Clinician's Roundtable

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Ron Nelson, PA Ron Nelson, a physician assistant and president of Health Services Associates, Inc., discusses with host Lisa D'Andrea different models for calculating the value of a physician assistant to a medical practice. Mr. Nelson explains several compensation models that may be used for a physician assistant and the benefits of different models that incentive both production and quality of care. Mr. Nelson outlines a simple model which establishes a floor for compensating a physician assistant based upon the physician assistant's costs to overhead, net charges, and quality of care.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Ron Nelson, PA Ron L. Nelson explains to host Lisa D'Andrea the structure of rural health clinics and the reimbursement incentives offered by the government for rural health clinics in order to assure access to healthcare in rural communities. Mr. Nelson describes the certification requirements for rural health clinics, which include that mid-level providers must provide fifty percent of the services. Mr. Nelson also outlines the relationship rural health clinics have with hospitals and the ownership opportunities for physician assistants. Mr. Nelson also highlights some of the difficulties Rural Health Clinics face in recruiting physician assistants to work at Rural Health Clinics.

Host: Michael Greenberg, MD Guest: Anna Dhody, MFS Host Dr. Michael Greenberg continues part three of his informative tour of Philadelphia's Mutter Museum, part of the College of Physicians of Philadelphia, the oldest professional society in continuous operation in the United States since 1787. Curator Anna Dhody guides this tour of many of the museum's specimens, including the Hyrtal collection of 139 skulls and a medicinal herb garden representative of medicines of the 18th and 19th centuries. This is Part 3 of an on-site discussion in three parts. Part 1 >> Part 2 >>

Host: Michael Greenberg, MD Guest: Anna Dhody, MFS Host Dr. Michael Greenberg continues part two of his disturbingly informative tour of Philadelphia's Mutter Museum, part of the College of Physicians of Philadelphia, the oldest professional society in continuous operation in the United States since 1787. Curator Anna Dhody illuminates many of the museum's specimens, including preserved organs and a cast of the world's most famous Siamese twins. This is Part 2 of an on-site discussion in three parts. Part 1 >> Part 3 >>

Host: Michael Greenberg, MD Guest: Anna Dhody, MFS Host Dr. Michael Greenberg takes the show on the road to Philadelphia, where he enjoys a fascinating journey through the Mutter Museum, part of the College of Physicians of Philadephia, the oldest professional society in continuous operation in the United States since 1787. Dr. Greenberg tours the museum with its curator, Anna Dhody, who guides us through many of the museum's headliner exhibits. This is Part 1 of an on-site discussion in three parts. Part 2 >> Part 3 >>

Host: Mary Leuchars, MD Guest: Désirée Ratner, MD Dr. Désirée Ratner, director of dermatologic surgery at Columbia University Medical Center, discusses Mohs micrographic surgery, at technique developed by Frederick Mohs to allow complete visualization of high-risk skin cancer margins for complete removal. Learn how this procedure, initially developed with zinc floride paste to tag cancerous lesions, is now practiced. How does this surgery relate to standard frozen section histology and immunostaining techniques with which physicians are more familiar? Dr. Mary Leuchars hosts.

Host: Leslie P. Lundt, MD Guest: Ori Brafman Guest: Rom Brafman, PhD How often have you seem seemingly rational and experienced clinicians do something completely irrational and out of character? Like overlook an obvious diagnosis? Ori and Rom Brafman authors of Sway join host Dr. Leslie Lundt to discuss the irresistible pull of irrational behavior.

Host: Leslie P. Lundt, MD Guest: Bruce Walker, MD Chronic viral infections can manifest in two different ways: one group, such as Epstein-Barr virus, are immunologically contained after the acute infection. The other group, including HIV, lead to persistent viremia and progressive clinical disease. Are there patients who are able to escape the latter without antiviral medications? The director of the Center for AIDS Research at Harvard Medical School, Dr. Bruce Walker, joins host Dr. Leslie Lundt to discuss these so-called "elite controllers."

Host: Leslie P. Lundt, MD Guest: Roger McIntyre, MD It is reported that up to a fifth of bipolar disorder patients will commit suicide, yet there are few studies looking at clinical risk factors in this population. What is the latest research? Host Dr. Leslie Lundt welcomes Dr. Roger McIntyre, associate professor of psychiatry and pharmacology at the University of Toronto School of Medicine, to discuss his latest research investigating childhood abuse with adult bipolar suicide rates.

Host: Leslie P. Lundt, MD Guest: Stuart McGill, PhD How might back pain be prevented? Dr. Stuart McGill, professor of spine biomechanics and chair of the Department of Kinesiology at the University of Waterloo, shares his research with host Dr. Leslie Lundt regarding the mechanisms of back injury. A greater understanding of these mechanisms can help patients prevent back pain and injuries. They discuss twisting, lifting, disk hydration and stabilization. In addition, Dr. McGill talks about spine research observing athletes and their spines as they come in and out of the game.

Host: Leslie P. Lundt, MD Guest: Stuart McGill, PhD Each year, 40 to 60 percent of American adults suffer from chronic back pain. More than one million spine surgery procedures are performed annually in the US, with medical costs to treat back pain approaching $24 billion per year. Dr. Stuart McGill, professor of spine biomechanics and chair of the department of kinesiology at the University of Waterloo in Ontario, Canada, joins host Dr. Leslie Lundt to talk about cost-effective treatments for back pain.

Host: Leslie P. Lundt, MD Guest: Stuart McGill, PhD At some point nearly 85% of your patients below age 50 will present with back pain and nearly all of them will have at least one recurrence. Host Dr. Leslie Lundt welcomes Dr. Stuart McGill, professor of spine biomechanics and chair of the Department of Kinesiology at the University of Waterloo to review the primary causes of back pain.

Host: Leslie P. Lundt, MD Guest: Matthew W. Johnson, PhD It used to be common for researchers to study the potential medicinal uses for hallucinogenic drugs, including psilocybin, ecstasy, and LSD; however, the 60's left a blemish on legitimate research and it grinded to a halt. Host Dr. Leslie Lundt welcomes Dr. Matthew Johnson, a psychopharmacologist in the Department of Psychiatry at the Johns Hopkins School of Medicine, who is studying psychoactive drug effects in human participants.

Host: Leslie P. Lundt, MD Guest: Peter R. Breggin, MD Our guest Dr. Peter Breggin, a psychiatrist now in private practice in Ithica New York has been convinced by the weight of scientific evidence and his years of clinical experience that psychiatric medications frequently cause patients to lose their judgment and their ability to control their emotions and actions. Needless to say, he is a controversial figure in our field. He joins host Dr. Leslie Lundt to discuss why he believes that psychotropics "spellbind" patients.

Host: Bruce Japsen Guest: Peter Farrell Point-of-care testing has evolved in the last decade, allowing for immediate diagnostic testing at a patient's bedside. But a new study points to perhaps some usages and healthcare benefits not previously realized, particularly in the emergency room. Peter Farrell, divisional vice president of marketing and clinical affairs for Abbott Laboratories Point of Care business tells the Chicago Tribune's Bruce Japsen about the importance of point of care testing, which essentially puts diagnostic testing in the physicians' hands.

Host: Bruce Japsen Guest: Peter Farrell Some doctors may view it as a laboratory in their hand - the new point-of-care method of diagnostic testing, right at the patients bedside. Peter Farrell, divisional vice president of marketing and clinical affairs for Abbott Laboratories Point-of-Care business, tells the Chicago Tribune's Bruce Japsen about the movement of hospitals, doctors and other health facilities to point-of-care testing, which allows for quicker diagnoses and subsequent treatment plans.

Host: Maurice Pickard, MD Guest: James L. Gulley, MD, PhD, FACP Can a vaccination help prevent prostate cancer? Dr. James Gulley, director of the Clinical Trials Group of the Laboratory of Tumor Immunology and Biology at the National Institutes of Health discusses studies involving the use of cancer vaccines to modulate the immune response in cancer patients. These trials contrast classic "tumor response" with "patient response" that have shown increased survival post therapy.

Host: Michael Greenberg, MD Guest: Sharon Mitchell, PhD A patient tells you that they have a sexual issue. Do you get queasy? Do you know how to guide this patient to a specialist who can help them? Dr. Sharon Mitchell, founder of the Adult Industry Medical Healthcare Foundation and a former actress in adult films, aims to help us maintain our commitment to addressing our patients' needs, including those issues that might make for a slightly uncomfortable discussion. How should you respond if some of these concerns are presented to you during a routine office visit? To whom can you refer those patients who would benefit from an opportunity to speak with an expert on sexual issues? Dr. Michael Greenberg hosts.

Host: Michael Greenberg, MD Guest: Anthony Jahn, MD "A night at the opera" means more than mere entertainment for some. For guest Dr. Anthony Jahn, otolaryngologist and volunteer medical director for the New York Metropolitan Opera, it's part of a second career. Host Dr. Michael Greenberg speaks with Dr. Jahn about his practiced art of caring for professional singers, addressing several unique occupational health issues from this select population.

Host: Michael Greenberg, MD Guest: Anthony Jahn, MD Dr. Anthony Jahn, an otolaryngologist and volunteer medical director for the New York Metropolitan Opera, introduces you to the art of caring for professional singers. What are the idiosyncrasies of providing care to this select population, who must be doggedly devoted to preserving strong health and maintaining good overall occupational status, most specifically those breathtaking voices? Host Dr. Michael Greenberg talks with Dr. Jahn about the delicate balance of prescribing steroids to elite vocalists, their exposure to alternative medicines and belief systems, as well as the role of placebos in mollifying superstition among high-level performers.