Clinician's Roundtable

Patients with a history of trauma or neglect are at increased risk for dissociative disorders. These are often hidden and remain undiagnosed even after years of treatment. How can a physician best understand these problems? Dr. Kai MacDonald, assistant professor of psychiatry at the University of California in San Diego joins host Dr. Leslie Lundt to explain how the non-psychiatrist may be missing patients with dissociative disorders.

Physician Innovator - Is that you? Our guest, psychiatrist and author of the recent best selling book Innovation Nation, Dr. John Kao talks of his most recent career. Dr. Kao calls himself an ‘instigator of new things.' Join host Dr. Leslie Lundt as she learns the ingredients of innovation and how it differs from creativity. Physicians can be innovators in their own practice or as part of a larger team to help make improvements in the delivery of healthcare.

Treatment of early-stage cervical and endometrial cancer is associated with significant sexual difficulties in at least half of women following hysterectomy. The success in treating these cancers has resulted in a focus on quality of life issues during remission. What can we do to help these women?

Host Dr. Leslie Lundt welcomes Dr. Lori Brotto, assistant professor in the Department of Obstetrics and Gynecology and director of the Sexual Health Laboratory at the University of British Columbia where her research primarily focuses on developing and testing psychological and psychoeducational interventions for women with sexual desire and arousal difficulties.

Host Lisa D'Andrea speaks with Candace Cain about the ability of physician assistants and nurse practitioners to change specialties within all fields of medicine. Ms. Cain informs us of the steps necessary to make the transition from one specialty to another in a competent and safe manner.

Patrick O'Doherty, vice president of the ProAssurance Insurance Company and a leading expert on insurance coverage and potential liability exposure, explains the new federal rule of civil procedures, regarding the discovery of electronic records, to which medical practices are now being exposed. Mr. O'Doherty talks with host Dr. Larry Kaskel about the new requirements for electronic document management, which include employee e-mails, and the limitations of professional liability coverage with respect to this risk. Mr.O'Doherty also outlines the scope of this supplemental coverage and the value in terms of litigation management, given the relatively low cost of coverage.

Several studies looking at efficacy for custom and off-the-shelf orthotics indicate that the vast majority of patients don't need a custom device. How do we decide who is an appropriate candidate for each product? How does this debate about specialized product lines project to running shoes and other items that help us work toward better foot health for our patients? Host Dr. Jordan Metzl welcomes Dr. John Kennedy, assistant professor of orthopaedic surgery at Weill Medical College of Cornell University and an orthopaedic surgeon at the Hospital for Special Surgery in New York.

Commonly perceived as a minor injury, ankle sprains are dismissed by many athletes, in particular, who are encouraged to shake it off, play through pain, and pursue some simple rehab as their game and practice schedule allows. Yet there is more to simple ankle sprains than we may realize, including diminished proprioception and balance that may leave our patients more vulnerable to chronic injury. Why is this loss of proprioception specific to the ankle? Are we approaching our treatment of these injuries in the proper manner? Dr. John Kennedy, assistant professor of orthopaedic surgery at Weill Medical College of Cornell University and an orthopaedic surgeon at the Hospital for Special Surgery in New York, details effective diagnostic and treatment strategies with host Dr. Jordan Metzl. Dr. Kennedy urges us not to underestimate what may be perceived as a simple ankle sprain.

Anticoagulants like heparin have been around for decades, but the drugs have drawbacks for many patients. Dr. Ted Love, Chief Executive of biotech company Nuvelo, tells host Bruce Japsen about targeted anticoagulant therapies that are being developed to be safer and more effective than the old standby heparin therapy and other blood treatments.

With ongoing questions about the manufacturing of heparin in China and concerns about a potential shortage of the anticoagulant, some are wondering whether there is a need for new heparin alternatives. Dr. Ted Love, chief executive officer of the San Francisco biotech company Nuvelo, tells host Bruce Japsen about the biotech industry's pursuit of synthetic variations of the popular blood thinner.

The climate for innovation in the pharmaceutical and biotech industries is fraught with risk, but also holds great potential for reward. Tim Walbert, the chief executive of Horizon Therapeutics, tells host Bruce Japsen about the prospects for growth in life sciences and the biopharmaceutical industry outside of Big Pharma and what that means for physicians.