Clinician's Roundtable

A century after Abraham Flexner recommended medical schools be located within a university, new research indicates that this may have contributed to the proliferation of medical specialties and higher costs. Dr. Michael Prislin, Professor of Clinical Medicine and Vice Chairman of the Department of Family Medicine at the University of California, Irvine, tells host Bruce Japsen about Flexner's impact on medical specialties, patients and their costs.

When talk of Canadian healthcare emerges in US political debate, the spin often turns to long lines and waits for medical care and short-changed quality. But there are also those, like Dr. Mark Kaplan, whose study indicates more equity and efficiency for our neighbors to the north than here in the US. Dr. Kaplan, professor of community health at Portland State University, tells host Bruce Japsen about advances in the Canadian health system that might surprise you.

What can a medical student or resident learn from a midwife about childbirth? Dr. Elisabeth Howard and Edie McConaughey, both certified nurse midwives at Women & Infants Hospital in Providence, Rhode Island, recently completed research on midwives as educators to medical students. They discuss with host Lisa Dandrea Lenell why it's important for these two professions to collaborate even though there may be a difference in philosophy and why midwives are good teachers for future doctors.

PA Eric Holden hasn't had time to eat or sleep much since arriving in Haiti. He is one of two physician assistants on the team of NYC Medics, a medical volunteer organization treating the sick and injured following the January 12th earthquake in Haiti. In their first two days on the job, he and his team of medical professionals treated more than 800 patients, traveling from makeshift tent city to tent city, providing care where it's needed. Host Lisa Dandrea Lenell talks to Mr. Holden from the front lines of the medical tent, where they have teamed up with the US Army's 82nd Airborne division to treat everything from pelvic fractures to dehydration. They discuss the difficulty of treating patients without the proper drugs and medical supplies.

Medical professionals across the world have joined together to help treat the injured survivors of Haiti's devastating earthquake. Physician assistants are also part of this global effort. PA Eric Holden, a volunteer with NYC Medics didn't know what to expect when he arrived in Haiti. Holden and the rest of his team have teamed up with the 82nd airborne division of the US Army to treat the most critically injured patients in Port-au-Prince. Host Lisa Dandrea Lenell talks with Holden about the types of injuries he's treating, and what it's like to work and live in a disaster zone.

Financial incentives to implement electronic health records are a welcome payment to the nation's physicians. But the proposed rules and regulations to implement this system under the economic stimulus are creating complexities and challenges physicians may face in the coming years. Physicians might want to first listen to words of advice from Robert Tenant, senior policy advisor for the Medical Group Management Association, which represents group practices and other organizations representing some 275,000 physicians.

Healthcare reform may bring more medical care services to patients, which means more and complex business for the nation's physicians. But are doctors prepared to be the best business people now and in the future for their patients? Dr. Wright Pinson, deputy vice chancellor for health affairs and CEO of the Hospitals and Clinics at Vanderbilt University Medical Center, tells host Bruce Japsen about master's programs in healthcare business, like Vanderbilt's Masters of Management in Health Care program.

How do employees working in large facilities know it's safe to return to work after being injured on the job? More than likely they must get clearance from one of the 2000 physician assistants working in occupational medicine across the country. Jack Lasoski, director of health services for the United States Enrichment Corporation in Paducah Kentucky, joins host Lisa Dandrea Lenell to talk about the history of PAs in occupational medicine, the typical day of a PA in this field, and the challenges and changes taking place within the specialty.

More than 10 million surgical and non surgical cosmetic procedures were performed in the United States in 2008. Many of those procedures were performed by physician assistants. Krystie Lennox, the co-founder of the Aesthetic Extender Symposium, talks with host Lisa Dandrea Lenell about the state-by-state rules related to PAs performing cosmetic procedures, how to become part of this expanding specialty, and how to stay informed in this fast changing area of medicine.

How does a doctor know when it's the right time to add a physician assistant to the office staff? There are a lot of factors to take into consideration when making the decision to add new employees. Dr. Roderick Hooker, co-author of the book Physician Assistant Policy and Practice, 3rd Edition, joins host Lisa Dandrea Lenell to discuss the cost effectiveness and productivity of the PA in a primary care practice, as well as how to build a cooperative relationship between a supervising doctor and a PA.