Clinician's Roundtable

Each state has its own laws and regulations on what physician assistants may and may not do within their practice. Host Lisa D'Andrea Lenell is joined by two guests for her discussion on state law. PA Ann Davis, director of state government advocacy and outreach with the American Academy of Physician Assistants discusses six key elements that help determine good state law for the PA practice. PA Beth Grivett, legislative chair for the California Academy of Physician Assistants, talks about how she lobbied and succeeded in removing restrictions on PAs when it comes to performing and signing physicals for the division of motor vehicles in California.

Thinking about adding an ancillary service to your practice? It's a move that certainly has the potential to be an additional source of revenue, but in order to make that happen, you'll need to do your due diligence research to ensure that it makes sense for your patients and your practice. Host Dr. Larry Kaskel gets some helpful guidance from Owen Dahl, nationally recognized medical practice management expert, on what you need to know to make your new toy a moneymaker: finding the necessary space within your facility, accruing needed sources of funding, and juxtaposing these items and much more with your patients' clinical needs.

Decisions on practice philosophy, finances, marketing, and much more are yours to make when starting your own medical practice. That's the good news. But it can also make the prospect of setting up your own shop seem extremely daunting. From picking a location, to creating a business plan, to seeking expert advice on accounting, credentialing and legal issues, how can you put it all together to create a successful private practice? Host Dr. Larry Kaskel welcomes Dr. William Hutton, founder and chairman of the board of MedSynergies, a medical practice management firm based in Irving, Texas, who provides pointers you can use when launching your own practice.

Does the title Physician Assistant truly capture the core of the PA's role in the 21st century? Does the title hinder efforts to advance the role of the PA profession? Is the word "assistant" confusing to patients, doctors and other healthcare professionals? Those are just a few of the questions explored by host Lisa D'Andrea Lenell and Dave Mittman, president elect of the American College of Clinicians and founder of Clinician 1, the online home for physican assistants and nurse practitioners. The two discuss the history behind the PA moniker and the debate over whether or not the physician assistant should become "physician associate."

The highly publicized decision by President Obama to add more federal dollars toward embryonic stem cell research may be fueling misconceptions about how drugs and medical products are created. But it's a part of the debate on stem cells that some in medicine think needs to be heard. Dr. Scott Gottlieb, former Food and Drug Administration deputy commissioner and resident fellow at the American Enterprise Institute, discusses with host Bruce Japsen funding realities, and what he sees as misconceptions related to the National Institutes of Health's new funding powers in the area of embryonic stem cells.

Testosterone therapy for men is controversial, but some new research suggests physicians might want to re-evaluate increasing the levels of testosterone in men with lower levels. Sexual dysfunction is one of the more apparent symptoms of low testosterone, but what are the other non-sexual symptoms of low "T" physicians should be aware of? What are the parameters for determining appropriate testosterone levels in our male patients? Isn't there an increased risk of developing prostate cancer among men undergoing testosterone therapy? Tune in to hear Dr. Abraham Morgentaler, associate clinical professor of surgery (urology) at Harvard Medical School and author of the book Testosterone for Life, weigh in on these and other questions surrounding testosterone therapy. Hosted by Dr. Maurice Pickard.

Hospitals are closing nationwide, but is it really a case of here-we-go-again because of reductions in reimbursement? This time, we are in the most serious recession in decades. Dr. Alan Sager, professor of health policy and management at Boston University School of Public Health, tells the Chicago Tribune's Bruce Japsen about what lies ahead for physicians and their patients with this uptick in consolidation.

The face transplant is a relatively new, experimental procedure still in its early stages. This operation is comparable to a hand transplant, in that the patient’s quality of life may be improved with the procedure, but the condition is not immediately life-threatening. How can physicians discuss the risk-benefit ratio of this procedure with potential face transplant patients? What happens if the procedure fails? How does a multidisciplinary team prepare a patient considering this procedure, from the psychological to the financial aspects? Tune in to hear Dr. Stuart Finder, director of the center for healthcare ethics at Cedars-Sinai Medical Center, discuss these and other ethical considerations of the face transplant procedure with host Dr. Maurice Pickard.

While many patients with asthma are allergic to pollen or pet dander, new evidence suggests inner city asthma patients may be most allergic to cockroach remains found in household dust. Dr. Daniel Remick, chair and professor of pathology at Boston University School of Medicine, discusses his new research demonstrating the relationship between household dust from city buildings and asthma. What implications for treatment does this research provide? Will there be an attempt to desensitize children to this cockroach allergen in the future? Dr. Maurice Pickard hosts.

Physicians often collaborate with other doctors when caring for patients with various medical problems. Yet disagreements with our colleagues may occur more frequently than we would like to admit, and there can be consequences to these disagreements among physicians. How can we best deal with these differences in medical opinion, while keeping in mind our common goal of providing the best care possible for our patients? Host Dr. Jennifer Shu covers this question and a range of related issues with Dr. Rahul Parikh, a pediatrician at Kaiser Permanente in Walnut Creek, California, and a regular contributor to the Vital Signs medical column on Salon.com. Dr. Parikh recently wrote an article for the Los Angeles Times on disagreements between doctors: Does a patient's input often play a role in generating or exacerbating a disagreement? Do we tend to gravitate away from others with whom we have a difference of philosophy or medical opinion?