Dahl, MBA Thinking about adding an ancillary service to your practice? It's a move that certainly has the potential to be an additional source of revenue, but in order to make that happen, you'll need to do your due diligence research to ensure that it makes sense for your patients and your practice. Host Dr. Larry Kaskel gets some helpful guidance from Owen Dahl, nationally recognized medical practice management expert, on what you need to know to make your new toy a moneymaker: finding the necessary space within your facility, accruing needed sources of funding, and juxtaposing these items and much more with your patients' clinical needs.

Host: Larry Kaskel, MD Guest: William Hutton, MD Decisions on practice philosophy, finances, marketing, and much more are yours to make when starting your own medical practice. That's the good news. But it can also make the prospect of setting up your own shop seem extremely daunting. From picking a location, to creating a business plan, to seeking expert advice on accounting, credentialing and legal issues, how can you put it all together to create a successful private practice? Host Dr. Larry Kaskel welcomes Dr. William Hutton, founder and chairman of the board of MedSynergies, a medical practice management firm based in Irving, Texas, who provides pointers you can use when launching your own practice.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Dave Mittman, PA Does the title Physician Assistant truly capture the core of the PA's role in the 21st century? Does the title hinder efforts to advance the role of the PA profession? Is the word "assistant" confusing to patients, doctors and other healthcare professionals? Those are just a few of the questions explored by host Lisa D'Andrea Lenell and Dave Mittman, president elect of the American College of Clinicians and founder of Clinician 1, the online home for physican assistants and nurse practitioners. The two discuss the history behind the PA moniker and the debate over whether or not the physician assistant should become "physician associate."

Host: Bruce Japsen Guest: Scott Gottlieb, MD The highly publicized decision by President Obama to add more federal dollars toward embryonic stem cell research may be fueling misconceptions about how drugs and medical products are created. But it's a part of the debate on stem cells that some in medicine think needs to be heard. Dr. Scott Gottlieb, former Food and Drug Administration deputy commissioner and resident fellow at the American Enterprise Institute, discusses with host Bruce Japsen funding realities, and what he sees as misconceptions related to the National Institutes of Health's new funding powers in the area of embryonic stem cells.

Host: Maurice Pickard, MD Guest: Abraham Morgentaler, MD Testosterone therapy for men is controversial, but some new research suggests physicians might want to re-evaluate increasing the levels of testosterone in men with lower levels. Sexual dysfunction is one of the more apparent symptoms of low testosterone, but what are the other non-sexual symptoms of low "T" physicians should be aware of? What are the parameters for determining appropriate testosterone levels in our male patients? Isn't there an increased risk of developing prostate cancer among men undergoing testosterone therapy? Tune in to hear Dr. Abraham Morgentaler, associate clinical professor of surgery (urology) at Harvard Medical School and author of the book Testosterone for Life, weigh in on these and other questions surrounding testosterone therapy. Hosted by Dr. Maurice Pickard.

Host: Bruce Japsen Guest: Alan Sager, PhD Hospitals are closing nationwide, but is it really a case of here-we-go-again because of reductions in reimbursement? This time, we are in the most serious recession in decades. Dr. Alan Sager, professor of health policy and management at Boston University School of Public Health, tells the Chicago Tribune's Bruce Japsen about what lies ahead for physicians and their patients with this uptick in consolidation.

Host: Maurice Pickard, MD Guest: Stuart Finder, PhD The face transplant is a relatively new, experimental procedure still in its early stages. This operation is comparable to a hand transplant, in that the patient’s quality of life may be improved with the procedure, but the condition is not immediately life-threatening. How can physicians discuss the risk-benefit ratio of this procedure with potential face transplant patients? What happens if the procedure fails? How does a multidisciplinary team prepare a patient considering this procedure, from the psychological to the financial aspects? Tune in to hear Dr. Stuart Finder, director of the center for healthcare ethics at Cedars-Sinai Medical Center, discuss these and other ethical considerations of the face transplant procedure with host Dr. Maurice Pickard.

Host: Maurice Pickard, MD Guest: Daniel Remick, MD While many patients with asthma are allergic to pollen or pet dander, new evidence suggests inner city asthma patients may be most allergic to cockroach remains found in household dust. Dr. Daniel Remick, chair and professor of pathology at Boston University School of Medicine, discusses his new research demonstrating the relationship between household dust from city buildings and asthma. What implications for treatment does this research provide? Will there be an attempt to desensitize children to this cockroach allergen in the future? Dr. Maurice Pickard hosts.

Host: Jennifer Shu, MD, FAAP Guest: Rahul Parikh, MD Physicians often collaborate with other doctors when caring for patients with various medical problems. Yet disagreements with our colleagues may occur more frequently than we would like to admit, and there can be consequences to these disagreements among physicians. How can we best deal with these differences in medical opinion, while keeping in mind our common goal of providing the best care possible for our patients? Host Dr. Jennifer Shu covers this question and a range of related issues with Dr. Rahul Parikh, a pediatrician at Kaiser Permanente in Walnut Creek, California, and a regular contributor to the Vital Signs medical column on Salon.com. Dr. Parikh recently wrote an article for the Los Angeles Times on disagreements between doctors: Does a patient's input often play a role in generating or exacerbating a disagreement? Do we tend to gravitate away from others with whom we have a difference of philosophy or medical opinion?

Host: Larry Kaskel, MD Guest: Judy Capko Inventory management is a fine balance. You want to have what you need when you need it, but you can run the risk of overstocking certain items. We hear a lot about the wasteful spending of our government, but we may look no further than our own medical practices to find the pork. How can you pare down wasteful spending on supplies, and how can your suppliers help you do this? Judy Capko, founder of the practice management and marketing firm, Capko & Company, provides you with some sound advice on inventory management, saving valuable dollars for your practice. Dr. Larry Kaskel hosts.

Host: Larry Kaskel, MD Guest: Judy Capko Focus on customer service. Participate in community activities to raise local visibility. Reward patients who bring referrals to your practice. These are just a few simple ways to market your practice, even on a limited budget. What is it about these strategies that will give you the biggest bang for your buck, and what else can you to keep your patient volume up during these leaner times? Judy Capko, founder of the practice management and marketing firm, Capko & Company, joins host Dr. Larry Kaskel to give you a range of helpful tips on marketing tactics that will give your practice the biggest bang for your buck.

Host: Bruce Japsen Guest: Donato Tramuto E-sampling is a new way of marketing drugs to physicians that's gaining momentum via the Internet. It's an approach that may reach more doctors and may prove to be more convenient to those who either don't like or don't want the traditional pharmaceutical industry pitches. Donato Tramuto, CEO and vice chairman of Physicians Interactive Holdings, tells the Chicago Tribune's Bruce Japsen about the trend emerging of marketing and applying business practices to doctors in a digital world online.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Cynthia Lord, MHS, PA-C Is the clinical doctorate appropriate for the physician assistant as an entry-level degree, as a post-graduate degree, or not at all? Those are just a few of the questions discussed recently at the PA Clinical Doctorate Summit held in Atlanta. Cynthia Lord, president of the American Academy of Physician Assistants and the program director of the Physician Assistant Program at Quinnipiac University in Hamden, Connecticut, joins host Lisa D'Andrea Lenell to discuss the recommendations made by an independent panel of health professionals. The two also talk about a possible bridge program for PAs to go to medical school as well as future summits and advanced training for PAs in the future.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Cynthia Lord, MHS, PA-C Despite the current economic recession in the United States, the PA profession is growing at a rapid pace. Currently there are 73,000 PAs nationwide and 5000 new PAs are graduating every year. Cynthia Lord, president of the American Academy of Physician Assistants and the program director of the Physician Assistant Program at Quinnipiac University in Hamden, Connecticut, talks with host Lisa D'Andrea Lenell about why the PA profession remains solid and whether a PA career is immune to troubled financial times. The two also look at the growing pains of a thriving field and how the profession is dealing with current growth.

Host: Shira Johnson, MD Guest: Gloria Kuhn, MD When should ER doctors become concerned about burnout? Many physicians show signs of career fatigue but continue to practice year after year. Dr. Gloria Kuhn, vice chair for academic affairs for the department of emergency medicine at Wayne State University, discusses her latest research with host Dr. Shira Johnson. Dr. Kuhn surveyed ER doctors to see what causes physicians to become unhappy in their jobs and the warning signs ER doctors and other physicians should look for to combat burnout.

Host: Bruce Japsen Guest: John Kreger News of mega-mergers involving the likes of Pfizer and Wyeth or Merck and Schering Plough have turned the pharmaceutical industry on its ear. But what does this mean for you and your patients? John Kreger, a principal with the health care investment bank William Blair & Company, tells the Chicago Tribune's Bruce Japsen about how consolidation among drug companies could impact doctors and their patients.

Host: Larry Kaskel, MD Guest: Leslie Ramirez, MD With tens of millions of people in the United States living without health insurance, lower prices for medicine and tests can mean the difference between seeking care and going without it. Even for those with insurance, lower prices can significantly ease out-of-pocket costs. How can we help patients find these lower prices, and might we also use price comparisons in our own practice? One physician has taken these issues into her own hands, creating a website that offers comparative pricing for tests and medications in the Chicagoland area. Host Dr. Larry Kaskel learns more about this website, leslieslist.org, from its founder, Dr. Leslie Ramirez, who also works full-time as a general internist. How has her work on the website changed her prescribing habits, and could they change yours too? Dr. Ramirez also shares a few tips for you to help your patients with bargaining on prices, and other ways to drive down costs.

Host: Larry Kaskel, MD Guest: Elizabeth Pector, MD Though healthcare is seemingly one of the more stable sectors of our turbulent economy, many practitioners are still struggling to subdue rising costs. For patients who may be unable to pay up front, can you employ effective payment plans that won't sidetrack your financial outlook? What else can we do to maintain our practice while dealing with the burdens of these tough times? Host Dr. Larry Kaskel welcomes Dr. Elizabeth Pector, a family physician practicing in Naperville, Illinois, just west of Chicago, and a member of the editorial board for Medical Economics magazine. Dr. Pector also delves into an assortment of other issues in medicine today: reimbursement increases, chronic illness management and wellness services merged into one office visit, and maintaining an office staff that can effectively balance good business acumen with respectful patient relations.