Clinician's Roundtable

Host: Matthew J. Sorrentino, MD, FACC, FASH Guest: Kevin Fu, PhD Guest: William Maisel, MD It may seem like a notion better suited to a spy novel than medicine, but medical cardiac devices using wireless technology are vulnerable to security breaches. Dr. William Maisel, director of the Medical Device Safety Institute at the Beth Israel Deaconess Medical Center in Boston, and Dr. Kevin Fu, co-director of the Medical Device Security Center at the University of Massachusetts, Amherst, and director of the Radio Frequency Identification (RFID) Consortium on Security and Privacy, share their research. They were able to obtain unauthorized access to a pacemaker defibrillator, and more. Find out about this disturbing dilemma with host Dr. Matthew Sorrentino.

Host: Larry Kaskel, MD Guest: Akira Sekikawa, MD, MPH, PhD Japan's unusually low mortality rate from coronary heart disease may be tied to the large amount of fish in the Japanese diet. Dr. Akira Sekikawa, assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health, discusses with host Dr. Larry Kaskel the results of his recent study showing how fish consumption may protect against heart disease. They explore the benefits of fish oil, and the unique attributes of this study compared to other studies examining the relationship between fish intake and heart disease.

Host: Larry Kaskel, MD Guest: Tom Charland Guest Tom Charland, chief executive officer of Merchandise Medicine, a research and consulting firm specializing in retail healthcare clinics, reports on the status of the retail clinics nationwide. Mr. Charland explains to host Dr. Larry Kaskel the different structures of retail health clinics and the emerging hospital system-owned retail clinic. Tune in to hear Mr. Charland make sense of the conflicting data reported in the newspapers concerning the growth and success of the various retail health clinic models.

Host: Larry Kaskel, MD Guest: Tom Charland Recent reports tell us that the number of retail health clinics is declining, but according to Tom Charland, chief executive officer of Merchant Medicine, this data incorrectly implies that the retail clinic model is an unsuccessful fad. Mr. Charland clarifies with host Dr. Larry Kaskel what he characterizes as misconceptions, held by members of the medical community, concerning retail health clinics, and further explains that continued expansion by retailer-owned in-store clinics is likely to result in overall growth. Mr. Charland also sheds light on other myths on patient populations, patient care practices, insurance coverage, and prescription-writing habits of retail-clinic operations.

Host: Bruce Bloom, DDS, JD Guest: Raymond P. Onders, MD Dr. Raymond Onders, director of Minimally Invasive Surgery at University Hospitals Case Medical Center in Cleveland, Ohio, describes the development of the Diaphragm Pacing System that electrically stimulates breathing. Hear how this life-saving technology has helped spinal cord patients, and is being tested for use with ALS patients and in the critical care setting to replace ventilators. Hosted by Dr. Bruce Bloom.

Host: Bruce Bloom, DDS, JD Guest: Raymond P. Onders, MD What is the process required to implant a Diaphragm Pacing System which eliminates the need for ventilator care in ALS patients? Dr. Raymond Onders, director of the Minimally Invasive Surgery at University Hospitals Case Medical Center describes the diagnostic and laparoscopic surgical techniques used to implant a Diaphragm Pacing System that electrically stimulates breathing in spinal cord injury and ALS patients. Hear how this amazing technology changes the lives of patients through a very simple surgery. Hosted by Dr. Bruce Bloom.

Host: Bruce Bloom, DDS, JD Guest: Raymond P. Onders, MD A diaphragm pacing system electronically stimulates breathing in patients with amyotrophic lateral sclerosis (ALS). Not only can this device prolong the lives of ALS patients, it can greatly enhance the quality of their lives. Dr. Raymond Onders, associate professor of surgery and medicine at Case Western Reserve University School of Medicine, and director of minimally invasive surgery at University Hospitals Case Medical Center in Cleveland, tells host Dr. Bruce Bloom about a novel diaphragm pacing system that is making international inroads in the treatment of ALS.

Host: Jennifer Shu, MD, FAAP Guest: Lori Feldman-Winter, MD, MPH Although breast milk is widely considered to be the best nutrition for infants, research tells us that breastfed babies may be at elevated risk for vitamin D deficiency, anemia, and tooth decay. What other health considerations may be associated with breastfeeding? Can we definitively say that breast milk is still the best option for infants? Dr. Lori Feldman-Winter, associate professor of pediatrics at the University of Medicine and Dentistry of New Jersey, division head of adolescent medicine at Cooper University Hospital in Camden, N.J., and an Executive Committee member of the American Academy of Pediatrics section on breastfeeding, shares her expertise with host Dr. Jennifer Shu.

Host: Jennifer Shu, MD, FAAP Guest: Lori Feldman-Winter, MD, MPH Mothers in the United States have the lowest rates of breastfeeding in the developed world. What are the immediate and lasting benefits of breastfeeding for infants and their nursing mothers? How does breast milk compare to formula, in terms of the baby's nutrition and long-term growth development? Host Dr. Jennifer Shu welcomes Dr. Lori Feldman-Winter, associate professor of pediatrics at the University of Medicine and Dentistry of New Jersey, division head of adolescent medicine at Cooper University Hospital in Camden, New Jersey, and an executive committee member of the American Academy of Pediatrics section on breastfeeding.

Host: Jennifer Shu, MD, FAAP Guest: Lori Feldman-Winter, MD, MPH Despite ambitious recommendations that new mothers breastfeed their infants for at least one year after birth, very few mothers meet this objective. Knowing there are barriers to breastfeeding--social, economic, and beyond--how can we help mothers get past these difficulties, where possible? Further, how can we allay the guilt many mothers feel when they're unable to breastfeed? For answers, host Dr. Jennifer Shu talks with Dr. Lori Feldman-Winter, associate professor of pediatrics at the University of Medicine and Dentistry of New Jersey, division head of adolescent medicine at Cooper University Hospital in Camden, N.J., and an Executive Committee member of the American Academy of Pediatrics section on breastfeeding.

Host: Bruce Bloom, DDS, JD Guest: Timothy Coetzee, PhD Through a venture philanthropy called Fast Forward, LLC the National Multiple Sclerosis Society plans to deploy 1.5 to 2 million dollars in the next 18 months as seed funding to biotech companies on the path towards cures for Multiple Sclerosis. Our guest, Timothy Coetzee executive director of Fast Forward, LLC joins host Dr. Bruce Bloom to talk about genomics, novel immune system therapies and other hopeful possibilities leading towards cures for multiple sclerosis. Interesting also is the process by which the biotech companies are evaluated and followed after an investment is made.

Host: Bruce Bloom, DDS, JD Guest: Timothy Coetzee, PhD Speeding up the translation process for MS patients is the mission of Fast Forward, LLC, a venture philanthropy of the National Multiple Sclerosis Society. Our guest today, Dr. Timothy Coetzee executive director of Fast Forward, LLC tells us how they are taking a business venture approach to find cures. Funded by private donations, the Fast Forward team makes investments in promising science backed by companies with a plan and strategy in place. Says Coetzee, "Its pivotal that charities think about using their capital towards commercial development. We are not sure where the next cure will come from."

Host: Jennifer Shu, MD, FAAP Guest: Robert Lamberts, MD Are your patients always honest with you about their symptoms and related conditions? Do they treat your staff with the proper level of respect and courtesy? We all know that both patients and physicians are equal contributors to the doctor-patient relationship, yet this partnership isn't always as constructive and amiable as either side would hope. Are there simple rules we can encourage our patients to follow toward making a positive impact on this relationship? Dr. Rob Lamberts, board-certified internist and pediatrician, and author of the popular blog Musings of a Distractible Mind, prioritizes several keys from the patient's perspective toward maintaining a good working relationship with you, their healthcare provider.

Host: Jennifer Shu, MD, FAAP Guest: Robert Lamberts, MD We all know that both patients and physicians play an integral role in the doctor-patient relationship. Yet this partnership isn't always as balanced as we might hope. Why might our patients become frustrated with us or feel uncomfortable in our office? Are there simple rules that we, as physicians, can follow to make a positive impact on this relationship, and to feel good about the connections we have built with our patients? Dr. Rob Lamberts, board-certified internist and pediatrician, and author of the popular blog Musings of a Distractible Mind, shares his insights on helping doctors and patients build a stronger rapport. Dr. Jennifer Shu hosts.

Host: Larry Kaskel, MD Guest: Robert Portman, JD, MPP Converting a private practice to the concierge medical practice model raises many legal issues. Attorney Rob Portman, a partner with the law firm of Powers, Pyles, Sutter & Verville, explains the legal issues of a concierge medicine practice, including contract terms for participating patients, care obligation to non-participating patients, and rules for billing Medicare for services on concierge patients. In addition, Host Larry Kaskel explores with Mr. Portman the legal arguments that render concierge medicine unlawful, and the pending federal legislation to regulate this business model.

Host: Mary Leuchars, MD Guest: M. Harvey Brenner, PhD No one is exempt from feeling sick of his or her job from time to time. But in whom does employment confer actual serious health consequences? Are socioeconomic status differences the only distinguishing factors in selecting low vs high longevity occupations? Host Dr. Mary Leuchars explores how work impacts health with Dr. Harvey Brenner, professor of public health at the University of North Texas School of Public Health.

Host: Leslie P. Lundt, MD Guest: Rebecca Puhl, MS, PhD Obesity is associated with multiple medical and psychological co-morbidities. An often under recognized problem is that of weight related stigmatization which can lead to unfair treatment, prejudice and discrimination. Are you guilty? Dr. Rebecca Puhl, director of research and anti-stigma initiatives at the Rudd Center for Food Policy and Obesity at Yale University, joins host Dr. Leslie Lundt to explain how weight bias may affect your obese patients.

Host: Leslie P. Lundt, MD Guest: Robert M. Post, MD Mixed bipolar episodes as defined by the DSM-IV are relatively rare. But for those of us in clinical practice, this definition may be too conservative to be of use. What is a mixed bipolar episode and how do we best treat these patients? Host Dr. Leslie Lundt welcomes Dr. Robert Post, professor of psychiatry at George Washington University School of Medicine and Penn State College of Medicine, to discuss the management of mixed episodes.

Host: Leslie P. Lundt, MD Guest: Robert M. Post, MD The efficacy of the gold standard for bipolar treatment as been reported to be as high as 80%. But in the real world, that number is more like 25%. Why the disparity? What can we do for our treatment resistant bipolar patients? Dr. Robert Post professor of psychiatry at George Washington University School of Medicine and Penn State College of Medicine and head of the Bipolar Collaborative Network joins host Dr. Leslie Lundt to give us the latest on how to diagnose and treat these patients.

Host: Leslie P. Lundt, MD Guest: Michael Camilleri, MD In the past, bilateral truncal vagotomy had been used to treat patients with peptic ulcer disease. Astute clinicians noted these patients had loss of appetite following the procedure. How did this eventually led to the development of a new treatment for obesity? Dr. Michael Camilleri, a gastroenterologist and professor of medicine and physiology at the Mayo Clinic College of Medicine, describes to host Dr. Leslie Lundt the latest research using vagal blockade to treat obesity.