Clinician's Roundtable

Guest: Carolyn Zaumeyer, NP, RN Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Carolyn Zaumeyer, a nurse practitioner, discusses with host Lisa D'Andrea the key factors to evaluate and analyze when starting an independent practice. Ms. Zaumeyer also provides guidance on establishing competitive charges for services, a relationship with a supervising physician, defining one's scope of practice, and the applicable state laws that define the limitations of a nurse practitioner's independent practice.

Guest: Donald Patrick, MD, JD Host: Larry Kaskel, MD Medical license applications have jumped 58% since Texas approved tort reform legislation that limited non-economic damages in medical liability cases to $250,000 among other provisions. Dr. Donald Patrick, JD, the former executive director of the Texas Medical Board discusses with host Dr. Larry Kaskel the key elements of the legislation and the role of the state's medical board in fixing the medical crisis that affected Texas.

Guest: Jay Fotland, NP, RN Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA With a focus on wellness rather than illness, Jay Fotland opened a healthcare clinic that offers flat fee health memberships to patients. Host Dr. Lisa D'Andrea discusses with guest Jay Fotland, a nurse practitioner, the low-cost business model that Mr. Fotland developed as a means to reduce the red tape associated with the health care system. Mr. Fotland also discusses his business philosophy and, located in the backyard of the well-established Mayo clinic, is able to compete.

Guest: Sue Kling-Colson, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Hyperglycemia in critically ill patients increases the risk factor for inpatient morbidity and mortality. Host Lisa D'Andrea explores with guest Sue Kling-Colson, a physician assistant at the University of Michigan Health System, the intensive insulin protocols established for managing hyperglycemic inpatients. Ms. Colson outlines the protocols and explains the responsibilities of the physician assistant under the Hospital Intensive Insulin Program.

Guest: Deirdre Conroy, PhD Host: Leslie P. Lundt, MD From alcohol to nicotine to prescription opioids, most substances of abuse can create sleep disturbances that continue even into abstinence. Untreated sleep disturbance can be a significant relapse trigger. Yet, most FDA-approved hypnotics are controlled substances. How can you break the cycle of insomnia in patients with addictive disease? Dr. Deirdre Conroy, clinical assistant professor of psychiatry at the University of Michigan, joins host Dr. Leslie Lundt to review the treatment options for this population.

Guest: Deirdre Conroy, PhD Host: Leslie P. Lundt, MD Substance abuse and subsequent withdrawal can lead to sleep disturbances. How do you evaluate the substance abuser with sleep difficulties? Dr. Deirdre Conroy, clinical assistant professor of psychiatry at the University of Michigan, joins host Dr. Leslie Lundt to discuss the complex interaction between sleep and substance abuse.

Guest: Gerald Bernstein, MD Host: Bruce Japsen Diabetes has become such a worldwide epidemic that some are turning to over-the-counter products as a way to help patients with this disease that has afflicted nearly 24 million in the U.S. alone. Dr. Gerald Bernstein, the vice president of medical affairs at Generex, a biotech company based in Toronto, tells host Bruce Japsen about nutritional products and over-the-counter options for patients with diabetes.

Guest: Allison Aiello, PhD, MS Host: Lee Freedman, MD Dr. Allison Aiello discusses the possiblity that the use of common household products such as soaps and surface cleaners are be promoting bacterial resistance. Should we be telling our patients to avoid the use of certain products so that they not subject themselves to infection with resistant organisms? What products might pose a risk? What is the mechanism of this resistance? Is it clinically relevant?

Guest: Jay Berkelhamer, MD Host: Jennifer Shu, MD, FAAP The medical community provides a vital public health service when we vaccinate our patients. However, this practice is often a money-losing proposition for us, as evidenced by the many primary care physicians who are discontinuing immunizations in their practice. What can physicians, vaccine manufacturers and insurers do to improve the current vaccine financing and delivery system? Dr. Jay Berkelhamer, senior vice president and chief academic officer at Children’s Healthcare of Atlanta, and past president of the American Academy of Pediatrics, joins host Dr. Jennifer Shu to explores a series of ways through which organizations and workers throughout the healthcare community can do their part to improve our system for financing vaccines.

Guest: Will Parsons, MD, PhD Host: Leslie P. Lundt, MD The complete genetic blueprint for two of the deadliest cancers, pancreatic and brain cancer, was recently deciphered by a team at the Johns Hopkins Kimmel Cancer Center. Understanding the molecular mechanisms of these cancers can help us develop new therapeutic modalities. In this segment, Dr. Will Parsons, one of the trial investigators, joins host Dr. Leslie Lundt to discuss the groundbreaking results of their work.