Clinician's Roundtable

Guest: William Leinweber, MBA Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Chief executive officer of the American Academy of Physician Assistants, Bill Leinweber, discusses the developments and goals of the organization with host Lisa D'Andrea Lenell. Mr. Leinweber highlights the professional responsibilities of physician assistants, the need to ensure physician assistants fill the increasing demand for primary care services, and the issues arising out of specialization within the profession. The conversation outlines the organization's goals in terms of addressing the needs of its membership and supporting the medical community.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Vic Germino, PA-C Guest Vic Germino, a member of the 1961 first graduating class of the physician assistant program established at Duke University, discusses the history of the profession with host Lisa D'Andrea Lenell. Mr. Germino explains how Dr. Eugene Stead, Jr., then chairman of the department of medicine at Duke University, conceived of the program and the obstacles confronting the first physician assistants. Mr. Germino also discusses the development of the practice and the changes he has observed of the physician assistant's role in providing healthcare services.

Guest: Yuri Danilov, PhD Host: Bruce Bloom, DDS, JD Patients with brain damage can learn to see and balance through sensory substitution using the tongue. Join host Dr. Bruce Bloom for a fascinating look into new research with Dr. Yuri Danilov, senior scientist at the Tactile Communication & Neurorehabilitation Laboratory at the University of Wisconsin-Madison. A new understanding of the anatomy and physiology of the central nervous system can help patients with neurological and neuromuscular diseases such as multiple sclerosis and Parkinson's disease regain visual and motor skills.

Host: Susan Dolan, RN, JD Guest: Sue Ann Thomas, PhD, RN Should terminally ill patients have implantable cardioverter defribrillators (ICDs)? Join Dr. Sue Thomas, assistant dean for PhD studies and professor at the University of Maryland School of Nursing, as she discusses the implications of ICDs for terminally ill patients. Dr. Thomas tells host Susan Dolan how the ICDs is deactivated. They also talk about whether an ethics committee should be involved in the decision to deactivate an ICD, and the nurse's role in caring for patients with these implanted devices.

Guest: Sue Ann Thomas, PhD, RN Host: Susan Dolan, RN, JD What is the psychological impact of having an ICD? Dr. Sue Thomas, assistant dean for PhD studies and professor at the University of Maryland School of Nursing, shares her research as principal investigator on the PRHAT trial, in which she investigated long-term changes in anxiety and depression amongst patients post-MI. Dr. Thomas also outlines a holistic model of cardiovascular health. Susan Dolan hosts.

Guest: Trevor Duke, MD Host: Shira Johnson, MD In 2000 the UN developed the Millennium Developmental Goals and the fourth goal is to reduce child mortality by 2015. Dr. Trevor Duke is head of the Centre for International Child Health in Australia and collaborates with the World Health Organization to meet this goal. He is interviewed by Dr. Shira Johnson to discuss the mammoth task of reducing pediatric mortality world wide and the initial steps taken by countries involved in this effort.

Guest: Trevor Duke, MD Host: Shira Johnson, MD A simple medical device such as an oxygen saturation monitor can make all the difference in a developing country. Dr. Trevor Duke, an intensive care specialist at Royal Children's Hospital in Melbourne, Australia, talks about his study which reduced the death rate from pneumonia in New Guinea by measuring oxygen saturation and administrating oxygen through a concentrator. He and host Dr Shira Johnson discuss this study and his work with the World Health Organization.

Guest: William Jessee, MD Host: Larry Kaskel, MD Each year the Medical Group Management Association produces a report on practice operating costs and profitability. Dr. Larry Kaskel discusses the most recent results with Dr. William Jessee, president of Medical Group Management Association. The critical finding is that practice-operating costs are increasing at a higher rate than practice revenue in all areas of medicine. Dr. Jessee reports that the greatest driver of costs is labor due to shortages of healthcare workers and resulting increases in salaries. Notwithstanding, Dr. Jessee notes that practices with more FTE support staff were more profitable than those with fewer FTE support staff, highlighting the importance of proper staffing for the job function. Dr. Jessee discusses the importance of real-time adjudication and the developing trend of more hospital-owned practices.

Guest: Caleb Alexander, MD Out-of -pocket costs account for approximately one fifth of healthcare expenditures. Dr Caleb Alexander,an assistant professor of medicine at the University of Chicago, discusses with host Larry Kaskel, MD, the findings of his recent study that focused on patient-physician communications regarding out-of-pockets costs for outpatient treatment. An unfortunate finding is that doctors rarely communicate with patients about these costs, notwithstanding the fact that patients are quite burdened by these expenses. Tune in to hear Dr. Alexander discuss the key barriers to communications between physicians and patients and the recommendations for overcoming such hurdles. Interestingly, Dr. Alexander's research has found that giving patients free drug samples can often increase a patient's out-of-pockets costs, rather than reduce these expenses.

Host: Jennifer Shu, MD, FAAP Guest: Andrew Muir, MD Type 1 diabetes has long been considered a disease of childhood and adolescence. However, current research suggests that infant nutrition, in addition to genetics and other factors early in life, can significantly impact a child's risk for developing the condition later in life. How can we identify children at risk for Type 1 diabetes, and what can we do to prevent or intervene with the disease process? Dr. Andrew Muir, professor of pediatrics and chief of pediatric endocrinology at Emory University School of Medicine, speaks with host Dr. Jennifer Shu about early predictors of Type 1 diabetes.