Clinician's Roundtable

Host: Bill Rutenberg, MD Guest: Charles Samenow, MD, MPH How do you define disruptive physician? They are not always the loud, intimidating, abusive physician but also the one unwilling to return phone calls timely or properly chart a case. Dr. Charles Samenow, psychiatrist in the Department of Psychiatry and Behavioral Sciences at George Washington University Medical Faculty Associates joins host Dr. Bill Rutenberg to discuss a recent paper he co-authored, Disruptive Physician - A CME Course Aimed At Addressing Disruptive Physician Behavior. Better communication programs and more teaching of self-awareness can help to decrease inappropriate behavior. We must also become a healthcare community that does not tolerate this type of behavior.

Host: Maurice Pickard, MD Guest: Stewart Justman, PhD Professor Stewart Justman discusses his new book "Do No Harm" in which the results of finasteride trial that ended in 2003 are looked at again. By reducing the size of the gland, what previously had appeared to be causing increased aggressive cancers may now be called into question. We will have to decide whether a healthy man should take a treatment to prevent a disease he may never get and if he did might be better off in not going through treatment.

Host: Maurice Pickard, MD Guest: Stewart Justman, PhD Professor Stewart Justman discusses his new book "Do No Harm" in which the results of the Prostate Cancer Prevention Trial cause us to reflect on Hippocratic ethical principals of 300BCE in our present practice. Finasteride leaves us with an ambiguity of reducing the incidence of cancer but also associated with a higher rate of aggressive neoplasm. In chemoprevention is any risk too much to be expectable? Hosted by Maurie Pickard.

Host: Maurice Pickard, MD Dr. William Galanter, assistant professor of pharmacy at University of Illinois College of Medicine, speaks to doctors about the real cost of drug industry lunches and samples. It is time that the government looks at comparative drug efficacy. Also physicians should not have to be confronted by pharmaceutical representatives who know their prescription data. Join Host Maurie Pickard.

Host: Maurice Pickard, MD Dr. William Galanter, assistant professor of pharmacy at University of Illinois College of Medicine, discusses the ongoing relationship between physicians and drug representatives and how the 19 billion dollars that pharmaceutical companies spend on this "educational/marketing tool" can be used to provide the best and most cost effective care for our patients. Education institutions must teach young learners how to evaluate the literature that is not biased so that they are not overwhelmed by industrial pressures their first day in practice.

Host: Mark Nolan Hill, MD Guest: Richard B. Lipton, MD For decades, researchers and medical professionals have pursued a more concrete understanding of migraine headaches. We're still not sure of the origin of migraines, but we may have found a device that minimizes their impact. Dr. Richard Lipton, professor and vice chair of neurology at Albert Einstein College of Medicine, and director of the Montefiore Headache Center in New York City, shares details on this device with host Dr. Mark Nolan Hill.

Host: Mark Nolan Hill, MD Guest: Joel Saper, MD The sources of migraine headaches have long been a mystery in medicine. Over the years, many theories have come and gone, with few enduring leads on this debilitating problem that affects many of our patients. Could finding a new therapy for migraines bring us back to the root cause of this condition? Dr. Joel Saper, director of the Michigan Head Pain and Neurological Institute in Ann Arbor, discusses his clinical research on occipital nerve stimulation as treatment for migraine headaches with host Dr. Mark Nolan Hill.

Host: Bruce Japsen Guest: Vonda Wright, MD As baby boomers age, they develop different medical needs. For our super-active older athletes, commonly known as Masters, the needs can be that much different. Dr. Vonda Wright, director of the Performance and Research Initiative for Masters Athletes at the University of Pittsburgh Medical Center, tells host Bruce Japsen how doctors can benefit by understanding the distinctive medical needs of older athletes.

Host: Mark Nolan Hill, MD Guest: Michael Marin, MD Research data indicates an increasingly significant percentage of all elective aortic aneurysm repairs are endovascular procedures. How are new tools for endovascular repair improving our ability to provide minimally invasive options to our patients? How common are subsequent re-interventions following endovascular repair, and what is the key to finding success in this secondary procedure? Dr. Michael Marin, professor and chair of surgery at Mount Sinai School of Medicine in New York City, tells host Dr. Mark Nolan Hill how we are addressing the biggest challenges in endovascular aortic repair.

Host: Mark Nolan Hill, MD Guest: Michael Marin, MD Techniques for open repair of aortic aneurysms have remained remarkably steady over the past several decades. But with the trend toward minimally-invasive procedures sweeping across medicine, how are advancing techniques in endovascular repair of aortic aneurysms enhancing the standard of care? How do the current success rates for emergent and elective endovascular procedures compare with open repair? Dr. Michael Marin, professor and chair of surgery at Mount Sinai School of Medicine in New York City, examines these questions and more with Dr. Mark Nolan Hill.