Clinician's Roundtable

Host: Susan Dolan, RN, JD Guest: Steve McKee Hear Steve McKee, author of the book, My Father's Heart: A Son's Journey, as he discusses why it was so difficult for him to make the decision to take a statin for his heart disease.

Host: Susan Dolan, RN, JD Guest: Steve McKee Steve McKee's paternal grandfather died of a heart attack at age 53, his father died of a heart attack at age 50 and he discovered he had heart disease at the age of 52. Hear author Steve McKee as he discusses his experience with heart disease in his book, My Father's Heart: A Son's Journey.

Host: Susan Dolan, RN, JD Guest: Suzanne Clough, MD Dr. Suzanne Sysko Clough is the Chief Medical Officer of WellDoc Communications, a technology based healthcare company located in Baltimore, Maryland. Hear Dr. Clough as she discusses how the WellDoc cell phone-based technology helps patients manage their diabetes.

Host: Bill Rutenberg, MD Guest: Mitchel Berger, MD Malignant Glioma: A diagnosis your patient wants do not want to receive. As their primary physician what more can you tell your patient? What does the latest research indicate about the pathobiology of Gliomas? In this segment our guest Dr. Mitchel Berger, Professor and Chair of Neurological Surgery at the University of California, San Francisco, talks with host Dr. Bill Rutenberg about the latest Glioma research. They discuss the genetic advances that may lead to new treatments including a possible vaccination currently being developed that could one day replace mainstay treatments including radiation and chemotherapy.

Host: Bill Rutenberg, MD Guest: Richard Rosenfeld, MD Dr. Richard Rosenfeld, professor of otolaryngology at the State University of New York Health Sciences Center, joins host Dr. Bill Rutenberg for an in-depth discussion of the current guidelines for the management of sinusitis. Dr. Rosenfeld discusses current criteria for evidence-based diagnosis and recommended treatment.

Host: Bill Rutenberg, MD Guest: Richard Rosenfeld, MD Dr. Richard Rosenfeld, professor of otolaryngology at the State University of New York Health Sciences Center, joins host Dr. Bill Rutenberg for an insightful discussion of the current care guidelines for pediatric otitis media. Dr. Rosenfeld addresses difficulty and necessity of accurate diagnosis in order to safely apply "watchful waiting" as first-line treatment. What do you do if the patient doesn't get better?

Host: Maurice Pickard, MD Guest: Mira Milas, MD There are many new techniques to evaluate patients with thyroid and parathyroid disease. Dr. Mira Milas, associate professor at the Institute of Surgery, Endocrinology and Metabolism Institute at Cleveland Clinic Lerner College of Medicine, speaks about the use of ultrasound in thyroid disease detection. She also updates host Dr. Maurice Pickard on the development of a new test, TSHrmRNA, to augment intermediate FNA as well as to show if there is residual disease or recurrence. They also discuss osteoporosis found in some men with parathyroid disease.

Host: Maurice Pickard, MD Guest: Mira Milas, MD Dr. Mira Milas, associate professor of surgery at the Cleveland Clinic Lerner College of Medicine, discusses with host Dr. Maurie Pickard the expanding field of endocrine surgery and how ultrasound and fine needle aspirations have led to successful pre-operative evolutions. Intraoperative parathyroid procedures can help avoid reoperations. In addition, we learn that decisions to operate on asymptomatic patients with hyperparathyroidism need to be seriously considered.

Host: Maurice Pickard, MD Guest: Robert Klitzman, MD The current research in Huntington's disease still leaves us with more questions than answers. We know the causative gene, identified the proteins involved, and can postulate the mechanisms. Yet despite the universal outcome from this disease, patients may still live much of their adult lives productively, leading to added dfficulty in making life choices. Dr. Robert Klitzman, Associate Professor of Clinical Psychology at Columbia University College of Physicians and Surgeons, joins host Dr. Maurie Pickard on the subject of counseling patients with Huntington's Disease through life's milestones.

Host: Maurice Pickard, MD Guest: Robert Klitzman, MD Dr. Robert Klitzman, Associate Professor of Clinical Psychology at Columbia speaks about the need for more genetic counselors to help with families of Huntington's disease, breast cancer, alpha-1 antitrypsin deficiency and familial polyposis. People can order genetic testing and disease ancestry search directly on the internet. Many physicians have not been able to keep up with developments of the genome but will be asked to be knowledgeable about this exploding field. Dr. Maurie Pickard hosts.

Host: Maurice Pickard, MD Guest: Robert Klitzman, MD Dr. Robert Klitzman, associate professor of clinical psychology at Columbia University, discusses how to prepare patients and their families to deal with the complex issues that arise in families that have inherited Huntington's disease. Join host Dr. Maurice Pickard for this important discussion.

Host: Larry Kaskel, MD Guest: Marcy Zwelling, MD In 2004 Dr. Zwelling-Aamot dramatically reduced the size of her practice, adopting the concierge model in order to provide a higher level of access and attention to a smaller number of patients. Host Dr. Larry Kaskel speaks with Dr. Aamot about the failings of the current healthcare system in the United States and the decision to convert her practice into a concierge model.

Host: Larry Kaskel, MD Guest: Steven Knope, MD One of the leading pioneers and innovators in concierge medicine, Dr. Steven Knope discusses how the concierge medicine practice model is a solution to the failing health care system in the United States. Dr. Knope opened one of the nation's first concierge medical practices and discusses why the arrangement is the perfect resource for practitioners and patients alike. Dr. Knope also discusses some of the key steps necessary for converting a practice to a concierge model, outlined in his book, Concierge Medicine A New System to Get the Best Healthcare.

Host: Larry Kaskel, MD Guest: Renu Virmani, MD Drug-eluting stents or bare metal stents: can pathology research give us a clearer picture? An internationally recognized cardiopathologist, Dr. Renu Virmani, sorts through what we know and what don’t know about drug-eluting stents with host Dr. Larry Kaskel. According to Dr. Virmani, the long-term outlook for stents is quite good, with key improvements in polymers and advances that afford us better quantitative control over the drugs administered via stents.

Host: Larry Kaskel, MD Guest: Renu Virmani, MD What does pathological data tell us about vulnerable plaque and how can we detect it before it’s too late? Join internationally recognized cardio pathologist, Dr. Renu Virmani talking about what she has discovered in the path lab about patients who have died from plaque rupture. She discusses with Dr. Kaskel the variations in soft and hard plaque, the role of the vaso vasorum in disease and whether or not non-invasive techniques can lead to a diagnosis about plaque.

Host: Larry Kaskel, MD Guest: Mark Willenbring, MD What is the one screening question you can ask your patient to identify if they have a drinking problem? What solutions can you offer as a general physician, outside of counseling programs to help your patient stop drinking? What pharmalogical options are on the market to help patients stop drinking? Do they work? Dr. Mark Willenbring, director of the Treatment and Recovery Research Division of the National Institute on Alcohol Abuse and Alcoholism talks with Dr. Larry Kaskel about the role a general physician can take in screening and treating patients who drink too much.

Host: Larry Kaskel, MD Guest: Mark Willenbring, MD Given the pervasiveness of alcohol use disorders (AUDs) in the United States, Dr. Mark Willenbring says, “we need to be intervening at a much earlier stage and providing treatment to a much broader range of people then we currently do.” Dr. Willenbring, director of the National Institute on Alcohol Abuse and Alcoholism's Division of Treatment and Recovery Research, joins host Dr. Larry Kaskel to talk about new information from epidemiologic research on the prevalence and progression of heavy drinking and alcohol use disorders. In addition, Dr. Willenbring discusses the subtypes of alcohol dependence, and the nature of AUDs, in the context of DSM revisions.

Understanding the unique stressors of growing up in today’s world is an important part of treating children and adolescents. One of the most challenging events that our children endure is the college application process. Competition for spots at top colleges is at an all-time high. How does this affect our children and their families? Author of Fat Envelope Frenzy, Former Assistant Director of Admissions at Dartmouth College, Joie Jager-Hyman joins host Dr. Leslie Lundt.

Host: Leslie P. Lundt, MD Guest: James Welker, DO The time to first antibiotic dose in patients with community-acquired pneumonia is a core quality measure by which hospitals and physicians are evaluated. Might this time pressure have a negative effect on the accuracy of diagnosis of pneumonia? Dr. James Welker, the Director of the Franklin Square Clinical Research Center, joins host Dr. Leslie Lundt to discuss his research in this area.

Host: Leslie P. Lundt, MD Guest: Leon Sloman, MD Dr. Leon Sloman has developed a new comprehensive evolutionary model of depression and anxiety which may prompt a radically new approach to psychotherapy. He joins host Dr. Leslie Lundt to discuss IDS – the involuntary defeat strategy.