Clinician's Roundtable

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Cynthia Lord, MHS, PA-C Despite the current economic recession in the United States, the PA profession is growing at a rapid pace. Currently there are 73,000 PAs nationwide and 5000 new PAs are graduating every year. Cynthia Lord, president of the American Academy of Physician Assistants and the program director of the Physician Assistant Program at Quinnipiac University in Hamden, Connecticut, talks with host Lisa D'Andrea Lenell about why the PA profession remains solid and whether a PA career is immune to troubled financial times. The two also look at the growing pains of a thriving field and how the profession is dealing with current growth.

Host: Shira Johnson, MD Guest: Gloria Kuhn, MD When should ER doctors become concerned about burnout? Many physicians show signs of career fatigue but continue to practice year after year. Dr. Gloria Kuhn, vice chair for academic affairs for the department of emergency medicine at Wayne State University, discusses her latest research with host Dr. Shira Johnson. Dr. Kuhn surveyed ER doctors to see what causes physicians to become unhappy in their jobs and the warning signs ER doctors and other physicians should look for to combat burnout.

Host: Bruce Japsen Guest: John Kreger News of mega-mergers involving the likes of Pfizer and Wyeth or Merck and Schering Plough have turned the pharmaceutical industry on its ear. But what does this mean for you and your patients? John Kreger, a principal with the health care investment bank William Blair & Company, tells the Chicago Tribune's Bruce Japsen about how consolidation among drug companies could impact doctors and their patients.

Host: Larry Kaskel, MD Guest: Leslie Ramirez, MD With tens of millions of people in the United States living without health insurance, lower prices for medicine and tests can mean the difference between seeking care and going without it. Even for those with insurance, lower prices can significantly ease out-of-pocket costs. How can we help patients find these lower prices, and might we also use price comparisons in our own practice? One physician has taken these issues into her own hands, creating a website that offers comparative pricing for tests and medications in the Chicagoland area. Host Dr. Larry Kaskel learns more about this website, leslieslist.org, from its founder, Dr. Leslie Ramirez, who also works full-time as a general internist. How has her work on the website changed her prescribing habits, and could they change yours too? Dr. Ramirez also shares a few tips for you to help your patients with bargaining on prices, and other ways to drive down costs.

Host: Larry Kaskel, MD Guest: Elizabeth Pector, MD Though healthcare is seemingly one of the more stable sectors of our turbulent economy, many practitioners are still struggling to subdue rising costs. For patients who may be unable to pay up front, can you employ effective payment plans that won't sidetrack your financial outlook? What else can we do to maintain our practice while dealing with the burdens of these tough times? Host Dr. Larry Kaskel welcomes Dr. Elizabeth Pector, a family physician practicing in Naperville, Illinois, just west of Chicago, and a member of the editorial board for Medical Economics magazine. Dr. Pector also delves into an assortment of other issues in medicine today: reimbursement increases, chronic illness management and wellness services merged into one office visit, and maintaining an office staff that can effectively balance good business acumen with respectful patient relations.

Host: Shira Johnson, MD Guest: Angela Gardner, MD Emergency medical care makes up only three percent of the 1.5 trillion dollars the nation spends on healthcare. There are currently two bills before Congress that propose an increase in dollars spent on emergeny medical services. Host Dr. Shira Johnson is joined by Dr. Angela Gardner, president-elect of the American College of Emergency Physicians, to discuss how this legislation will improve the care in the nation's crowded emergency rooms, what part of the population will be impacted most by this legislation, and how the Obama plan will affect practicing physicians.

Host: Shira Johnson, MD Guest: Angela Gardner, MD The practice of emergency room diversion began back in the late 1980s to help prevent overcrowding in busy hospitals. But does it still work? Hospitals across the country are so crowded today that ambulances are turned away regularly. Dr. Angela Gardner, president-elect of the American College of Emergency Physicians and assistant professor of emergency medicine at the University of Texas at Galveston, explores the issue of overcrowding and the policies designed to combat the problem, with host Dr. Shira Johnson.

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Guest: Allan Platt, PA-C, MMSc Busy PAs don't have time to stop and look up answers in a reference book or even online from a PC. Answers to new medical treatments, diagnostic tests, medical journals, rapid references are now available on PDA platforms. Allan Platt, clinical instructor at Emory University in Atlanta and author of Evidence Based Medicine for PDAs: A Guide for Practice, joins host Lisa D'Andrea Lenell to talk about the latest advances in medical applications on PDAs. They also discuss the best software for medical professionals and where this software is headed in the future.

Host: Larry Kaskel, MD Guest: John Chuey, MD In the city that never sleeps, there's a new physician-staffed medical clinic that, well, doesn't sleep either. We all have a few night owls, night-shifters or insomniacs in our practice; we also have patients who may be bothered by pain or illness in the middle of the night, but will avoid a visit to the emergency at all costs. In New York City, at least, these patients have another option for late-night care. For more on this interesting new option for patient care, host Dr. Larry Kaskel welcomes Dr. John Chuey, senior physician at the 23rd Street Office of the Beth Israel Medical Group in New York City, a 24-hour medical clinic staffed round-the-clock by physicians.

Host: Bruce Japsen Guest: Les Paul, MD Evidence-based medicine has been gaining momentum among the medical community, but there are things happening in our nation's capital that could impact this coming trend. Dr. Les Paul, vice president of clinical and scientific affairs for the National Pharmaceutical Council, tells host Bruce Japsen about the economic stimulus, bills in Congress and other initiatives that could move evidenced-based medicine further into the physician's office. But he also warns of potential pitfalls from the pharmaceutical industry's perspective.