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The Doctors Roundtable

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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

 

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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

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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

 

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Cardiologist Dr. Jason Reingold on The Doctors Roundtable

 Tanya Mack, Host and Dr. Jason Reingold, Cardiologist and Guest

 

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

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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

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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

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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

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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.”

 

Pediatric Vision Therapy featuring Dr. Takeia Locke

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If you have children, you must listen to how pediatric vision therapy can have a dramatic effect. This show features Dr. Takeia Locke- Leef of Family Eye Care Center of Atlanta … all brought to you by HealthGate.

Vision skills are quite complex and seeing 20/20 is only one component of having great vision. Children who do not know what is “normal” may not discern a problem with vision; parents may not notice. In the U.S., one in ten children are at risk for undetected vision problems. Uncorrected vision problems in children may be a key reason why over 60% of students are identified as “problem learners.” Professional eye associations recommend first eye exams at 6 months of age, yet only 13% of parents report scheduling exams for their children before they reach 2 years of age. This broadcast on pediatric vision therapies serves to educate parents , educators, and the medical community about such orthoptic conditions as accommodative dysfunction, amplyopia (lazy eye) and strabismus and what can be done to correct vision issues to reduce symptoms (such as headache, double vision), improve learning and enhance quality of life.

 

Takeia Locke, Optometrist/Family Eye Care Center of Atlanta

An Atlantan optometrist specializing in treatment for family members but has a special interest in pediatric vision therapy, Dr. Takeia Locke is committed to making sure kids have a great start in life, given that 80% of a child’s learning initially comes from their visual sense. She knew at age 16 that she was going to dedicate her professional career to vision. She completed her Bachelor of Science in Health Management at Howard University. She then completed her Doctor of Optometry at Nova Southeast University specializing in primary care, pediatrics and vision therapy. Dr. Locke has published articles on autism, Dry Eye Disease and Glaucoma. She is also an InfantSEE provider (a public health program for infants).

 

Dr. Takeia Locke

Dr. Takeia Locke on Pediatric Vision Therapy

Dr. Takeia Locke and Tanya Mack

Studio Shot with Dr. Takeia Locke – Guest and Tanya Mack – Host

Doctors Roundtable - Tanya Mack, Host and Dr. Takeia Locke, Guest

Doctors Roundtable – Tanya Mack, Host and Dr. Takeia Locke, Guest

Advances in Female Infertility: Help, Hope and What’s New w/Dr. Dorothy Mitchell- Leef

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Fertility is an explosive issue. With advances in female infertility, we explore this topic and features Dr. Dorothy Mitchell- Leef of Reproductive Biology Associates … all brought to you by HealthGate. Guest host today is Deloris Hartley.

April 21-27th is National Infertility Week in the United States. As more women delay their childbearing years until after the age of 30, when natural fertility starts to fall off, the issue of fertility is a growing issue in American culture. Technology advances in genetics, fertility techniques and testing have provided new tools to help women know their personal fertility status earlier and make plans accordingly to help manage their fertility over time for the best possible outcome. Listen in as local southeast and national fertility expert, Dr. Dorothy Mitchell- Leef, whose practice has helped bring over 30,000 babies into the world in 30 years shares critical information on this topic.

 

Dorothy Mitchell- Leef, M.D./Reproductive Biology Associates

A board certified OB/GYN, Dr. Mitchell-Leef joined Reproductive Biology Associates , the Southeast’s largest infertility practice, in 1991. She received her MD and completed her OB/GYN residency at the University of Louisville, KY. She went on to specialize and complete her fellowship in Reproductive Endocrinology and Infertility at the University of Louisville. She is a past president of the Medical Association of Atlanta. She is the recipient of numerous awards: The 2010 Womenetics POW Award, the 2006 Atlanta Business Chronicle’s Healthcare Heroes Award, and the Medical Association’s prestigious 2005 Aven Cup award given periodically to individuals for their outstanding contributions to public health.

 

Dr. Dorothy Mitchell-Leef

Dr. Dorothy Mitchell-Leef discusses Fertility