Clinician's Roundtable

Host: Bruce Japsen Guest: Les Paul, MD Evidence-based medicine has been gaining momentum among the medical community, but there are things happening in our nation's capital that could impact this coming trend. Dr. Les Paul, vice president of clinical and scientific affairs for the National Pharmaceutical Council, tells host Bruce Japsen about the economic stimulus, bills in Congress and other initiatives that could move evidenced-based medicine further into the physician's office. But he also warns of potential pitfalls from the pharmaceutical industry's perspective.

Host: Bruce Japsen Guest: Les Paul, MD Comparative effectiveness is gaining momentum as a way to decide what drugs and devices should be used by doctors. But why was it part of the economic stimulus approved by Congress and pushed by President Obama? Dr. Les Paul, vice president of clinical and scientific affairs at the National Pharmaceutical Council, tells the Chicago Tribune's Bruce Japsen about how policymakers are looking at comparative effectiveness and how medical care providers and the healthcare industry should be involved.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Janet Lathrop Every six years, physician assistants are required to take a re-certification exam on primary care medicine. Many PAs question if this test is still relevant, given that more than 70 percent of physician assistants work in more than 60 different specialites. Host Lisa D'Andrea Lenell is joined by Janet Lathrop, president and CEO of the National Commission on Certification for Physician Assistants, to talk about the pros and cons of PA specialty certification and how the PA's role is evolving into specialized areas of expertise.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Janet Lathrop Certification for the physician assistant field has come a long way since 1965, when four ex-navy corpsmen were enrolled in the first physician assistant program. Now more than 40 years later, PAs are the most tested profession in medicine. Janet Lathrop, president and CEO of the National Commission on Certification of Physicians Assistants, talks with host Lisa D'Andrea Lenell about how the certification process has changed and where it's headed.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Michelle Heinan Primary care is as short of physician assistants as it is doctors. More than half of all graduating PAs go into specialty medicine. But the goal of the newest physician assistant training program at Lincoln Memorial University in Harrogate, Tennessee, is to keep PAs in primary care. They also hope graduates will stay in rural Cumberland Gap, where the University is located, identified by the federal government as medically under-served. Dr. Michelle Heinan, director of Lincoln Memorial University's PA program, joins host Lisa D'Andrea Lenell to discusses the need for PAs in primary care and the need for them to stay in rural medicine. In the second half of this interview, Dr. Heinan talks about the challenges the University took on in establishing a PA training program, and what distinguishes this program from others around the country.

Host: Larry Kaskel, MD Guest: Robert Lamberts, MD We've heard a lot about the economic stimulus funding for electronic medical records (EMR), but the central question for you is whether your practice or institution is ready to take on the effort to install it, maintain it and flourish with it. Stimulus money aside, it's a major investment of time, energy and other resources. When considering the purchase of an EMR, how can your practice ensure that you are buying the right product for the right reasons? Dr. Robert Lamberts, board-certified internist and pediatrician and an experienced lecturer on the subject of electronic medical records, shares a few tips to help you make sure it doesn't become an unnecessary hassle for your practice. Dr. Larry Kaskel hosts.

Host: Shira Johnson, MD Guest: Alex Rosenau, MD Doctors and nurses in the emergency department work under constant stress. So, what happens when a case is so stressful and horrific that it affects medical personnel emotionally? Dr. Alex Rosenau, vice chair of the department of emergency medicine at Lehigh Valley Hospital and Health Network in Lehigh, Pennsylvania, joins host Dr. Shira Johnson to discuss techniques and counseling services to help ED staff deal with unusually brutal cases.

Host: Bruce Japsen Guest: David Troxel, Dr. The use of online communication and consultation between doctors and patients is becoming so common in everyday physician practice that there is now buzz about "eRisk Guidelines." Dr. David Troxel, medical director of The Doctors Company, tells the Chicago Tribune's Bruce Japsen about the dangers of using e-mail and other electronic communications with patients.

Host: Bruce Japsen Guest: David Troxel, Dr. Telemedicine continues to increase in popularity, but doctors need to understand the risks when communicating by e-mail or phone. Dr. David Troxel, medical director of the Doctors Company, tells the Chicago Tribune's Bruce Japsen about potential risks and liability physicians can open themselves up to if they are not careful about how they use telemedicine and related consultations with their patients over the phone.

Host: Larry Kaskel, MD Guest: Nicholas Galantino, JD Many of our practices could be more efficient at checking in patients, or perhaps more precise in our record keeping. Insurance claims denials and the process of fighting them can be one source of time-consuming, money-draining aggravation for any practice. But we may be seeing a trend toward technologies that could ease these clerical and financial burdens. To learn a little more about the digital developments that are helping us validate patients' insurance eligibility in advance of their medical visit, host Dr. Larry Kaskel welcomes Nick Galantino, chief executive officer of the LoCicero Medical Group, a nine-provider internal medicine practice in Tampa, Florida, which uses one of the devices currently on the market.