Clinician's Roundtable

Host: Lee Freedman, MD Guest: Sanford Baim, MD Dr. Baim discusses how to apply the FRAX model in clinical practice. How does the FRAX score combine with local assessments of cost-effectiveness and clinical judgment in order to give guidance on how and when to treat patients with bone loss? Why might a 45 year old with a T-score of -2.5 not need treatment but a 70 year old with a T-score of -1.4 be...

Host: Lee Freedman, MD Guest: Sanford Baim, MD Dr. Sanford Baim discusses the assessment of patients for bone loss. He emphasizes why relying on bone density data is inadequate to truly treat our patients properly, and provides details on a new approach to assessing the absolute risk of fracture, called the FRAX model. Dr. Lee Freedman hosts.

Host: Susan Dolan, RN, JD Guest: Barbara Lee, PA, FNP, JD Barbara Coombs Lee is a nurse, a physician's assistant, an attorney, and the president of Compassion and Choices, an organization dedicated to expanding and protecting the rights of the terminally ill. Ms. Lee discusses the biggest misconceptions doctors have about end-of-life care. Susan Dolan hosts.

Host: Larry Kaskel, MD Guest: Bill Cleveland, MBA, CPA, Personal financial decisions are often less clear for us than making tough medical calls. How much disability insurance should we carry, if any at all? Should we pay insurance premiums with pre-tax dollars? If we have income outside of our primary working situation, can we--and should we--contribute to a 401k? Host Dr. Larry Kaskel quizzes Bi...

Host: Larry Kaskel, MD Guest: Bill Cleveland, MBA, CPA, Where and how should you invest in a down market? What strategies have been used by some of the wealthiest investors over time? Join host Dr. Larry Kaskel as he explores personal finance with Bill Cleveland, a certified financial planner with Preston & Cleveland Wealth Management. What are some of the best strategies for doctors? How do y...

Host: Bruce Japsen Guest: Joseph Heyman, MD Drug industry marketing, a long controversial aspect of a physicians' practice and life, may perhaps be experiencing its tightest guidelines yet. Dr. Joseph Heyman, chair of the American Medical Association board of trustees, tells host Bruce Japsen about his thoughts on the new voluntary pharmaceutical industry guidelines on marketing and gift-giving to...

Host: Bruce Japsen Guest: Toni Mills By adopting even one change to a health care business practice, some experts believe lives can be saved. How about 5 million of them? Toni Mills, executive director of the Office of Clinical Affairs for the Blue Cross and Blue Shield Association, tells host Bruce Japsen about the group's effort to get pledges from hospitals to follow several safety guidelines t...

Host: Stuart Gitlow, MD, MPH, MBA Guest: Kevin Kunz, MD, MPH Addiction Medicine may be on track to become a board certified specialty in the future, differentiating itself from the current ABMS-approved subspecialty of Addiction Psychiatry. How has the advancing field reached this stage, and what does it mean for us and our patients? Additionally, what will an Addiction Specialist be able to do th...

Host: Larry Kaskel, MD Guest: Marc Halley, MBA Using philosophies borrowed from the property management field, Marc Halley, president of Halley Consulting Group, shares with host Dr. Larry Kaskel the key to efficient utilization of the support staff within a medical practice. Mr. Halley highlights the importance of delegation within a well managed practice, which means that the physician should de...

Host: Larry Kaskel, MD Guest: Marc Halley, MBA As hospitals get back into the game of owning and running medical practices what must they do to succeed? Our guest Marc Halley, president of Halley Consulting Group, a firm specializing in services to hospital-owned primary care networks shares with host Dr. Larry Kaskel his 8 initiatives for success including improving worker productivity and maximi...

Host: Mark Nolan Hill, MD Guest: Randi Hagerman, MD Diagnosis of the genetic disorder Fragile X syndrome can be devastating for our young patients and their families, knowing that both the patient and their elders can be affected by this condition. Should we expand current screening measures for Fragile X? As clinicians, how do we guide patients and their families through this process of understan...

Host: Mark Nolan Hill, MD Guest: Randi Hagerman, MD We are rapidly learning more about the genetic disorder Fragile X syndrome, and a series of conditions related to Fragile X. We're also seeing great progress in promising therapies under investigation. How will these therapies, along with other treatment strategies, improve the lives of children and families affected by Fragile X and related cond...

Host: Mark Nolan Hill, MD Guest: Randi Hagerman, MD It's responsible for more than five percent of all cases of autism, and it's the most common cause of inherited mental retardation. But are we as familiar as we need to be with Fragile X syndrome, and a series of genetic conditions related to Fragile X? Host Dr. Mark Nolan Hill welcomes Dr. Randi Hagerman, professor and endowed chair of Fragile X...

Host: Mark Nolan Hill, MD Guest: Jamie Hutchison, MD A young patient is brought into the emergency department having suffered a traumatic brain injury. Hypothermia may be considered as part of the treatment regimen. If so, how soon after the injury should treatment begin, and how long should treatment last? Dr. Jamie Hutchison, associate professor of critical care medicine and pediatrics at the Un...

Host: Mark Nolan Hill, MD Guest: Jamie Hutchison, MD Traumatic brain injuries can present a lifetime of consequences. Previous studies indicate that hypothermia may be a viable treatment option, but little data has demonstrated efficacy for our youngest patients. Is hypothermia effective in treating pediatric brain trauma patients in a more rigorous research setting? What are the key mechanisms be...

Host: Mark Nolan Hill, MD Guest: Jim Hu, MD, MPH We are still working to minimize the major risks of complications involved in minimally invasive prostatectomy. This becomes even more important as more patients undergo these procedures. How has the training and certification process impacted our success? What improvements can we expect in this minimally invasive technique to treat prostate cancer...

Host: Mark Nolan Hill, MD Guest: Jim Hu, MD, MPH Research indicates that demand for minimally invasive prostatectomy is growing, from 12 percent to more than 30 percent of our candidate patients over a recent two-year span. But research also tells us that there are still drawbacks to a laparoscopic approach to prostate cancer. What are the immediate and enduring pitfalls to laparoscopy, and are th...

Host: Mark Nolan Hill, MD Guest: Dana Christian Lynge, MD Dropping reimbursement for general surgical procedures and increased everyday expenses are two issues, in addition to many others, that make the future viability of a general surgery practice a more difficult proposition. What if this disturbing trend continues? Could medicine withstand the loss of general surgery altogether? Dr. Dana Chris...

Host: Mark Nolan Hill, MD Guest: Dana Christian Lynge, MD Training, recruiting and retaining general surgeons are key workforce issues for many hospitals across the United States. In a broad sense, these concerns impact the entire field of surgery, from students interested in surgery, to the most established surgeons in practice. What can our profession do to reconcile these issues? Dr. Dana Chris...

Host: Mark Nolan Hill, MD Guest: Dana Christian Lynge, MD A nationwide survey reveals that the number of general surgeons has dropped 25 percent in the past 25 years. A continuation of this decline could have profound implications on patient populations that depend on general surgeons. What are the key demographic concerns surrounding a potential national shortage of general surgeons? Dr. Dana Chr...

Host: Mark Nolan Hill, MD Guest: Dana Christian Lynge, MD Thirty to forty years ago, the field of general surgery was truly flourishing. General surgeons treated patients for an array of surgical conditions, as the concept of present day sub-specialties had yet to take hold. What has led to this significant shift in the focus of general surgery? Host Dr. Mark Nolan Hill welcomes Dr. Dana Christian...

Host: Michael Greenberg, MD Guest: Sharon Mitchell, PhD Dr. Sharon Mitchell joins host Dr. Michael Greenberg to detail her role in addressing healthcare for the adult film industry. Known to many as 'Dr. Mitch,' she describes her own transformation from adult film star to sexual health expert and founder of the Adult Industry Medical (AIM) Healthcare Foundation. She'll also give us an idea of the...

Host: Bruce Japsen Guest: Gail Rosseau, MD More than half of all students accepted into medical schools are women, but only a fraction of neurosurgeons are female. Dr. Gail Rosseau, of the American Association of Neurological Surgeons, tells host Bruce Japsen about a new paper that highlights these challenges and provides recommendations on how to improve the profession and care for patients.

Host: Bruce Japsen Guest: Winifred Hayes, PhD The health technology assessment, something gaining momentum in hospitals as a way to improve patient care, can be a challenge to implement. Dr. Winifred Hayes, founder and chief executive officer of Hayes Inc. tells host Bruce Japsen how this can be done and what the doctor's role should be in this process.

Host: Bruce Japsen Guest: Winifred Hayes, PhD Evidence-based technology assessment may be an unfamiliar term to most of us, but it is gaining momentum in the health-care industry. Dr. Winifred Hayes, chief executive of Hayes Inc., tells the Chicago Tribune's Bruce Japsen why it may be a solution to controlling health care costs, and how it has gained the support of such varied sources as Federal R...