If you think the seismic shift in U.S. healthcare is all a result of the Affordable Care Act, you may not be seeing a large part of the picture. This has become an era of "BIG MEDICINE" and that phenomenon is increasing through mergers and acquisitions. Some of these mergers are strategic, while others are defensive. Practical advice on how doctors and companies can improve their chances of merging successfully is provided. The lecture concludes with potential implications of the insurance-industry merger wave on patients and those working in the healthcare industry.

This episode offers some advice in thinking about the very difficult topic of pancreatic pseudocysts. Some philosophical waxing about pain control and some items not addressed in the previous episodes are also discussed.

Imaging, fluid resuscitation, fine needle aspiration, determining sterile vs infected necrosis, and suggestions from the guidelines are discussed.

This episode addresses some of the debates regarding nutrition timing in acute pancreatitis. Methods such as nasogastric, nasojejunal, and oral feeding are compared.

Treatments that include hydration, cinacalcet, calcitonin, bisphosphonate, denosumab, and other options are reviewed.

Indications for parathyroidectomy, pre-operative localization issues, diagnosing hyperparathyroidism, and a brief summary of the guidelines are among the topics addressed in this episode.

Special attention is paid to gastrointestinal, bone, and cardiovascular disease as a result of hypercalcemia. Laboratory interpretation of calcium and phosphorus levels is also discussed.