Clinician's Roundtable

Patients that undergo bariatric surgery may expect to lose up to 35 percent of their body weight in the first year. What if that doesn't happen? Host Dr. Leslie Lundt, talks about the problem of post-op suboptimal weight gain with Dr. David Sarwer, director of clinical services at the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine.

We know that the weight loss outcome following bariatric surgery can be impressive - patients lose as much as 35% of their initial body weight in the first 18 months post-op. Does their psychosocial outcome also improve? Host Dr. Leslie Lundt welcomes Dr. David Sarwer, director of clinical services at the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine to discuss what happens after bariatric surgery.

Do you know what it costs you to see a patient? How can you improve the profitability of your practice? Owen Dahl, author of Think Business! Medical Practice Quality, Efficiency, Profits, talks with host Dr. Larry Kaskel about the costs of running a medical practice, and provides real-world advice.

Many successful Fortune 500 companies have used 'Six Sigma' for years to systematically increase their revenue and operational efficiencies. Mr. Owen Dahl, president of Owen Dahl Consulting, discusses with host Dr. Larry Kaskel how those same proven principles can be applied to patient scheduling and other medical office operations. Mr. Dahl specifically outlines how a physician could analyze the patient scheduling process by focusing on the quality of each process step.

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.

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.

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.

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.

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.

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.