Clinician's Roundtable

Healthcare reform will bring health insurance benefits to more than 30 million uninsured Americans but the nation's largest doctor group and its new-president elect see more work to be done. Dr. Peter Carmel, elected in June as president-elect of the American Medical Association, tells host Bruce Japsen how he plans to lead the nation's doctors group into a post-health reform era and what additional improvements need to be made by Congress.

Pharmaceutical sales representatives can have great impact on patient care but until now have not always been subject to rigorous certification standards. Dr. Lyle Bootman, chairman of the Medical Representatives Certification Commission and dean of the University of Arizona College of Pharmacy, tells host Bruce Japsen about a new initiative that will prepare drug, device and other medical sales representatives to deal with the complex regulator, legal and political environment they face when selling health care products to physicians.

Pharmaceutical sales representatives can have great impact on patient care but until now have not always been subject to rigorous certification standards. Dr. Lyle Bootman, chairman of the Medical Representatives Certification Commission and dean of the University of Arizona College of Pharmacy, tells host Bruce Japsen about a new initiative that will prepare drug, device and other medical sales representatives to deal with the complex regulator, legal and political environment they face when selling health care products to physicians.

The cancer treatment Provenge, known as a "therapeutic vaccine," was approved by the Food and Drug Administration in April, 2010 as a novel way to attack prostate tumors. But this is more than the story of a new treatment. Host Bruce Japsen learns about the long path to FDA approval for this unique therapy that some see as a watershed development in oncology, from Dr. Mark Frohlich, senior vice president of clinical affairs and chief medical officer of Dendreon Corporation, the Seattle-based biotech company that manufactures Provenge.

Doctors know their patients often don't take their medications, whether because they simply forget or procrastinate on obtaining refills. But the lack of compliance with prescriptions has enormous financial ramifications. Dr. Steve Miller, senior vice president & chief medical officer, research and clinical sciences for Express Scripts, one of the nation's largest managers of pharmacy benefits, tells host Bruce Japsen about Express Scripts most recent survey on patient behavior when it comes to pharmaceuticals. He also talks about how, based on this research, improved patient compliance and other factors could save the healthcare system $100 billion a year.

Employers, insurers and providers are all increasingly focused on keeping patients healthy by encouraging prevention and wellness. Many wellness strategies revolve around behavioral issues, so what is the clinician's role in changing patient behavior, and how does the clinician become more tied to initiatives in the community? Dr. Dennis Richling, senior medical director and vice president at the Trustmark Companies, talks with host Bruce Japsen about the move in healthcare toward wellness initiatives, how the clinician's services are involved, and efforts to make those services reimbursable by insurance.

When our guest makes a house call, it's usually because a suspected criminal has barricaded himself, with or without hostages, inside the house. Dr. Andrew Dennis is a sworn police officer and medical director of two Chicago-area SWAT teams. Dr. Dennis is also an attending surgeon in the trauma and burn units at John H. Stroger Jr. Cook County Hospital in Chicago. How is what happens in the emergency department similar to what happens in the field, and how do a surgeon's skills complement the work of law enforcement? Also, host Dr. Maurice Pickard hears how television affects the outcome of gunshot and knife injuries.

While much of the nation's attention has been on expanding medical benefits to millions of Americans under health care reform, President Obama has also taken steps to ensure his medical care delivery is conducted in an "ethically responsible manner." The President does this with the help of a Commission for the Study of Bioethical Issues. Dr. Daniel Sulmasy, a member of the President's Commission, tells host Bruce Japsen about this panel's role and some of the bioethical challenges the administration may face.

For over a decade, patients have been turning to the Internet for health information and support. At least one new online venture gives patients the opportunity to access data about medications and therapies and their effects and outcomes. But this isn't clinical trial data. This is detailed, highly quantified, "real-world" data that patients put on the social networking site Patients Like Me about themselves, in order to connect with others who share their disease and learn from their experiences. Co-founder and chairman Jamie Heywood, a graduate of MIT, talks to host Bruce Japsen about privacy, doctor-patient communication, conflict of interest, and the potential effect on pharmaceutical development of giving patients the opportunity to review their treatments.

In 1975, Jim Schuelen began his career working as a PA in an emergency room. Today he is the chief administrative officer for the Johns Hopkins Department of Emergency Medicine and president of Johns Hopkins Emergency Medical Services. He joins host Lisa Dandrea Lenell to discuss the skill sets, preparation and challenges that are in store for a PA who wants to transition from clinical medicine to hospital management.