Clinician's Roundtable

Host: Larry Kaskel, MD Guest: Christopher Ruhm One would think that the health of the nation would suffer during an economic downturn. But strange as it may seem, bad times can be good for the health of entire societies. Forgetting about individual health, Christopher Ruhm, professor of economics, explains the results of his study that showed that during a recession, traffic accidents, obesity, alcohol consumption, smoking and even deaths from heart disease go down. Professor Ruhm discusses these counterintuitive results with host Dr. Larry Kaskel, which also shows this interesting relationship between the health of an economy and its population.

Host: Jennifer Shu, MD, FAAP Guest: H. Gilbert Welch, MD, MPH Physicians need to be knowledgeable about both the potential benefits and possible harms of early screening and detection. What should we do when a healthy patient comes to our office requesting a full-body CT scan, genetic testing for cancer markers, or other screening measures that may not be suitable for their condition? How can we put health risks into perspective and give our patients basic information about the overdiagnosis and unnecessary treatment that may follow screening? For an interesting discussion about these questions and much more, host Dr. Jennifer Shu welcomes Dr. H. Gilbert Welch, professor of medicine and community and family medicine at Dartmouth Medical School, and author of Should I Be Tested for Cancer? Maybe Not, and Here's Why.

Host: Jennifer Shu, MD, FAAP Guest: H. Gilbert Welch, MD, MPH Preventive medicine in primary care has traditionally focused on health promotion and disease prevention. Due to advances in technology, a typical well visit may now include a series of tests to detect early disease. How is this shift toward preventive medicine affecting patient care, survival outcomes and health care costs? And how can physicians decide when is the optimal time to screen for cancer and other conditions? Dr. H. Gilbert Welch, professor of medicine and community and family medicine at Dartmouth Medical School, and author of Should I Be Tested for Cancer? Maybe Not, and Here’s Why, joins host Dr. Jennifer Shu to examine the realities behind our growing expectations of preventive care.

Host: Bruce Japsen Guest: Robin Rudowitz, Ms. With the economy in a downturn, more Americans are turning to Medicaid and related government health insurance programs as they lose private coverage. This may lead to some serious repercussions for medical-care providers and their patients. Robin Rudowitz, principal policy analyst for the Kaiser Commission on Medicaid and the Uninsured tells the Chicago Tribune's Bruce Japsen about how health benefit program cuts and reduced government spending in a slow economy could impact patients and their medical-care providers.

Host: Bruce Japsen Guest: Bianca Dijulio, MHS Healthcare costs for family coverage continue to rise. But what are the trends this year faced by US workers? Bianca DiJulio, senior policy analyst for the Health Care Marketplace Project at the Henry J. Kaiser Family Foundation, tells the Chicago Tribune's Bruce Japsen how cost shifts will impact consumers and patients as they deal with rising deductibles and co-payments.

Host: Mary Leuchars, MD Guest: Christine Ren, MD Surgical weight loss: what are the recent advances in this exploding field, and what can patients expect from today's evolving procedures? Joining host Dr. Mary Leuchars to speak on bariatric surgery's emergence and development in practice is Dr. Christine Ren, founder and director of the NYU Program for Surgical Weight Loss and assistant professor of surgery at NYU School of Medicine. Dr. Ren talks about the history of gastric bypass procedures, and the past to current trends of practice for bypass, banding, and malabsorptive operations.

Host: Shira Johnson, MD Guest: Scott E. Rudkin, MD, MBA Do you understand the financial impact of the on-call crisis and how it affects the emergency department? Dr. Scott Rudkin, associate professor of emergency medicine in the department of emergency medicine at the University of California, Irvine School of Medicine explains his research findings about the on-call crisis as well as solutions explored in California and across the nation. Learn why ambulance diversion may soon end while a fee for on-call service may be implemented. Dr. Shira Johnson hosts.

Host: Shira Johnson, MD Guest: Scott E. Rudkin, MD, MBA Who will be there to take call in your emergency department? Dr Scott Rudkin associate professor of emergency medicine at the University of California, Irvine School of Medicine, is interviewed by Dr. Shira Johnson to discuss the on-call crises which may be impacting your emergency department. Dr. Rudkin discusses the instrumental causes which include low financial reimbursement, an increased risk of litigation in trauma cases, and a desire for a better lifestyle, all of which have taken their toll on emergency department call schedules.

Host: Larry Kaskel, MD Guest: Brian Rank, MD Executive physicals are marketed widely as the ultimate medical checkups for discerning consumers. Dr. Brian Rank, the medical director of HealthPartners Medical Group and Clinics of Minnesota, discusses with host Dr. Larry Kaskel the basis for his belief that the popularity of executive physicals isn't good for medicine or the patients who undergo them. Tune in to hear Dr. Rank explain why executive physicals can be harmful to one's health, are a waste of healthcare resources, and create anxiety and a false sense of wellness.

Host: Larry Kaskel, MD Guest: Theodore Eisenberg, JD According to the results of a recent study, the use of statins for primary prevention in women is not supported by clinical-trial data. Theodore Eisenberg, a law professor at Cornell University, discusses the scope of the meta-analyses of the primary prevention clinical statin trial, and the conclusion, which found no statistically significant evidence of cardioprotective effect for women. Mr. Eisenberg explores with host Dr. Larry Kaskel the important questions raised by these findings, including whether the drugs should be used in the primary prevention in women and how the unqualified marketing and advertising claims of protection are misleading to physicians and consumers.