Clinician's Roundtable

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Carolyn Zaumeyer, NP, RN Carolyn Zaumeyer, a nurse practitioner, discusses with host Lisa D'Andrea the key factors to evaluate and analyze when starting an independent practice. Ms. Zaumeyer also provides guidance on establishing competitive charges for services, a relationship with a supervising physician, defining one's scope of practice, and the applicable state laws that define the limitations of a nurse practitioner's independent practice.

Host: Larry Kaskel, MD Guest: Donald Patrick, MD, JD Medical license applications have jumped 58% since Texas approved tort reform legislation that limited non-economic damages in medical liability cases to $250,000 among other provisions. Dr. Donald Patrick, JD, the former executive director of the Texas Medical Board discusses with host Dr. Larry Kaskel the key elements of the legislation and the role of the state's medical board in fixing the medical crisis that affected Texas.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Jay Fotland, NP, RN With a focus on wellness rather than illness, Jay Fotland opened a healthcare clinic that offers flat fee health memberships to patients. Host Dr. Lisa D'Andrea discusses with guest Jay Fotland, a nurse practitioner, the low-cost business model that Mr. Fotland developed as a means to reduce the red tape associated with the health care system. Mr. Fotland also discusses his business philosophy and, located in the backyard of the well-established Mayo clinic, is able to compete.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Sue Kling-Colson, PA-C Hyperglycemia in critically ill patients increases the risk factor for inpatient morbidity and mortality. Host Lisa D'Andrea explores with guest Sue Kling-Colson, a physician assistant at the University of Michigan Health System, the intensive insulin protocols established for managing hyperglycemic inpatients. Ms. Colson outlines the protocols and explains the responsibilities of the physician assistant under the Hospital Intensive Insulin Program.

Host: Leslie P. Lundt, MD Guest: Deirdre Conroy, PhD From alcohol to nicotine to prescription opioids, most substances of abuse can create sleep disturbances that continue even into abstinence. Untreated sleep disturbance can be a significant relapse trigger. Yet, most FDA-approved hypnotics are controlled substances. How can you break the cycle of insomnia in patients with addictive disease? Dr. Deirdre Conroy, clinical assistant professor of psychiatry at the University of Michigan, joins host Dr. Leslie Lundt to review the treatment options for this population.

Host: Leslie P. Lundt, MD Guest: Deirdre Conroy, PhD Substance abuse and subsequent withdrawal can lead to sleep disturbances. How do you evaluate the substance abuser with sleep difficulties? Dr. Deirdre Conroy, clinical assistant professor of psychiatry at the University of Michigan, joins host Dr. Leslie Lundt to discuss the complex interaction between sleep and substance abuse.

Host: Bruce Japsen Guest: Gerald Bernstein, MD Diabetes has become such a worldwide epidemic that some are turning to over-the-counter products as a way to help patients with this disease that has afflicted nearly 24 million in the U.S. alone. Dr. Gerald Bernstein, the vice president of medical affairs at Generex, a biotech company based in Toronto, tells host Bruce Japsen about nutritional products and over-the-counter options for patients with diabetes.

Host: Lee Freedman, MD Guest: Allison Aiello, PhD, MS Dr. Allison Aiello discusses the possiblity that the use of common household products such as soaps and surface cleaners are be promoting bacterial resistance. Should we be telling our patients to avoid the use of certain products so that they not subject themselves to infection with resistant organisms? What products might pose a risk? What is the mechanism of this resistance? Is it clinically relevant?

Host: Jennifer Shu, MD, FAAP Guest: Jay Berkelhamer, MD The medical community provides a vital public health service when we vaccinate our patients. However, this practice is often a money-losing proposition for us, as evidenced by the many primary care physicians who are discontinuing immunizations in their practice. What can physicians, vaccine manufacturers and insurers do to improve the current vaccine financing and delivery system? Dr. Jay Berkelhamer, senior vice president and chief academic officer at Children’s Healthcare of Atlanta, and past president of the American Academy of Pediatrics, joins host Dr. Jennifer Shu to explores a series of ways through which organizations and workers throughout the healthcare community can do their part to improve our system for financing vaccines.

Host: Leslie P. Lundt, MD Guest: Will Parsons, MD, PhD The complete genetic blueprint for two of the deadliest cancers, pancreatic and brain cancer, was recently deciphered by a team at the Johns Hopkins Kimmel Cancer Center. Understanding the molecular mechanisms of these cancers can help us develop new therapeutic modalities. In this segment, Dr. Will Parsons, one of the trial investigators, joins host Dr. Leslie Lundt to discuss the groundbreaking results of their work.

Host: Jennifer Shu, MD, FAAP Guest: Young-Shin Kim, MD, PhD, MPH, MS Roughly one-third of children in the United States are involved in bullying, either as the bully, as the victim, or on both sides of the confrontation. What interventions can be taken that recognize patterns which lead to this all-too-common part of childhood, and that also work to prevent and combat its occurrence? Further, what can physicians do to help families and their children who are affected by bullying? Dr. Young-Shin Kim, assistant professor of child and adolescent psychiatry at the Yale University School of Medicine, talks with host Dr. Jennifer Shu about gender differences in bullying, risk factors for being targeted by bullies, and more generally, how we can approach an open and honest discussion of this topic with our young patients and their families.

Host: Maurice Pickard, MD Guest: Lisa A. Jackson, MD, MPH Do influenza vaccines for the elderly really make a difference? Dr. Lisa Jackson, research professor of epidemiology at the University of Washington and senior investigator at The Center for Health Studies in Seattle, Washington calls into question previous documentation of reducing deaths and hospitalizations in the elderly from flu vaccination. This is based on a fundamental difference between the kinds of people who get vaccines and those who do not. Join host Dr. Maurice Pickard to learn more.

Host: Bruce Bloom, DDS, JD Guest: David J. Kuter, MD Platelets have a unique regulatory system in the body that does not respond well to increased or decreased production or destruction. Join guest Dr. David J. Kuter, director of hematology at Massachusetts General Hospital in Boston as he tells host Dr. Bruce Bloom about new findings concerning the platelet regulatory molecule thrombopoietin that can lead to better management of platelet diseases like ITP.

Host: Bruce Bloom, DDS, JD Guest: David J. Kuter, MD New drug therapies have just become available for the rare disease Idiopathic Thrombocytopenic Purpura or ITP. Join our guest Dr. David J. Kuter, director of hematology, at Massachusetts General Hospital in Boston to explain the development of romiplostim and other ITP drugs and what clinical impact they are having. Hosted by Dr. Bruce Bloom

Host: Bill Rutenberg, MD Guest: John Ruge, MD Successful brain surgery correlates with the amount of tumor removed. What if the neurosurgeon could visualize the tumor in situ during the operation? Join host, Dr. Bill Rutenberg, and his guest Dr. John Ruge, associate professor of neurosurgery at Rush Medical College and director of the Midwest Children's Brain Tumor Center. Dr. Ruge will discuss the novel technique of fluorescence-guided brain surgery. This technique, used in Germany for 10 years, has recently been brought to the U.S. by Dr. Ruge, who is also the first to apply it in pediatric neurosurgery.

Host: Maurice Pickard, MD Guest: James Webster, MD Despite dramatic improvement in American health and life expectancy over the past several decades, racial and ethnic minorities have not benefited equally from this progress. Dr. James Webster, professor of medicine at Northwestern University's Feinberg School of Medicine, and president of the Chicago Board of Health, discusses how improving cultural competence in health care workers can reduce disparities amongst patients. Dr. Maurice Pickard hosts.

Host: Bruce Bloom, DDS, JD Guest: Thomas Seyfried, PhD We almost always cure mice of cancer, but the same treatment often fails in humans. Is the problem the mouse model? Join host Dr. Bruce Bloom, and his guest, Dr. Thomas Seyfried, professor of biology at Boston College and associate editor of the Journal of Nutrition and Metabolism, as they review the first mouse model that manifests all the major hallmarks of human metastatic cancer.

Host: Leslie P. Lundt, MD Guest: David Servan-Schreiber, MD, PhD How much do nutrition, environmental factors, exercise, and psychoneuroimmunology play role in helping your patients prevent and manage cancer? Dr. David Servan-Schreiber, clinical professor of psychiatry at the University of Pittsburgh School of Medicine and cofounder of the Center for Integrative Medicine, joins host Dr. Leslie Lundt to discuss his ways to help prevent cancer.

Host: Leslie P. Lundt, MD Guest: Aaron Gibson, PharmD In an ideal world, evidence-based medicine and thoughtful clinical research might guide our every treatment decision. But the body of research is sparse on combination therapy for schizophrenia. When is it logical to combine antipsychotics? Dr. Aaron Gibson, assistant professor in the college of pharmacy at the University of New Mexico, joins host Dr. Leslie Lundt to explain when a combination might be reasonable and what problems might occur.

Host: Leslie P. Lundt, MD Guest: Eva Schernhammer, MD, DrPH Physicians' suicide rates are often reported as higher than the general population or of other academics. Dr. Eva Schernhammer, assistant professor of medicine at the Harvard Medical School and assistant professor of epidemiology at the Harvard School of Public Health, discusses her research into physician suicide with host Dr. Leslie Lundt.