Clinician's Roundtable

When a patient visits the doctor's office, time is precious. But, given the rising cost of medical care in the United States, making time for direct and open conversation with patients about healthcare prices has never been more important. Dr. Jeffrey Kullgren of Penn Medicine tells host Bruce Japsen about the need for doctors to find a moments in their busy schedules for patient education on comparative costs of care.

While much of the nation's attention is focused on new medical benefits under the healthcare overhaul signed into law by President Obama, mental health advocates are stepping up attention to the Mental Health Parity and Addiction Equity Act, which began providing benefits to millions of patients with addictions, depression and other mental illness. The act was designed to put mental health services on equal footing with other medical services. Dr. Carolyn Robinowitz, past president of the American Psychiatric Association, tells host Bruce Japsen about this law and its importance for physicians and their patients.

Consumer groups for decades have criticized and wondered how much money health insurance companies actually spend on medical care. Under the health care reform law, they will actually come closer to knowing thanks to the so-called medical-loss ratio provisions of the legislation. Host Bruce Japsen talks with Washington and Lee University School of Law health reform expert Timothy Jost about the impact medical-loss ratio rules will have on physicians and their patients.

If patients take advantage of flexible spending accounts to help pay for their medical care, the health reform law is triggering some changes for them and doctor practices. Most notably, over the counter items like pain relievers and allergy meds will require a prescription. Host Bruce Japsen talks with Dr. Roland Goertz, president of the American Academy of Family Physicians about how patients and their doctors can prepare for these health reform law changes.

As health reform brings a focus on the budget for Medicare, a little-known but influential group with links to the AMA and specialty societies is getting a closer look. It's called the Relative Value Scale Update Committee and it is at the center of a debate over whether doctors have too much control over the flow of taxpayer dollars in the Medicare program. Dr. Barbara Levy, chair of the RUC tells Bruce Japsen about how this group works and the importance of what it does. In a previous segment, he spoke with Tom Scully, senior counsel in Alston & Bird, LLP, in Washington, DC, and former head of the Centers for Medicare & Medicaid Services, about the other side of this debate.

An estimated 4 out of 5 serious medical errors involve miscommunication that occurs when care is 'handed off' from one care provider to another. Dr. Mark Chassin, president of the Joint Commission, the organization that's studied handwashing and potentially dangerous acronyms and abreviations, tells host Bruce Japsen about how the Commission's Center for Transforming Health Care and 10 hospitals and health systems across the country are working to improve patient care by improving communication between 'senders' and 'receivers.'

In a two-part series, as health reform brings a focus on the budget for Medicare, we look from two sides at a little known but influential group convened by the American Medical Association. It's called the Relative Value Scale Update Committee and some critics say it has too much control over the flow of taxpayer dollars in the Medicare program. Tom Scully, senior counsel in Alston & Bird, LLP, in Washington, DC, and former head of the Centers for Medicare & Medicaid Services, tells host Bruce Japsen about problems with the AMA's role in the so-called RUC. In an upcoming program, Bruce Japsen talks with Dr. Barbara Levy, chair of the Relative Value Scale Update Committee.

An initiative sprouting on the South Side of Chicago that was once led by First Lady Michelle Obama aims to become a national model for re-educating communities on everything from appropriate emergency department usage to outpatient care and healthy life choices. Dr. Eric Whitaker, executive vice president of strategic affiliations and associate dean of community-based research at the University of Chicago Medical Center, tells host Bruce Japsen about the Urban Health Initiative and what it aims to achieve.

Physicians and scientists played an integral role in implementing the racial eugenics program in Nazi Germany, which culminated in the murder of six million European Jews. How can a better understanding of physician involvement in what ultimately led to the Holocaust help us frame issues being debated in medicine today? Susan Bachrach, curator of special exhibitions at the United States Holocaust Memorial Museum in Washington, D.C., and Richard Hirschhaut, executive director of the Illinois Holocaust Museum and Education Center in Skokie, Illinois, discuss the ideas behind the traveling exhibit, Deadly Medicine: Creating the Master Race. How did the idea of eugenics originate, and eventually turn into the racial eugenic ideas of the Nazis? How do we define science and pseudo-science, in the context of the roots of the Holocaust? Hosted by Dr. Michael Greenberg.

Health insurance companies are pushing physician ratings to steer more patients to what they see as less expensive but higher quality medical care. But doctors are finding these new measurements aren't always accurate. John Adams, a senior statistician at RAND Health in the Statistical Research and Consulting Group, tells host Bruce Japsen how doctor ratings are being used, their limitations, and their potetial impact as future quality measures.