Clinician's Roundtable

Host: Larry Kaskel, MD Guest: Robert Portman, JD, MPP Converting a private practice to the concierge medical practice model raises many legal issues. Attorney Rob Portman, a partner with the law firm of Powers, Pyles, Sutter & Verville, explains the legal issues of a concierge medicine practice, including contract terms for participating patients, care obligation to non-participating patients, and rules for billing Medicare for services on concierge patients. In addition, Host Larry Kaskel explores with Mr. Portman the legal arguments that render concierge medicine unlawful, and the pending federal legislation to regulate this business model.

Host: Mary Leuchars, MD Guest: M. Harvey Brenner, PhD No one is exempt from feeling sick of his or her job from time to time. But in whom does employment confer actual serious health consequences? Are socioeconomic status differences the only distinguishing factors in selecting low vs high longevity occupations? Host Dr. Mary Leuchars explores how work impacts health with Dr. Harvey Brenner, professor of public health at the University of North Texas School of Public Health.

Host: Leslie P. Lundt, MD Guest: Rebecca Puhl, MS, PhD Obesity is associated with multiple medical and psychological co-morbidities. An often under recognized problem is that of weight related stigmatization which can lead to unfair treatment, prejudice and discrimination. Are you guilty? Dr. Rebecca Puhl, director of research and anti-stigma initiatives at the Rudd Center for Food Policy and Obesity at Yale University, joins host Dr. Leslie Lundt to explain how weight bias may affect your obese patients.

Host: Leslie P. Lundt, MD Guest: Robert M. Post, MD Mixed bipolar episodes as defined by the DSM-IV are relatively rare. But for those of us in clinical practice, this definition may be too conservative to be of use. What is a mixed bipolar episode and how do we best treat these patients? Host Dr. Leslie Lundt welcomes Dr. Robert Post, professor of psychiatry at George Washington University School of Medicine and Penn State College of Medicine, to discuss the management of mixed episodes.

Host: Leslie P. Lundt, MD Guest: Robert M. Post, MD The efficacy of the gold standard for bipolar treatment as been reported to be as high as 80%. But in the real world, that number is more like 25%. Why the disparity? What can we do for our treatment resistant bipolar patients? Dr. Robert Post professor of psychiatry at George Washington University School of Medicine and Penn State College of Medicine and head of the Bipolar Collaborative Network joins host Dr. Leslie Lundt to give us the latest on how to diagnose and treat these patients.

Host: Leslie P. Lundt, MD Guest: Michael Camilleri, MD In the past, bilateral truncal vagotomy had been used to treat patients with peptic ulcer disease. Astute clinicians noted these patients had loss of appetite following the procedure. How did this eventually led to the development of a new treatment for obesity? Dr. Michael Camilleri, a gastroenterologist and professor of medicine and physiology at the Mayo Clinic College of Medicine, describes to host Dr. Leslie Lundt the latest research using vagal blockade to treat obesity.

Host: Leslie P. Lundt, MD Guest: Gregory Zimet, PhD Vaccines seem to always provoke controversy. Perhaps none so much as the HPV vaccine. Dr. Gregory D. Zimet, professor of pediatrics and clinical psychology at Indiana University School of Medicine, joins host Dr. Leslie Lundt to discuss the obstacles that may interfere with widespread acceptance of the HPV vaccine.

Host: Leslie P. Lundt, MD Guest: Lawrence Schneiderman, MD Our guest today writes in his book, Embracing Our Mortality, that lawyers (as officers of the court) are not permitted to tell their clients to lie but physicians are under no such obligation. Under what situations would it be best for us to advise people to polish their recollections? Medical ethicist Dr. Lawrence Schneiderman joins host Dr. Leslie Lundt to discuss the role of the physician in end of life decisions.

Host: Leslie P. Lundt, MD Guest: Lawrence Schneiderman, MD Is there something wrong with being aggressively optimistic? Dr. Lawrence Schneiderman, professor emeritus in the Department of Family and Preventive Medicine and adjunct professor in the Department of Medicine at the University of California, San Diego, takes a provocative stance on the harm of giving patients unfounded hope. Hosted by Dr. Leslie Lundt.

Host: Leslie P. Lundt, MD Guest: William Swiggart, MS, LPC Disruptive physician behavior is often tolerated until a crisis emerges which then triggers disciplinary action. How else might we handle this delicate situation? William Swiggart, the co-director for the Center for Professional Health at Vanderbilt University Medical Center, joins host Dr. Leslie Lundt to discuss their programs for physicians deemed disruptive by their peers.