Clinician's Roundtable

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 these concerns outweighed by the perceived benefits? Dr. Jim Hu, assistant professor of surgery at Harvard Medical School, and director of minimally invasive urologic oncology at Brigham and Women's Hospital and the Dana Farber Cancer Institute in Boston, explains why some surgeons may stick with the open procedure, even as others move ahead with the laparoscopic approach. Dr. Mark Nolan Hill hosts.

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 Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, peers into a theoretical future without general surgeons. What does he see? Dr. Mark Nolan Hill hosts.

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 Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, details his research, published in the Archives of Surgery, that has served to highlight much of the unease surrounding this issue. It used to be that many surgeons with subspecialty certifications also trained in general surgery, but now, their time in general surgery has decreased significantly: how is this trend affecting the matters at hand?

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 Christian Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, details his research, published in the Archives of Surgery, on a nationwide shortfall of general surgeons. Dr. Mark Nolan Hill hosts.

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 Lynge, associate professor of surgery at the University of Washington School of Medicine, and practicing general surgeon, to discuss the evolution of general surgery in the context of Dr. Lynge's research in the Archives of Surgery on the national shortage of general surgeons.

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 unique healthcare challenges of caring for adult film workers, and how the AIM Foundation is able to cater to the specific needs of these patients.

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 Reserve Chairman Ben Bernanke and the prestigious Institute of Medicine.

Host: Larry Kaskel, MD Guest: Xavier Sevilla, MD, FAAP Dr. Xavier Sevilla, practicing pediatrician and the Academy of Pediatrics representative to NCQA's Advisory Panel on the patient-centered medical home, walks us through the experience of building a medical home from the ground-up. From staffing to record-keeping, he considers the components that have helped him to develop a pediatric practice with the elements of a medical home. How can you use his experience to shape your practice? Hosted by Dr. Larry Kaskel.