Clinician's Roundtable

Host: Jennifer Shu, MD, FAAP Guest: Basil Clyman, MD Over the years, many studies have examined the ‘difficult' patient encounter. Consistently, these studies indicate that physicians deem nearly 1 in 6 outpatient appointments to be an arduous visit. These challenging episodes are often time-consuming and may also lead to adverse outcomes. Though it is unfair to look at all difficult visits in the same light, there are trends to suggest certain patients and certain physicians are more likely to be involved. What are these trends, and how might this knowledge allow us to better navigate these situations? Dr. Basil Clyman, clinical professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles, and staff physician at the VA Healthcare Center in West Los Angeles, visits with host Dr. Jennifer Shu to share his insights on turning a difficult encounter into a positive doctor-patient experience.

Host: Lee Freedman, MD Guest: Michael Hildebrand, PhD Researchers have discovered a CATSPER gene mutation that may lead to development of a male infertility treatment, as well as a male contraceptive. Are we really another step closer to developing a male contraceptive, and when might an oral contraceptive be available for men? Join host Dr. Lee Freedman as he talks with Dr. Michael Hildebrand, fellow in the department of otolaryngology at the Carver College of Medicine, University of Iowa, about this exciting new genetic discovery, and how it might lead to the development of a male contraceptive.

Host: Michael Greenberg, MD Guest: Donna Jarmusz, MA The healthcare village is a new setting for outpatient care that's similar to an upscale shopping mall. These villages may include cardiologists, primary care physicians, and ambulatory surgery centers, alongside pharmacies, restaurants, spas and health clubs. What are the advantages to this type of business model? Is the healthcare village model primarily a repackaging of existing services, or an entirely new way of delivering care? Dr. Donna Jarmusz, senior vice president for the Chicago-based company Alter+care, a real estate development firm promoting this model, discusses aspects of the healthcare village with host Dr. Michael Greenberg.

Host: Shira Johnson, MD Guest: Brendan Carr, MD Time is critical in a medical crisis, but according to new research, the nearest facility may not always be the best place for the patient. Dr. Brendan Carr, lead author of the study and assistant professor of emergency medicine and epidemiology at the University of Pennsylvania, discusses his research with host Dr. Shira Johnson. They also look at future technology that could tell doctors and paramedics the best place to take a patient using GPS and the same system used for trauma victims.

Host: Shira Johnson, MD Guest: Shan Liu, MD Patients that come into an emergency room sometimes have to wait hours even days before they are moved to a hospital floor. A new study says more than a quarter of patients who are "boarded" in the ER after being admitted to the hospital often suffer undesirable events like missing necessary treatments or medications. Dr. Shan Liu, an attending physician at Massachusetts General Hospital in Boston and an instructor at Harvard Medical School, joins Dr. Shira Johnson to discuss her study on this growing worldwide issue.

Host: Bruce Japsen Guest: David Himmelstein, MD The single payer form of health insurance for all Americans: could this be the year that the long-debated model for medical care coverage becomes a reality? Dr. David Himmelstein, associate professor of medicine at Harvard Medical School and a long-time advocate of single payer coverage, tells the Chicago Tribune's Bruce Japsen about the best chance in years for this model in the healthcare reform debate.

Host: Bruce Japsen Guest: William Hersh, MD The stimulus package approved by Congress and signed into law by President Barack Obama promises unprecedented money for health IT and electronic medical records. But if the money is enough, are there enough health informatics specialists to pull it off? Dr. Bill Hersh, chair of the Department of Medical Informatics & Clinical Epidemiology in the School of Medicine at Oregon Health & Sciences University in Portland, tells host Bruce Japsen about the healthcare system's needs from the world of health informatics.

Host: Larry Kaskel, MD Guest: Kelly Brownell, PhD It has been billed as the biggest boon to public health since tobacco taxes. And a one-cent per ounce tax on sodas could bring in as much as $400 million of annual revenue for the state of New York alone. How would a tax on sugared beverages impact our health and health care budget? Would the general public throw enough support behind this policy shift for politicians to think about putting it on the books? Host Dr. Larry Kaskel wades into the debate over soda taxes with Dr. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, where he is also a professor of epidemiology, public health and psychology. Dr. Brownell, who recently co-authored a New England Journal of Medicine article with then-New York City Health Commissioner Dr. Thomas Frieden in support of a soda tax, shares the scientific evidence that supports his position. He also considers other viewpoints in this debate: if a soda tax won't work, could we find a better way to discourage our insatiable taste for these sugary drinks?

Host: Maurice Pickard, MD Guest: Robert Brzyski, MD, PhD When a mother was granted legal permission to collect her 21 year old deceased son's sperm in April 2009, questions were raised about posthumous reproductive rights. Although the mother declared that her son always wanted to have children, does this meet the criteria of informed consent, or is it an example of substituted judgment? Can this situation be compared to a spouse or girlfriend having an in depth discussion about having a posthumous child? How should we consider the welfare of the child in such a situation? Host Dr. Maurice Pickard discusses these ethical questions with guest Dr. Robert Brzyski, associate professor of obstetrics and gynecology at the University of Texas Health Science Center at San Antonio and chair of the ethics committee of the American Society for Reproductive Medicine.

Host: Mark Nolan Hill, MD Guest: Anthony Miniaci, MD Early arthritis of the knee is a frustrating and painful condition, especially for our more active patients. Some will begrudgingly accept the end of their adult sports league careers, others will be less inclined to hang up their sneakers. In this case, depending on the severity of the condition, there could be several procedural options, including a new arthroscopic resurfacing technique for those with less severe arthritis: could this be the quickest route back to the playing field? Dr. Anthony Miniaci, executive director of Cleveland Clinic Sports Health and one of the developers of this new procedure, explains why this procedure could be the answer for patients who have failed all biologic procedures, but are not yet ready for a total knee replacement. Which of your patients might be a candidate? Dr. Mark Nolan Hill hosts.