Clinician's Roundtable

Host: Jennifer Shu, MD, FAAP Guest: Mary Catherine Beach, MD, MPH Many of us may share personal or professional experiences with patients, often times in an effort to strengthen our relationship with them. Unfortunately, these actions may not always produce the intended positive effects on the relationship. Further, you may be surprised to know that the effects may differ based on our specialty fields. Dr. Mary Catherine Beach, associate professor of medicine at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, has extensively studied these physician self-disclosures. She talks with host Dr. Jennifer Shu about situations in which the self-disclosures may become ‘too much information.' In a patient visit where you believe you've shared too much, how can you get back on track? What about involuntary self-disclosures, where patients may learn of information about you on the Internet or in the everyday chatter of a small town or community?

Host: Lisa Mazzullo, MD Guest: Jane Salmon, MD Twenty years ago, women who suffered from lupus were discouraged from having children; today women with lupus are successfully having healthy babies. Doctors have found that counseling lupus patients prior to conception significantly increases the chances of a healthy pregnancy. Dr. Jane Salmon, professor of medicine at Weill Medical College in New York, joins host Dr. Lisa Mazzullo to talk about her groundbreaking research for pregnant women dealing with this autoimmune disease.

Guest: Joshua J. Freemire, JD In 2009, doctors who prescribe medication through electronic means became entitled to a year-end bonus payment from Medicare. What are Medicare's reasons for the incentive, and what are the program's parameters? Joshua J. Freemire, an associate in the health practice law firm Ober|Kaler in Baltimore, Maryland, explains. Dr. Larry Kaskel hosts.

Guest: Joshua J. Freemire, JD What is medical identity theft? What is the physician's responsibility as far as protecting patients from this threat? Attorney Joshua J. Freemire, with the firm Ober|Kaler, discusses identity security issues and your practice, with host Dr. Larry Kaskel.

Host: Lee Freedman, MD Guest: John Carey, MB, BCh, BAO What are the mechanisms that are suspect for increasing incidence of osteonecrosis of the jaw in those taking bisphosphonates? Is this a significant risk? Dr. John Carey, consultant physician in internal medicine and rheumatology at Galway University Hospitals, reviews the evidence potentially modifying or increasing the risk of patients developing osteonecrosis of the jaw if they take bisphosphonates. Do patients need an oral exam before they begin taking bisphosphonates? Dr. Lee Freedman hosts.

Host: Bruce Bloom, DDS, JD Guest: Dan Roden, MD What are the tools that will finally make personalized medicine a reality? Dr. Dan Roden, the William Stokes Professor of Experimental Therapeutics, vice-chancellor for personalized medicine and the director of the John Oates Institute for Experimental Therapeutics at Vanderbilt University School of Medicine, joins host Dr. Bruce Bloom, DNA banks, electronic medical records and more.

Host: Bruce Bloom, DDS, JD Guest: Dan Roden, MD The greatest side effect of medications is that they often don't do what we expect them to do. Dr. Dan Roden, professor in the departments of medicine and pharmacology at Vanderbilt University School of Medicine, talks with Dr. Bruce Bloom about variability in response to drugs. Genetic components are just one of many reasons patients respond differently. Dr. Roden also discusses his specific work with customizing treatment for patients with arrhythmias based upon the disease mechanism.

Host: Larry Kaskel, MD Guest: Mike Katke What are medical foods? Are they good for patients, and what exactly are the benefits? Host Dr. Larry Kaskel investigates these products with Mike Katke, co-founder of Metagenics, Inc., a manufacturer and distributor of medical foods.

Host: Larry Kaskel, MD Guest: Mike Katke Scientific evidence shows that therapeutic lifestyle programs are the most cost effective programs to prevent, improve, or cure chronic diseases such as diabetes. Host Dr. Larry Kaskel discusses with Mike Katke, co-founder of Metagenics, Inc., the elements of a therapeutic lifestyle program and the practical requirements for implementing a program. Tune in to hear how primary care physicians can easily establish a therapeutic lifestyle program that will benefit their patients' health and be financially rewarding.

Host: Mark Nolan Hill, MD Guest: Selene Parekh, MD, MBA Ankle injuries extend from the common sprain, to the complex arthritis case that could warrant total joint replacement surgery. With respect to the basic sprain, why do we see so many of these injuries in our practices: are our ankles not strong enough, are we wearing the wrong shoes or are we simply more active than we used to be? What are the keys to a good clinical evaluation for these ankle injuries and what can you counsel your patients to anticipate following a more serious ankle injury? Dr. Selene Parekh, head of the foot and ankle division of the department of orthopaedic surgery at the University of North Carolina School of Medicine, assesses a range of ankle injuries in this conversation with host Dr. Mark Nolan Hill.

Host: Mark Nolan Hill, MD Guest: Marc Bessler, MD As the field of bariatric and minimally invasive surgery continues to grow, the gastric bypass procedure has grabbed many of the headlines, with solid interest in gastric banding as well. Looking ahead, how might the landscape change? Will a new bariatric procedure emerge as the safest and most effective choice? Host Dr. Mark Nolan Hill welcomes Dr. Marc Bessler, assistant professor of surgery at Columbia University College of Physicians and Surgeons, and director of the Columbia University Center for Metabolic and Weight Loss Surgery, to detail one procedure that could represent the next step in reducing the invasiveness of bariatric surgery: the transoral gastroplasty.

Host: Lauren Streicher, MD Guest: Margery Gass, MD If you have a patient who suffers from hypoactive sexual desire disorder, you may want to consider helping their libido with testosterone. One recent study showed improvement in women who used a testosterone-only patch without estrogen. Even though the patch is not FDA approved at this point, it could be an alternative in the future. Dr. Margery Gass, an associate professor of clinical obstetrics at the University of Cincinnati talks with host Dr. Lauren Streicher about her recent research and what can be done to boost a woman's libido before and after menopause.

Host: Lauren Streicher, MD Guest: Michael Holick, PhD, MD It seems these days patients know more about the benefits of Vitamin D than their physicians. Doctors are soaking up the information and making sure their patients are taking the proper levels of Vitamin D. Dr. Michael Holick, professor of medicine, physiology and biophysics and director of the Bone Health Care Clinic and the Heliotherapy, Light, and Skin Research Center at Boston University Medical Center, joins host Dr. Lauren Streicher to discuss the proper dosage, risk factors, geographical factors and benefits of Vitamin D.

Host: Leslie P. Lundt, MD Guest: Matthew A. Menza, MD Impulse control disorders have become increasingly reported in Parkinson's Disease patients. Dr. Matthew Menza, professor of psychiatry and neurology at Robert Wood Johnson Medical School, joins host Dr. Leslie Lundt to explore the etiology of impulse control disorders in the general population and in Parkinson's patients. Are impulse control disorders more common in Parkinson's patients, or are we just identifying them more readily? What can we do to help these patients?

Host: Leslie P. Lundt, MD Guest: Matthew A. Menza, MD Depression is present in as many as half of the one million people with Parkinson's disease in the United States. What evidence-based treatments should we be using? Host Dr. Leslie Lundt welcomes Dr. Matthew Menza, professor of psychiatry and neurology at Robert Wood Johnson Medical School, to talk about his work on diagnosing and treating depression in Parkinson's disease patients.

Host: Bruce Japsen Guest: Keith Kelleher Why is healthcare been such a growing area for organized labor to expand? From home health care workers and registered nurses, and even doctors, organized labor is finding an important audience in the medical care field. Keith Kelleher, president of SEIU Healthcare of Illinois and Indiana tells host Bruce Japsen about the labor movement among health professionals.

Host: Bruce Japsen Guest: Keith Kelleher Following the historic election of Barack Obama, one of the new president's longtime allies in organized labor now has a key voice in the nation's economic recovery and the healthcare debate. Keith Kelleher, president of Service Employees International Union (SEIU) Healthcare of Illinois and Indiana, talks with host Bruce Japsen about the seat at the table SEIU will have when the Obama administration and the Democratic Congress push a stimulus package that could make strides to expand medical care for more Americans while benefiting doctors and other providers.

Host: Bruce Bloom, DDS, JD Guest: Berish Rubin, PhD Host Dr. Bruce Bloom welcomes Dr. Berish Rubin, professor in the department of biological sciences and head of the Laboratory for Familial Dysautonomia research at Fordham University in Bronx, New York. A genetic condition, symptoms include inability to swallow, respiratory congestion, poor muscle tone, and delayed developmental milestones. Dr. Rubin reports on the latest research and how close we are to finding a cure.

Host: Bruce Bloom, DDS, JD Guest: Berish Rubin, PhD In only three months' time, researchers Dr. Berish Rubin and Dr. Sylvia Anderson and their team uncovered the genetic cause of familial dysautonomia (FD). Dr. Rubin, professor in the department of biological sciences at Fordham University, joins host Dr. Bruce Bloom to share his story and the research that led them to identify the gene mutation responsible for FD, a variation most often found in the Ashkenazi Jewish population. They also discuss symptoms a clinician can use to diagnose FD, common treatments and the future direction of FD research.

Host: Mary Leuchars, MD Guest: Jeffrey D. Cirillo, PhD Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB) has been present in the human population since antiquity. Today over 2 billion people have been exposed. What can we learn form this remarkably resilient bacteria, and how do we address the formidable challenge of treating drug resistant strains? Dr. Jeffrey Cirillo, associate professor of microbial and molecular pathogenesis at the Texas A&M Health Science Center College of Medicine, examines tuberculosis from molecular to organ-specific levels and outlines the emergence of multidrug resistance across the world. Hosted by Dr. Mary Leuchars.