Clinician's Roundtable

Host: Leslie P. Lundt, MD Guest: Gregory Zimet, PhD Vaccines seem to always provoke controversy. Perhaps none so much as the HPV vaccine. Dr. Gregory D. Zimet, professor of pediatrics and clinical psychology at Indiana University School of Medicine, joins host Dr. Leslie Lundt to discuss the obstacles that may interfere with widespread acceptance of the HPV vaccine.

Host: Leslie P. Lundt, MD Guest: Lawrence Schneiderman, MD Our guest today writes in his book, Embracing Our Mortality, that lawyers (as officers of the court) are not permitted to tell their clients to lie but physicians are under no such obligation. Under what situations would it be best for us to advise people to polish their recollections? Medical ethicist Dr. Lawrence Schneiderman joins host Dr. Leslie Lundt to discuss the role of the physician in end of life decisions.

Host: Leslie P. Lundt, MD Guest: Lawrence Schneiderman, MD Is there something wrong with being aggressively optimistic? Dr. Lawrence Schneiderman, professor emeritus in the Department of Family and Preventive Medicine and adjunct professor in the Department of Medicine at the University of California, San Diego, takes a provocative stance on the harm of giving patients unfounded hope. Hosted by Dr. Leslie Lundt.

Host: Leslie P. Lundt, MD Guest: William Swiggart, MS, LPC Disruptive physician behavior is often tolerated until a crisis emerges which then triggers disciplinary action. How else might we handle this delicate situation? William Swiggart, the co-director for the Center for Professional Health at Vanderbilt University Medical Center, joins host Dr. Leslie Lundt to discuss their programs for physicians deemed disruptive by their peers.

Host: Leslie P. Lundt, MD Guest: Philip Ninan, MD After many years of trying, Wyeth has received approval and is currently marketing the newest antidepressant in the US -- desvenlafaxine. What do you need to know about this medicine? Host Dr. Leslie Lundt welcomes Dr. Philip Ninan, vice president for Neuroscience Global Medical Affairs at Wyeth Pharmaceuticals to discuss the ins and outs of desvenlafaxine.

Host: Leslie P. Lundt, MD Guest: Philip Ninan, MD Have you ever wondered how and why the physicians in the top positions of the pharmaceutical companies leave academia to enter industry? Host Dr. Leslie Lundt welcomes Dr. Philip Ninan to talk about his transition from being an academic professor at Emory University School of Medicine to becoming vice president for Neuroscience in Global Medical Affairs for Wyeth Pharmaceuticals. Dr. Ninan has an international reputation for excellence in research in the neurobiology and treatment of anxiety and depressive disorders.

Host: Leslie P. Lundt, MD Guest: Kaimana MacDonald, MD Patients with a history of trauma or neglect are at increased risk for dissociative disorders. These are often hidden and remain undiagnosed even after years of treatment. How can a physician best understand these problems? Dr. Kai MacDonald, assistant professor of psychiatry at the University of California in San Diego joins host Dr. Leslie Lundt to explain how the non-psychiatrist may be missing patients with dissociative disorders.

Host: Leslie P. Lundt, MD Guest: John Kao, MD, MBA Physician Innovator - Is that you? Our guest, psychiatrist and author of the recent best selling book Innovation Nation, Dr. John Kao talks of his most recent career. Dr. Kao calls himself an ‘instigator of new things.' Join host Dr. Leslie Lundt as she learns the ingredients of innovation and how it differs from creativity. Physicians can be innovators in their own practice or as part of a larger team to help make improvements in the delivery of healthcare.

Host: Leslie P. Lundt, MD Guest: Lori Brotto, PhD Treatment of early-stage cervical and endometrial cancer is associated with significant sexual difficulties in at least half of women following hysterectomy. The success in treating these cancers has resulted in a focus on quality of life issues during remission. What can we do to help these women? Host Dr. Leslie Lundt welcomes Dr. Lori Brotto, assistant professor in the Department of Obstetrics and Gynecology and director of the Sexual Health Laboratory at the University of British Columbia where her research primarily focuses on developing and testing psychological and psychoeducational interventions for women with sexual desire and arousal difficulties.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Candace Cain, PA-C Host Lisa D'Andrea speaks with Candace Cain about the ability of physician assistants and nurse practitioners to change specialties within all fields of medicine. Ms. Cain informs us of the steps necessary to make the transition from one specialty to another in a competent and safe manner.

Host: Larry Kaskel, MD Guest: Patrick O'Doherty Patrick O'Doherty, vice president of the ProAssurance Insurance Company and a leading expert on insurance coverage and potential liability exposure, explains the new federal rule of civil procedures, regarding the discovery of electronic records, to which medical practices are now being exposed. Mr. O'Doherty talks with host Dr. Larry Kaskel about the new requirements for electronic document management, which include employee e-mails, and the limitations of professional liability coverage with respect to this risk. Mr.O'Doherty also outlines the scope of this supplemental coverage and the value in terms of litigation management, given the relatively low cost of coverage.

Host: Jordan Metzl, MD Guest: John Kennedy, MD Several studies looking at efficacy for custom and off-the-shelf orthotics indicate that the vast majority of patients don't need a custom device. How do we decide who is an appropriate candidate for each product? How does this debate about specialized product lines project to running shoes and other items that help us work toward better foot health for our patients? Host Dr. Jordan Metzl welcomes Dr. John Kennedy, assistant professor of orthopaedic surgery at Weill Medical College of Cornell University and an orthopaedic surgeon at the Hospital for Special Surgery in New York.

Host: Jordan Metzl, MD Guest: John Kennedy, MD Commonly perceived as a minor injury, ankle sprains are dismissed by many athletes, in particular, who are encouraged to shake it off, play through pain, and pursue some simple rehab as their game and practice schedule allows. Yet there is more to simple ankle sprains than we may realize, including diminished proprioception and balance that may leave our patients more vulnerable to chronic injury. Why is this loss of proprioception specific to the ankle? Are we approaching our treatment of these injuries in the proper manner? Dr. John Kennedy, assistant professor of orthopaedic surgery at Weill Medical College of Cornell University and an orthopaedic surgeon at the Hospital for Special Surgery in New York, details effective diagnostic and treatment strategies with host Dr. Jordan Metzl. Dr. Kennedy urges us not to underestimate what may be perceived as a simple ankle sprain.

Host: Bruce Japsen Guest: Ted Love, MD Anticoagulants like heparin have been around for decades, but the drugs have drawbacks for many patients. Dr. Ted Love, Chief Executive of biotech company Nuvelo, tells host Bruce Japsen about targeted anticoagulant therapies that are being developed to be safer and more effective than the old standby heparin therapy and other blood treatments.

Host: Bruce Japsen Guest: Ted Love, MD With ongoing questions about the manufacturing of heparin in China and concerns about a potential shortage of the anticoagulant, some are wondering whether there is a need for new heparin alternatives. Dr. Ted Love, chief executive officer of the San Francisco biotech company Nuvelo, tells host Bruce Japsen about the biotech industry's pursuit of synthetic variations of the popular blood thinner.

Host: Bruce Japsen Guest: Tim Walbert The climate for innovation in the pharmaceutical and biotech industries is fraught with risk, but also holds great potential for reward. Tim Walbert, the chief executive of Horizon Therapeutics, tells host Bruce Japsen about the prospects for growth in life sciences and the biopharmaceutical industry outside of Big Pharma and what that means for physicians.

Host: Bruce Japsen Guest: Tim Walbert Why take two pills when you can just take one? Welcome to the latest phenomenon in healthcare: combination pills. Tim Walbert, president and chief executive officer of Horizon Therapeutics, tells host Bruce Japsen about the drug industry's push toward combining two or more treatments into one pill, and the potential benefits for us and for our patients.

Host: Mark Nolan Hill, MD Guest: Roy Steigbigel, MD We are getting our first in-depth look at some of the research behind raltegravir, a powerful therapy for multi-drug resistant HIV infection already approved by the FDA. How is this raltegravir data impacting current clinical strategies for attacking the virus in multi-drug resistant patients? Host Dr. Mark Nolan Hill probes this question and much more with Dr. Roy Steigbigel, professor of medicine and pathology, molecular genetics and microbiology, and pharmacological sciences, and founding director of the Comprehensive AIDS Center at the State University of New York at Stony Brook.

Host: Mark Nolan Hill, MD Guest: Roy Steigbigel, MD In the quest to find therapies for multi-drug resistant HIV, researchers have zeroed in on raltegravir. The latest data indicates this potent agent provides the highest reported virologic suppression rate among multi-drug resistant patients. Is raltegravir proving more effective than antiretrovirals? Does it carry any prominent side effects? Dr. Roy Steigbigel, professor of medicine and pathology, molecular genetics and microbiology, and pharmacological sciences, and founding director of the Comprehensive AIDS Center at the State University of New York at Stony Brook, details his New England Journal of Medicine research on raltegravir therapy for multi-drug resistant HIV with host Dr. Mark Nolan Hill.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Robert M. Blumm, PA-C Surgical physician assistants are becoming an important part of the workflow of hospitals. Guest Robert Blumm, a practicing physician assistant since 1970 and president of the Association of Plastic Surgery Physician Assistants, outlines with host Lisa D'Andrea the capabilities and contributions of the surgical physician assistant in the hospital setting.