Clinician's Roundtable

Host: Maurice Pickard, MD Guest: Irvin Yalom, MD Dr. Irvin Yalom, professor emeritus of psychiatry at Stanford University and the author of several highly acclaimed booksspeaks about how striving for direct engagement with others opens us to the many possibilities of life enrichment. Compassionate connections combined with wisdom of great thinkers allow us to overcome the terror of death that is the theme of his new book Staring at the Sun. Join host Dr. Maurie Pickard.

Host: Maurice Pickard, MD Guest: Irvin Yalom, MD Can addressing death directly through open dialogue inform us about the way we live? Dr. Irvin Yalom, professor emeritus of psychiatry at Stanford University School of Medicine and author of several highly acclaimed books,discusses his newest book, Staring at the Sun, which deals with how thoughts of our own mortality can interfere with life's fulfillments. First, we must become aware that this anxiety exists for both patients and physicians. Then, we can begin to use the power of ideas such as transiency to avoid accumulating regrets. Dr. Maurie Pickard hosts.

Host: Gary Kohn, MD Guest: Jan Stepanek, MD As a specialist in aerospace physiology and altitude-related clinical conditions, Dr. Jan Stepanek, medical director of the Aerospace Medical Program, assistant professor of medicine at the Mayo Clinic in Scottsdale, AZ, and aviation medical examiner (AME) discusses medical qualifications for pilots in the U.S. and the interaction between pilots, AMEs, and the FAA. Your host, Dr. Gary Kohn discusses with Dr. Stepanek the difference between a routine physical and an AME, FAA mandated exam, and medication precautions for pilots considered outside the realm of the normal patient.

Host: Gary Kohn, MD Guest: Jan Stepanek, MD Medical standards for pilots focus on eliminating the sudden incapacitation endangering passengers. Looking ahead, as more passengers seek orbit, and sub-orbit, what is the medical criteria used for clearance? Dr. Jan Stepanek, Medical Director of the Aerospace Medical Program, and Assistant Professor of Medicine at the Mayo Clinic in Scottsdale, AZ, discusses the self-regulated industry, detailed informed consent, preparation for, and the environment of flight with your host, Dr. Gary Kohn.

Host: Gary Kohn, MD Guest: Charles Enke, MD What's around the bend for radiation targeting systems? Dr. Charles Enke, professor and chair of radiation oncology at the University of Nebraska College of Medicine, speaks with host Dr. Gary Kohn about the potential of electromagnetic targeting and tracking as used in the GPS-like Calypso-guided technology. Detecting prostate motion in real-time, eliminating inter-observer variation, and providing the benefit of more precise radiation targeting are, as Dr. Enke mentions, just a few of the benefits with this new technology.

Host: Gary Kohn, MD Guest: Charles Enke, MD Keeping closer tabs on the intrafractional movement of the prostate during radiation therapy will continue to play an increasingly significant role in improving our overall success when treating prostate cancer. So says Dr. Charles Enke, professor and chair of radiation oncology at the University of Nebraska College of Medicine. He details the latest in prostate imaging with host Dr. Gary Kohn. How are we enhancing our command of real-time monitoring modalities?

Host: Bill Rutenberg, MD Guest: Mitchel Berger, MD Join Dr. Mitchel Berger, the Kathleen M. Plant Distinguished Professor and Chairman of the Department of Neurological Surgery at the University of California San Francisco and host Dr. Bill Rutenberg for a discussion of novel targeted therapies for the treatment of malignant brain tumors. Can immunoliposomes hone in like smart bombs attacking tumors not previously reachable?

Host: Bill Rutenberg, MD Guest: Mitchel Berger, MD Dr. Mitchel Berger, the Kathleen M. Plant Distinguished Professor and Chairman of the Department of Neurological Surgery at the University of California San Francisco joins host Dr. Bill Rutenberg for a discussion of new developments in language mapping leading to more successful resection of malignant gliomas. Surprising findings include locating language neurons outside of Broca's area.

Host: Maurice Pickard, MD Guest: David Johnson Our guest, David Johnson, managing director of Citi’s industry leading health care group addresses the potential of outsourcing patients across borders at great savings. This may make us realize that when our president in 1993 stated that the "system was broken and it was time to fix it "may have been right. Will we respond to the fact that "our greatness has not been in being more enlightened then other nations but in our ability to repair our faults." Hosted by Maurice Pickard.

Host: Paul Doghramji, MD Guest: Russell Breish, MD Is family practice a dying profession? Host Dr. Paul Doghramji welcomes Dr. Russell S. Breish, director of family practice and director of the residency program at Chestnut Hill Hospital in Philadelphia to discuss factors affecting family physicians. They will cover the effect of the increase in nurse practitioners and physician assistants, the increase of women medical students, as well as what fields medical students are choosing after graduation.

Host: Maurice Pickard, MD Guest: Robert Klitzman, MD HIV is a very preventable disease. If everyone who is HIV positive agreed not to spread the disease it could be stopped, says our guest, Dr. Robert Klitzman, associate professor of clinical psychology at Columbia University College of Physicians and Surgeons. Disclosure however is not easy and does not always happen. Dr. Klitzman explores with host, Dr. Maurice Pickard the size of this non-disclosure problem and why communications are so difficult. It could be that sexual partners are not asking the right questions.

Host: Matthew J. Sorrentino, MD, FACC, FASH Guest: Gust Bardy, MD Dr. Gust Bardy, president of the Seattle Institute for Cardiac Research and lead investigator of the Home Automated External Defibrillator Trial (HAT), published in the New England Journal of Medicine, will discuss the use of automated external defibrillators, both at home and in public locations, as a strategy to reduce mortality rates among patients who are at higher risk for sudden cardiac death.

Host: Matthew J. Sorrentino, MD, FACC, FASH Guest: Gust Bardy, MD In recent years, we've seen automated external defibrillators (AED) distributed in high-traffic areas throughout many of our communities. Though more cases of sudden cardiac events are occurring outside the home-owing to greater mobility for our older, at-risk patients-a great many cases do still occur in the home. With this in mind, researchers postulated that an AED placed in the home of an at-risk patient may limit their vulnerability to a sudden cardiac event. What did they find? Dr. Gust Bardy, president of the Seattle Institute for Cardiac Research and lead investigator of the Home Automated External Defibrillator Trial (HAT), published in the New England Journal of Medicine, discusses the findings of this trial with host Dr. Matthew Sorrentino.

Host: Larry Kaskel, MD Guest: Nancy H. Nielsen, MD, PhD How valid are consumer based physician ranking systems? In this segment Dr. Larry Kaskel learns the American Medical Association's position on physician ranking from AMA President Nancy Nielsen, MD, PhD who says while the information in these systems obviously cannot be relied upon we should try to understand why these systems are being created. Consumers want to know more about the quality of their doctor. What to do if you have been rated poorly? How do you find your true ranking? Join us to find out.

Host: Larry Kaskel, MD Guest: Nancy H. Nielsen, MD, PhD The trend of comparing and ranking physicians by economic efficiency has reached a breaking point. Insurers use ratings to create tiered programs, offering incentives to steer patients to their list of preferred doctors. How are physicians placed on this preferred list? As AMA President Dr. Nancy Nielsen explains, patients are often forced to base their choice of doctor on cost. How are tiered networks impacting healthcare in other ways? Find out more with host Dr. Larry Kaskel.

Host: Bruce Japsen Guest: Leah Binder Prescribing errors continue to be a major problem. But Leah Binder, chief executive officer of The Leapfrog Group, tells the Chicago Tribune's Bruce Japsen about a computerized physician order entry evaluation tool developed by the business community that enables medical providers to determine how well their system alerts users to common but serious prescribing errors.

Host: Bruce Japsen Guest: Leah Binder Rating hospitals has become the hallmark for the Leapfrog Group. Leah Binder, the Chief Executive Officer of The Leapfrog Group, tells the Chicago Tribune's Bruce Japsen about new quality ratings in this year's Leapfrog Hospital Survey.

Host: Sherwin Ho, MD Guest: Nicola Maffulli, MD, MS, PhD How can you help your patients with overused tendons and tendinopathies, like Achilles tendon problems and tennis elbow? Dr. Nicolas Maffulli, professor and chair of trauma and orthopaedic surgery at Keele University School of Medicine in Staffordshire, England, clinically specializes is tendinopathy. He says that we often misconceive tendinopathy as a degenerated tendon, when the problem is an actually injured tendon that cannot heal. Studies show that genetics as well as overuse may play a role in tendinopathy. Join us to learn about the latest research, treatment options and when the best solution may be surgery. Dr. Sherwin Ho hosts.

Host: Sherwin Ho, MD Guest: William J. Bryan, MD In many regions of our country, summer weather means more outdoor activities, competitive cycling among them. Though cycling is great exercise, our patients must take proper caution to limit their injury risk. Host Dr. Sherwin Ho talks with Dr. Bill Bryan, former medical doctor for the United States cycling team and an avid cyclist, about a range of cycling injuries, from carpel tunnel syndrome to the typical joint pains. What advice can you give your patients t help them avoid injury?

Host: Bruce Bloom, DDS, JD Guest: Roni Zeiger, MD Host Dr. Bruce Bloom welsomes Dr. Roni Zeiger, product manager of Google Health and primary care physician, to discuss the controversial realm of physician ratings and how Google will enter this arena.