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Concussions and New Legislation

August 8, 2013 by angishields

The Doctors Roundtable

Concussions and New Legislation

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In the US, over 173K people were treated for concussion in the past year. In Georgia alone last year, Scottish Rite hospital treated over 1400 kids for concussion. A concussion is a violent shaking of the brain or blow to the head and it is the most common traumatic brain injury. Earlier this year, GA joined over 43 other states by enacting into law a bill addressing the issue of concussions in youth sports, called “The Return to Play Act of 2013.” Collision sports and recreation is a primary area where concussions can occur. There is no quick, definitive test for concussion and many go undiagnosed or untreated. Less than 10% of concussions occur with a loss of consciousness. Symptoms can occur weeks and days after the triggering event that causes a concussion.

Symptoms can include headache, weakness, numbness, slurred speech, amnesia, sleep disturbances, changes in cognitive function, irritability, etc. Recovery from concussion varies widely and there can be long term effects of concussion, especially repeated concussion. Treatment can include physical and cognitive rest, physical and occupational therapy, cognitive therapy. The new law focuses on baseline assessment, prevention, information on risk to parents, on the field assessment and medical clearance requirements prior to returning to play. Join us in this segment to learn about concussion, the new Georgia law, and what parents, coaches and players need to know. Listeners can also find more information at: www.cdc.gov/concussion, www.concussiontreatment.com and www.kidsandpros.com.

Dr. Angela Yi

Ph. D in Psychology with the Sports Concussion Institute in Los Angeles

Diane King, CTC, RD

GA Concussion Coalition and President, GA Athletic Trainer Association

Buddy Curry

Master Trainer with Kids and Pro’s, former Atlanta Falcon pro football player
Advocate for passage of GA HB 284 “Return to Play” concussion legislation

Affordable Care Act 2013: What Consumers and Employers Need to Know

August 1, 2013 by angishields

The Doctors Roundtable

Affordable Care Act 2013: What Consumers and Employers Need to Know

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On March 23, 2010, the Affordable Care Act was signed into law in the United States. Since then, Americans have experienced some positive changes in health care reform such as: drug discounts, some tax credits, dependents’ coverage extending to age 26, and mandatory coverage of some preventive health screenings. By far, and even with recent delays, 2014 is poised to be the most active year for change brought about by ACA. Yet, recent polls showed that 6 in 10 Americans don’t know what to expect as far as health care reform that affects them in 2014. It has been estimated that 43% of Americans still do not know that individuals will be required to obtain essential health insurance in 2014 or they will pay a penalty.

The remaining months of 2013 will lay the groundwork for changes that become effective in 2014 for healthcare providers (fees), consumers (coverage) and businesses (benefit offerings). The Healthcare Marketplace and Small Business Health Option Program (SHOP) will be open on October 1 for policies effective Jan 1, 2014. Medicaid payments will increase for primary care providers in some states. Individuals with no health insurance coverage will now be mandated to obtain essential coverage. Preexisting conditions will mostly be a problem of the past. Millions of Americans are expected to find healthcare coverage. Join us in this segment of The Doctors’ Roundtable as we explore this highly relevant topic as three industry experts (representing law, consumers and employers) join us to discuss preparation for upcoming health care reform changes and we demystify some aspects of what is to come in a few short months with ACA. Listeners can also visit www.healthcare.gov to learn more.

Michele Madison

Partner at Morris, Manning and Martin law firm specializing in Healthcare practice

Jodie Braner

Vice-President of Hays Companies in Atlanta, Broker, Employee Benefits Division

Hospice and Palliative Care

July 25, 2013 by angishields

The Doctors Roundtable

Hospice and Palliative Care

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End of life completion and closure is an experience each of us will need to deal with at some point in our life journey. Hospice and palliative care provides a program of support that includes medical, social, emotional and spiritual support through a multidisciplinary team of nurses, physicians, volunteers and social services. Hospice and palliative are often considered when there is a shift from usual medical treatment for a cure to end of life pain relief and support.

Hospice services are provided in hospice facilities, the patient’s home, long term care facilities and sometimes even hospitals. Twice as many people die in hospice care as in hospitals or nursing homes compared to 10 years ago. This type of care used to be thought of mostly for cancer patients. However , in recent years, services have been expanded to a wide range of diagnoses that qualify for care including Alzheimer’s and Dementia. Medicare is the primary payor of hospice services in the United States and hospice has become one of the fastest growing Medicare programs. It is also one of the program’s that has proven to be of value cost/ benefit wise as the Medicare saves approximately $2300 per patient, over the course of their end of life care. This segment of The Doctor’s Roundtable focuses on an overview of hospice services, how to qualify for these services, the benefits and principals of palliative care management.

Dr. Lisa Rosa Re’

MD at University of Seville, Spain
Family Medicine residency at St. Mary’s Hospital in Hoboken, NJ
Completed fellowship at Albert Einstein College of Medicine, New York City
Private practice at Family and Integrative Medicine in Roswell, GA
Specializing in integration of holistic and traditional medicine, a multi-linguistic practice

Ms. Mary Triplett

Program Director, Compassion Care Hospice

Dr. Lisa Rose Re and Mary Triplett on The Doctors Roundtable — The Doctors Roundtable Topic: Hospice and Palliative Care

Craig Ridley - Dr. Rosa Re - Mary Triplett - Tanya Mack — The Doctors Roundtable with Dr. Lisa Rosa Re and Mary Triplett on Hospice and Palliative Care

Preventive Cardiology for Women

July 19, 2013 by angishields

The Doctors Roundtable

Preventive Cardiology for Women

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When most women are asked what the leading cause of death is for women over 25 yrs of age in the US, the most common answer is “cancer.” However, the correct answer is heart disease. One in three women in the US will die of heart disease and about 8 million women in the US are living with heart disease at any one moment. First cardiac events are more fatal in women than men. Did you know that 42% of women who have a heart attack, will die within one year after this event compared to 24% of men? A woman’s heart is different.

Risk factors for women and men are well documented and many are preventable. Despite this, alarming trends in the prevalence of risk factors continues. Aggressive cardiac risk factor management, education and intercepting women at key points like childbearing and menopause, can be keys to better outcomes. Risk factors include high blood pressure, elevated cholesterol, diabetes, poor lifestyle choices and family history. However, symptoms of a cardiac event in a woman differ from a man. Men report crushing chest pain with pain radiating down the left arm. Many women never experience this and report more atypical symptoms of a cardiac event including shortness of breath, nausea and unusual fatigue. Hormones and age are also influential with heart disease in women.

Effective treatment options are available to not only manage cardiac events but to slow down this often progressive disease process. Listen in to this segment to hear local cardiology expert, Dr. Jason Reingold address the topic of preventive cardiology for women. Understanding and managing cardiac risk factors today may reduce the chance of heart disease for women tomorrow.

Dr. Jason Reingold

MD from Emory University
Board-certified in Internal Medicine and Cardiology
Internal Medicine Residency program completed at UC San Francisco Med Ctr.
Completed cardiology fellowship at Mass General Hospital in Boston
Regular appearances on Sanjay Gupta’s CNN health program

Concierge Medicine

June 27, 2013 by angishields

The Doctors Roundtable

Concierge Medicine

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Where did the preferred old days of extended doctor –patient relationships go, in today’s healthcare system? Many are not only asking the question, but both physicians and patients are taking steps to get back to more of an extended knowledge and quality time relationship. Both physicians and patients are meeting their needs by joining the ranks of over 4400 primary care physicians practicing concierge medicine. Concierge medicine or “direct care” is a growing trend whereby the patient pays the physician an additional financial “retainer” (annually or by month) for enhanced benefits such as: 24/7 access, cell phone access, no wait times for appts, coordination of care and longer visit times.

Although there is controversy as to whether or not this delivery model promotes a two tiered health system, both patient and physician satisfaction levels are quite high. Physicians typically have more time to spend with patients during in office appointments as they care for a much smaller patient population (about 300-1000) than the traditional practice (3000-4000 patients). Typical services not included with a concierge physician: labs, ER visits, hospitalizations, medications, and consults outside of the practice.

Join concierge provider Dr. Ellie Campbell and Michael Tetreault, Editor-In-Chief of Concierge Medicine Today, as they discuss this growing trend from both a local medical practice and national trend perspective. Listeners can visit: www.campbellfamilymedicine.com and www.conciergemedicinetoday.com for more information on our great guests.

Dr. Eleanor Campbell

DO from Kirksville College of Osteopathic Medicine
Residency in Family Medicine from Medical College of GA
Board certified in Family Medicine
Private practice in Cumming, GA since 2005

Michael Tetreault

Editor of national publication, Concierge Medicine Today

Personalized Medicine and Pharmacogenetics

June 20, 2013 by angishields

The Doctors Roundtable

Personalized Medicine and Pharmacogenetics

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Personalized medicine is an emerging model that extends traditional approaches by using an individual’s genetic profile to guide medical decisions and treat illnesses. Genetics gives us a more detailed understanding of how genetic variability between people can be used to better predict a patient’s response to medicine, titrate doses, and significantly reduce adverse drug reactions. “One size does NOT fit all” in drug therapy. Low cost, easy to use gene testing is now available and moving closer to the mass market.

The FDA recently documented that genotyped patients receiving warfarin therapy are expected to have 31% fewer overall hospitalizations and 28% fewer bleeding incidents that may result in healthcare savings of $1.1B. Over 2 million adverse drug reactions are documented in the US annually and an estimated 100,000 deaths per year are caused by ADR’s in hospitals across the US . Like knowing your blood type, knowing a genetic baseline /genetic variations can be quite valuable. Patient profiles that benefit the most include: on 4+ medications, taking Warfarin (Coumadin) or Plavix, have unexplained symptoms, or where medications have not been effective.

Iverson Genetics, in Washington, is a leader in this exciting field. Today, on this segment, Dr. Christina Mailloux and Randy Satterlee will discuss “P4” medicine: predictive, personalized, preventive, and participatory new pharmacogenetic advances. Listeners can visit www.iversongenetics.com and www.personalizedmedicine.com to learn more.

Dr. Christina Mailloux and Randy Satterlee

Iverson Genetics

Telemedicine and High Risk Pregnancy Management

June 13, 2013 by angishields

The Doctors Roundtable

Telemedicine and High Risk Pregnancy Management

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Telemedicine is the provision of medical services across distances. The technology has been around for over 50 years and recent advancements are allowing specialists to reach a larger number of new patients. Although telemedicine had humble beginnings using audio and video technology, this field has moved from curiousity to mainstream acceptance. Last year, approximately 36 million Americans experienced telemedicine in some way.

Patients are often limited by distribution of doctors, their own disabilities, and distance. Recent telemedicine providers estimate that 80-90% of specialist care can be delivered remotely. Telemedicine works by having a physician in one location, connect to a patient at a “presenting” site. Varying types of technology allow for complex exams to take place without the “human touch”. Telemedicine as proven that it is 1) feasible 2) able to generate comparable clinical outcomes as in person and 3) of value to patients as it provides access, convenient ,and is cost effective. Challenges such as technology glitches, reimbursement and licensure issues are hindering adoption. However, health care reform is speeding up the implementation of telemedicine.

Listen to Dr. Patterson, a master’s degree engineer and double board certified physician, discuss telemedicine in general and how she applies it to her rare specialty of maternal fetal medicine. She shares achievements with numerous outcomes on high risk obstetric patients and more on how she is working to achieve some new breakthroughs in rural obstetric populations. Listeners can visit: www.americantelemed.org , www.gatelehealth.org and www.womenstelehealth.com for more information.

C. Anne Patterson, M.D.

Dr. Anne Patterson is a board-certified maternal fetal medicine specialist who received her medical training at Emory University after completing a masters engineering program at Georgia Tech. She has practiced at Northside Hospital, one of the largest OB delivering hospitals in the US for the past 25 years. Dr. Patterson is also an advisor to the Georgia OB/GYN Society. Most recently, she moved from private clinical practice to telemedicine and now is one of the nation’s top leaders in her field. She has presented at the national American Telemedicine Association, been a 2013 nominee for the Atlanta Business Chronicle’s Health Care Hero awards, and been featured in numerous videos on this subject.

Osteoarthritis and Rheumatoid Arthritis: Overviews to Breakthroughs

June 6, 2013 by angishields

The Doctors Roundtable

Osteoarthritis and Rheumatoid Arthritis: Overviews to Breakthroughs

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On the heels of National Arthritis month in the U.S., this segment of The Doctors Roundtable focuses on osteoarthritis and rheumatoid arthritis. These two illnesses, out of the over 100 musculoskeletal disorders, affect millions of Americans and their ability to maintain high quality physical movement throughout their lives. In the U.S., arthritis is the leading cause of disability and it is not just a disease caused by aging. Osteoarthritis and rheumatoid arthritis are chronic conditions with no clearly known causes. These diseases are progressive and degenerative , leading to the breakdown of cartilage, bones, muscles and membranes surrounding the joints. The effects of this breakdown include: inflammation, pain, fatigue, joint stiffness and at times joint deformity and disability. Imagine standing, sitting, lying down or coughing and all causing pain. Many patients report there is never a day they can forget they have arthritis.

The Arthritis Foundation is the nation’s largest private funder of research, public health programs and advocacy on behalf of the 50 million Americans living with this painful disease. With the aging of Baby Boomers, it has been estimated that by 2030, 67 million Americans will have some form of arthritis. Here, the Arthritis Foundation will discuss an overview of these two diseases and how they are working to fund research, change policies and educate to help arthritis patients today and tomorrow.

John H. Klippel, M.D.

John H. Klippel, M.D. is president and CEO of the Arthritis Foundation, the largest voluntary health organization serving the 50 million Americans living with the nation’s number one cause of disability. Dr. Klippel has held the position since October 2003.

Prior to joining the Arthritis Foundation, Dr. Klippel served as Clinical Director of the National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). During his professional career at the National Institutes of Health, he authored or co-authored 190 peer-reviewed publications and textbook chapters related to arthritis. He has served as editor of the Primer on the Rheumatic Diseases and the textbook Rheumatology.

Roberta Byrum

Roberta K. Byrum, CPA, is the chief operating officer of the Arthritis Foundation – the nation’s largest national, nonprofit health agency working on behalf of the 50 million Americans living with arthritis.

As COO, Ms. Byrum is accountable for all aspects of the daily operations of the Arthritis Foundation National Office, headquartered in Atlanta, Georgia. In addition to her operations leadership of the national office, Ms. Byrum works closely with the Foundation’s regional CEOs to ensure strategic alignment of nationwide operating activities.

Age Management Medicine, including hypothyroidism

May 30, 2013 by angishields

The Doctors Roundtable

Age Management Medicine, including hypothyroidism

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As over 8,000 baby boomers are reaching age 65 daily, Age Management Medicine is at the forefront of 21st century medicine. As we age, our body processes typically slow down. Healthy aging programs centered on evidenced based patient care are attracting record numbers of physicians interested in incorporating these ideas into their practices. This month, the Age Management Medicine Group held their annual conference for a membership of 14 thousand doctors from every state and 25 countries.

The goals of age management medicine include disease prevention, increased quality of life, enhanced wellbeing and longer health spans. The pillars of treatment in this area include: prevention and early detection, balanced hormone replacement, nutrition (including vitamin and mineral supplementation), and fitness. Symptoms that often indicate problems in the area of aging include: fatigue, decreased libido, increased belly fat, insomnia, mood changes. New thoughts in this field are: stem cell use, genetic testing, telomere length hormones and arterial conditioning.

Although there are many sub-topics in age management medicine, in this segment, Dr. Knott, who is an author in this field, will be discussing the hormonal aspects of aging and specifically hypothyroidism, its incidence, symptoms, and treatment. The thyroid’s decreasing function often develops slowly and most people may not notice symptoms of cold, decreased heart rate, fatigue, gradual weight gain, depression and thinning hair. The thyroid gland regulates metabolism in the body, affects every organ and slows down production as we age. Patients can find more information at www.managingyourage.com

Ken G. Knott, M.D.

Dr. Ken G. Knott received his medical degree (M.D) from the Memphis based University of Tennessee Center for the Health Sciences in 1976. He completed his internship and residency training through Ohio State University in 1980 and was awarded board certification in Physical Medicine and Rehabilitation. He relocated to Marietta, Georgia in 1988. In the early 1990’s, Dr. Knott developed a keen interest in hormone replacement for adults when he discovered the rather remarkable effect hormones had on the healing response when he successfully treated a patient with a knee problem through hormone therapy. During his studies, Dr. Knott discovered that many myths existed in regard to the subject of hormone replacement- some quite concerning. Dr. Knott wrote and published his book entitled, “Dangerous Medicine, What Your Doctor Doesn’t Know Can Hurt You.”