Gi Insights

Guest: Lawrence Cohen, MD Host: Mark DeLegge, MD Propofol is used for deep sedation, and is often preferred by patients undergoing an endoscopy, since it's a short-acting agent. Can it be administered safely and effectively by trained gastroenterologists, or should an anesthesiologist be present to monitor the procedure? Dr. Larry Cohen, associate clinical professor at Mount Sinai School of Medicine, joins host Dr. Mark DeLegge to discuss the benefits, costs and risks of using propofol during endoscopy. From a medical-legal perspective, are gastroenterologists at more risk if they administer propofol during endoscopy than they would be if an anesthesiologist had been present?

Guest: Lawrence Kosinski, MD Host: Mark DeLegge, MD We've heard quite a bit about electronic medical record (EMR) systems. Many of us have also counted the reasons why we're hesitant to make the switch. But are the benefits of EMRs too real and too many to pass up? Dr. Lawrence Kosinski, a member of the AGA's Practice Management and Economics Committee, counts simplified compliance, and valuable feedback from clinical performance improvement studies, as a few of the many advantages of EMRs in his group practice. Find out more with host Dr. Mark DeLegge.

Guest: Stephen A. McClave, MD Host: Mark DeLegge, MD Physicians were previously obligated to provide nutrition and hydration to all patients during end of life care. Now, the courts have placed the responsibility with the patient. How can you best counsel patients and their families in making difficult decisions on feeding for the terminally ill? Dr. Stephen McClave, professor of medicine and director of clinical nutrition at the University of Louisville School of Medicine, takes a closer look at the ethical, legal and practical ramifications related to end-of-life nutrition with host Dr. Mark DeLegge.

Guest: David Whitcomb, MD, PhD Host: Mark DeLegge, MD Because there are no early stage symptoms for pancreatic cancer, diagnosis is often delayed until after the cancer has metastasized. The search for a clue to the onset of this disease is a priority. Dr. David C. Whitcomb, professor of medicine, chief of gastroenterology and medical director of the Comprehensive Pancreas Program at the University of Pittsburgh School of Medicine discusses the latest biomarkers for cancer on the pancreas with host Dr. Mark DeLegge.

Guest: Phillip Toskes, MD Host: Jay Goldstein, MD A squeeze on federal funding is forcing researchers to explore different avenues for financing. What paths are most effective for finding support? Dr. Philip Toskes, professor of medicine in the division of gastroenterology, hepatology, and nutrition at the University of Florida College of Medicine, and former president of the AGA, speaks with host Dr. Jay Goldstein about NIH paylines, and the potential for small business innovation research grants, as well as the landscape for career building in academia.

Guest: Stephen O'Keefe, MD Host: Jay Goldstein, MD There is expanding evidence that colonic health is based on diet and the microenvironment of the colon and its contents. Dr. Stephen O'Keefe, professor of medicine in the division of gastroenterology at the University of Pittsburgh School of Medicine, joins host Dr. Jay Goldstein to discuss the microbiota of the colonic tract. How do these bacteria, many of which are linked to patients' diet and lifestyle, generate byproducts that lead to the health or disease processes of the colon?

Guest: Christopher Thompson, MD Host: Jay Goldstein, MD Advances in minimally invasive devices are fostering new endoscopic strategies in gastroenterology, including Natural Orifice Translumenal Endoscopic Surgery (NOTES). Dr. Christopher Thompson, assistant professor of medicine at Harvard Medical School and director of developmental endoscopy at Brigham and Women's Hospital in Boston, details the near-term impact of NOTES for liver biopsy, as well as long-range goals in bariatrics. Dr. Jay Goldstein hosts.

Guest: Peter Kaufman, MD Host: Jay Goldstein, MD Our healthcare system is methodically assimilating the age of electronic information, despite several barriers to widespread adoption for physicians. One key aspect of this trend centers on e-prescribing. In terms of safety, ease of use, and savings of time and cost, is e-prescribing a viable option? Host Dr. Jay Goldstein examines the issue and its effect on the GI practice with Dr. Peter Kaufman, a partner in the Metropolitan GI Group based in greater Washington, DC, and chief medical officer of DrFirst, a company specializing in electronic prescribing.

Guest: John Kuemmerle, MD Host: Jay Goldstein, MD Recertification for internal medicine (and subspecialties, including gastroenterology) continues to evolve, with new requirements for certification designed to improve practice quality and management. Dr. John Kuemmerle, professor of medicine and physiology, and associate chair of GI research at the Medical College of Virginia, details these requirements with host Dr. Jay Goldstein. How are these requisites impacting clinical practice?

Guest: James Leavitt, MD Host: Jay Goldstein, MD In these suffocating times of decreased reimbursement and intensified regulation, will electronic medical records (EMR) provide an opportunity to increase your service output and improve functionality? Dr. James Leavitt, assistant clinical professor of gastroenterology at the University of Miami Miller School of Medicine, weighs the immediate impact of EMRs on your practice and offers tips for approaching the choice of EMR adoption with host Dr. Jay Goldstein.

Guest: Kim Barrett, PhD Host: Jay Goldstein, MD Successfully navigating the tenure process in academic gastroenterology requires strategy, fortitude, and a firm understanding of its implications. What are the unwritten rules of the academic ladder? What can you do to make sure that you receive the promotion for which you strive? Host Dr. Jay Goldstein aims to remove the mystery behind tenure with Kim Barrett, PhD, professor of medicine and dean of graduate studies at the University of California, San Diego School of Medicine.

Guest: Helen Shields, MD Host: Jay Goldstein, MD Dr. Helen Shields, associate professor of medicine at Harvard Medical School, reviews key preparatory factors for a successful screening colonoscopy with host Dr. Jay Goldstein. Have we resolved recent controversies surrounding sodium phosphate preps? Beyond sodium phosphate, what alternatives can we rely on to cleanse the colon prior to colonoscopy? Dr. Shields addresses split-dosing considerations and provides dietary advice for your patients.

Guest: Helen Shields, MD Host: Jay Goldstein, MD Though sodium phosphate preparations for colonoscopy have been around for many years, we've recently encountered an influx of kidney problems related to this procedure. Which patient populations face the greatest risk of nephrotoxicity? How severe are these maladies, and what are possible alternatives for our patients? Host Dr. Jay Goldstein discusses the quality of current colonoscopy preps with Dr. Helen Shields, associate professor of medicine at Harvard Medical School.

Guest: Naga Chalasani, MD Host: Jay Goldstein, MD Nonalcoholic fatty liver disease and steatohepatitis are well-recognized clinical concerns. What are we learning from the latest research? What is the diagnostic value of liver biopsy? Dr. Naga Chalasani, professor of medicine in the division of gastroenterology and hepatology at Indiana University School of Medicine, also examines the manifestation and risk profile of each disease with host Dr. Jay Goldstein. How do statins factor into current treatment patterns?

Guest: Don Rockey, MD Host: Jay Goldstein, MD CT colonography has been touted as a less invasive and lower-risk alternative to traditional screening colonoscopy. When considering accuracy and test functionality, do the realities match the acclaim? Host Dr. Jay Goldstein speaks with Dr. Don Rockey, professor of internal medicine and chief of digestive and liver diseases at the University of Texas Southwestern Medical School, about the practicalities of CT colonography and its potential role in colorectal cancer screening.

Guest: Joel Brill, MD Host: Jay Goldstein, MD The emphasis on transparency in healthcare is beginning to impact the practice of gastroenterology. Host Dr. Jay Goldstein analyzes upcoming quality measures and accountability standards for GI medicine with Dr. Joel Brill, a prominent GI practice management expert and chair of the AGA Institute’s Clinical Practice and Economics Committee. Dr. Brill also elucidates trends in a new gastroenterology battleground: sedation administration.

Guest: Joel Brill, MD Host: Jay Goldstein, MD Some have judged recent times to be the ‘Golden Age of Gastroenterology.’ But will this so dubbed remarkable era in GI practice soon lose some of its luster? Host Dr. Jay Goldstein explores the evolving GI discipline—new screening and imaging techniques, the future of ambulatory endoscopy centers, and more—with Dr. Joel Brill, a prominent GI practice management expert and chair of the AGA Institute’s Clinical Practice and Economics Committee.

Guest: Imtiaz Alam, MD Host: David T. Rubin, MD We are developing increasingly effective therapies for patients with chronic hepatitis C, yet many physicians who treat a high volume of these patients are struggling to maintain economically viable strategies for providing care. Is treatment of hepatitis C becoming a money-losing proposition? Can a few simple adjustments revitalize your clinic's financial outlook? Dr. Imtiaz Alam, founding medical director of the Austin Hepatitis Center in Austin, Tex., joins host Dr. David Rubin.

Guest: Imtiaz Alam, MD Host: David T. Rubin, MD The number of new cases of hepatitis C has declined significantly since its peak in the late 1980s. But now, two decades later, we’re seeing the manifestation of long-term complications from this chronic disease. Dr. Imtiaz Alam, founding medical director of the Austin Hepatitis Center in Austin, Tex., examines the clinical obstacles that often occur when treating a large volume of patients with complex cases of hepatitis C. Looking to the future, how can screening and other prevention mechanisms aid in fighting the pervasive impact of this disease? Find out more with host Dr. David Rubin.

Guest: Carla Ginsburg, MD, MPH Host: David T. Rubin, MD Annually, Medicare payments to physicians are modified using the sustainable growth rate formula, or “SGR”. Recently, the formula mandated cuts to physicians in recent years; and only through quick congressional fixes were these cuts avoided. With payments expected to drop more than 40 percent in the next eight years, can the SGR truly be part of an effective solution to our healthcare crisis? What is the formula, and what impact will it continually have on patient care? Gastroenterologist, and Assistant Clinical Professor of Medicine at Harvard Medical School speaks with your host, Dr. David Rubin.