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Dealing with Holiday Stress and Sadness

December 26, 2013 by christa

The Doctors Roundtable

Dealing with Holiday Stress and Sadness

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As the holidays approach us, many people look forward to spending time with family and friends and to the joys of the season. However, the holidays can bring some unwanted guests- stress and depression, for adults and children. Changes occur from year to year and these changes can affect is especially around the holidays- even positive changes. For others, the holidays are associated with negative feelings. Even after the holidays, many people experience the “Post Holiday Blues.” A recent poll showed that 8 /10 Americans experience stress around the holidays.

External triggers for holiday stress and sadness may include: loss of a loved one through divorce, death or a move, loss of a job or home or toxic relationships. Internal triggers can may be unresolved grief, underlying medical conditions, fear, isolation and loneliness and the contrast between expectations and reality. Sometimes, these feelings may be more than the “blues” and mental health professional involvement may be warranted if problems such as changes in appetite, sleep and weight persist for more than a few weeks or there is a lack of energy, social withdrawal and continued sorrow.

For most of us, however, planning ahead and using some key strategies can get us through this season. Seeking serenity, practicing forgiveness, letting go of unrealistic expectations, avoiding substance abuse, staying away from toxic people, practicing self care, reaching out to others, planning things we enjoy ourselves can help.

Tune in to this segment for more information about holiday stress triggers and causes and some strategies to make your holiday experience be filled with more hope and gratitude. Dr. Theodore Morgan, a local Atlanta psychiatrist will lend his expertise on this timely topic and also discuss when more than our own strategies may be warranted and professional help enlisted. Listeners can also obtain more information on www.gabehavioralhealth.com.

Dr. Theodore Morgan

Medical training at Meharry College of Medicine
Completed psychiatry fellowship at University of Alabama
Board certified in child and adolescent psychiatry
Member of the America Academy of Child and Adolescent Psychiatry
In private practice at GA Behavioral Health

Clinical Research

December 19, 2013 by christa

The Doctors Roundtable

Clinical Research

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Clinical research is a systematic approach to finding out what clinical approaches do and do not work and then using this gained knowledge in to advance and improve clinical decision making. There are many kinds of research, but in the US, about 59% of research focuses on drug research. At any one point in time the FDA has approximately 9-11 thousand clinical trials registered and these trials are seeking 2.8- 3 million subjects. Clinical trial investigative work is conducted in every disease state. Currently, a great deal of research is ongoing in cancer, cardiovascular, Neurology, and anti-infectives.

Bringing a drug to market in the US is a long (10-15 years) and expensive endeavor as about 90% of drug trials do not make it past the first phase of clinical trials. High quality results, timeliness and actionable evidence remain key indicators for a clinical trial. There are four phases of drug trials. Phase I involves safety testing in small numbers of patients. Phase II tests the drug in larger patient populations who have conditions or diseases the drug is meant to treat. Phase III is a pre-approval round where large populations of subjects with affiliated health issues test the new drug as compared to standard treatment. Roughly, 2/3 of Phase III clinical trials are approved by the FDA. Phase IV trials are post- FDA approval trials to explore additional adverse events, performance vs. competitive drugs and additional possible uses.

Patients often enroll in clinical trials with the belief that their experience may be of benefit to future patients. Clinical trial management is highly regulated with involvement and monitoring from many agencies. Informed consent is required. Most consumers and clinicians think of clinical trial research as being performed in large academic medical centers. However, there are many community level models that are available to extend participation and the quality of the research across populations as we are finding that drug response may vary more than previously expected due to each person’s unique pharmacogenomics.

Tune in to this segment to learn about clinical trial research in general and for more information about unique and highly successful community based models of research occurring in GA and the Southeast. Dr. Jeff Kingsley, a clinical research veteran at the national level and his associates will lend their expertise in the field of drug clinical trial research. Listeners can also obtain more information on www.serrg.com and the FDA’s research site at www.clinicaltrials.gov.

Dr. Jeff Kingsley

Medical training at Philadelphia College of Osteopathic Medicine
Completed residency in Family Practice at Columbus Regional Medical Ctr
MBA from Emory University
CEO/Founder of Southeastern Regional Research Group

Winter Allergies Triggers and Treatment

December 12, 2013 by christa

The Doctors Roundtable

Winter Allergies Triggers and Treatment

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The CDC reports that over 50 million Americans suffer annually from allergies and that globally, the number of people that suffer from allergies is on the rise. They estimate that in the US, over $18 billion is spent annually on allergy related health care. Although, it may not seem that allergies are a serious problem at first blush, allergy problems can greatly affect quality of life in terms of sleep, work and school productivity and even the quality of our relationships. The same allergens that trigger a response in the spring’s high allergy season – pet dander, mold and mildew, can be intensified with increased exposure as we move indoors during the winter months. Colds are also common during winter months , but many people do not know how to distinguish between a cold flare and allergies. Climate changes can also affect allergic responses.

The most common signs and symptoms of allergies during this time of year include sniffling, sneezing, watery eyes and nasal congestion. Treatments include avoidance of allergens, lifestyle changes and both over the counter and prescribed medications. Desensitization treatments are also now an option that saves time over the long run. In this segment, Dr. David Redding, a board certified allergist, who has been featured on The Weather Channel and TLC will join us to discuss the triggers and treatments of winter allergies. Listeners can also obtain more information on www.reddingallergyatl.com and www.cdc.gov/niosh/topics/asthma.

Dr. David Redding

MD training at Medical College of GA in Augusta
Double Board-Certified in Internal Medicine and Pediatric and Adult Allergy
Residency at University of South Carolina
Fellowship completed at University of Texas Medical Branch
Featured on The Weather Channel and TLC

Patient Healthcare Literacy and Advocacy

December 5, 2013 by christa

The Doctors Roundtable

Patient Healthcare Literacy and Advocacy

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Medicine is not “one size fits all” and medicine involves making decisions- many of them. Traditionally, patients have relied on their health care providers thinking that “the doctor knows best” in the areas of medicine, treatments, procedures, surgery and hospitalizations. However, some of the most important and potentially life altering healthcare decisions are not the clinicians’ alone to make. Many believe that with shared medical decision making- when the provider brings evidenced based medical expertise and the patient brings their preferences and values, benefits soar such as: a focus on prevention, an increased ability to manage chronic conditions, increased patient satisfaction and decreased costs. Examples of common healthcare decisions include: elder care, end of life decisions, management of chronic back pain, charting a cancer treatment course, elective surgery and maternity care.

Health literacy also is a component of making better healthcare decisions as many providers overestimate the health literacy of their patients. Patient may lack the fundamental tools to understand what is happening in their bodies and what to do about it. They may not have been brought into the decision making by their provider, know how to work within the medical system, understand the right questions to ask or believe they have power to help heal themselves.

In this segment, Dr. Joseph Pinzone, a double board-certified physician who specializes in endocrinology and the provision of care through the concierge model, has written a new book titled, “Fireballs in My Eucharist” (which was a patient’s description of fibroids in her uterus!). He will discuss the book and how patients can get educated, obtain tools to help in their decision making and help better heal themselves and be an active participant in their healthcare. Listeners can visit www.medamai.com and www.informedmedicaldecisions.org for more information.

Dr. Joseph Pinzone

MD training at NYU in New York
Double Board-Certified in Internal Medicine and Endocrinology
Private practice in Santa Monica, CA
Author of the new book, “Fireballs in My Eucharist”

Diabetes and Eye Disease

November 28, 2013 by christa

The Doctors Roundtable

Diabetes and Eye Disease

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November is Diabetes Awareness month. Did you know that diabetic retinopathy is the leading cause of new, irreversible blindness in adults from industrialized nations for people aged 20-74? Globally, 93 million people suffer from Diabetic Retinopathy alone. Four primary eye diseases are linked to diabetes: cataracts, glaucoma, macular edema and the most common- diabetic retinopathy. Duration of diabetes, poor glycemic control and hypertension are the highest risk factors for diabetic eye disease. Diabetes affects the eye in specific ways.

First, high blood sugar can cause swelling in the lens of the eye. This can be a temporary condition. Over time, diabetes damages the tiny blood vessels in the retina and can cause blind spots, blurred and double vision, “flashing lights”, floating spots and decreased vision. Visual acuity can also fluctuate. Decreased vision, however affects daily living. There are four stages of Diabetic Retinopathy and eye exams for diabetics include more specialized test than a routine annual comprehensive eye exam. There are no treatments available to restore lost vision. However, there are treatments that can minimize further damage and aid in coping with the damage including: lasers, medicine, surgery and vision-related rehabilitation.

In this segment and as part of Diabetes Awareness Month, Dr. Janelle Davison, a local optometrist that specializes in clinically complex eye care will provide a general overview of how diabetes affects the eye, diabetic eye diseases, treatments and preventive strategies for diabetic patients to maintain their vision. Listeners can visit: www.brillianteyesmarietta.com, www.visionaware.org or www.diabetes.org for more information.

Dr. Janelle Davison

BS in Biology from Xavier University in LA
Doctor of Optometry from Pennsylvania College of Optometry
Specialist in clinically complex eye disease
Currently in private practice at Brilliant Eye Vision Center in Marietta, GA

Alzheimer’s Disease

November 21, 2013 by christa

November is National Alzheimer’s Disease Awareness month and unfortunately, the US ranks first in the increasing number of deaths associated with neurological disease, including Alzheimer’s Disease (dementia). Today, over 5.4M Americans suffer from some degree of Alzheimer’s and this number is expected to double between now and 2030. Did you know that Alzheimer’s affects twice as many patients as heart disease and three times as many patients as cancer in the US? Estimated annual expenditures for 2010 for Alzheimer related treatments were $200B. Yet- this disease, for which there is no cure or proven treatments to delay or stop the disease is almost absent from mainstream media-perhaps because there are not many profitable remedies.

Alzheimer’s is a neurological disease that disrupts the way electricity passes through our brain and also affects the activity of neurotransmitters in the brain. Over time, the brain, quite literally, shrinks due to nerve cell death. Risk factors for Alzheimer’s include: age, family history, genetics, head trauma and some lifestyle factors. The primary symptoms for Alzheimer’s is memory loss that disrupts daily life (this is different than normal aging memory changes). Diagnosis is made through a complete medical assessment that may include a physical exam, neurological tests, mental status tests, blood work and brain imaging. There are several stages of Alzheimer’s and patients do not all progress at the same rate. There is no cure for Alzheimer’s Disease and no treatments that have proven to delay or stop the progression. Treatments focus on symptom management for sleep disturbances and memory loss.

Most distressing to families of patients with Alzheimer’s are behavior changes such as irritability, depression, anxiety, sleep changes, verbal outbursts and delusions. There are also many “myths” surrounding Alzheimer’s like- do flu shots, aluminum or Aspartame lead to the development of Alzheimer’s? Can only older people get Alzheimer’s?

In this segment, Dr. Monica Parker, a board certified family medicine physician and gerontology specialist and Ms. Suzette Binford, the Program Director of the Atlanta Chapter of the Alzheimer Foundation, will provide a general overview of Alzheimer’s Disease and some tips on “life after a diagnosis of Alzheimer’s Disease. Listeners can visit: www.emoryhealthcare.com and www.alzfdn.org for more information.

Dr. Monica Parker

MD obtained from University of Nebraska
Residency completed at University of Mississippi
Board-Certified in Family Medicine, Gerontologist
Assistant Professor, Dept. of Medicine, Div. of Geriatric Medicine at Emory University

Suzette Binford

Master’s Degree in Clinical Counseling from The Citadel
Program Director, Alzheimer’s Foundation, ATL Chapter

Specialized Dentistry: Hospital, Special Needs Kids, Dental Trauma

November 14, 2013 by christa

The Doctors Roundtable

Specialized Dentistry: Hospital, Special Needs Kids, Dental Trauma

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Most of us think of dentistry as routine: teeth cleaning, period Xrays for cavities, fillings and the occasional crown or root canal. However, there is an a very specialized area of dentistry that handles such issues as hospital dentistry, dentistry for special needs children (autism, Down’s Syndrome and developmental delays) and dental trauma. These skilled dentists receive rigorous additional training in oral-maxillofacial surgery. It is rarely thought of until it is needed. Many of these procedures are performed in a hospital setting to care for medically compromised patient or patients with adjunct and compiled medical conditions. They treat patients requiring reconstructive surgery, implants, injuries to the head, face and neck.

Please join us as Dr. Albert Baawo educates us about the world of “specialized” dentistry! Listeners can learn more at www.tooth11.com.

Dr. Albert Baawo (DMD)

DMD obtained at Medical College of GA
Served as VP of N. GA Dental Society
Internship at Emory University (Oral and Maxillofacial Surgery)
Private practice in Buckhead

An Overview of Male Infertility

November 7, 2013 by christa

The Doctors Roundtable

An Overview of Male Infertility

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The male role in contraception has been thought of as relatively simple, when in fact, it is actually quite complicated. The Mayo Clinic estimates that 15% of couples are infertile (frequent , unprotected sex of childbearing age with no pregnancy in one year). Research estimates show that 7.5-10% of all males of reproductive age are infertile. Male infertility is a major cause of no conception in 50% of childless couples. Male infertility can be defined as abnormalities in sperm production, maturity or delivery that impedes the establishment of pregnancy.

The male reproductive cycle involves testosterone secretion that is the common link between the pituitary gland and the testes. To achieve a pregnancy from the male component the following is needed: 1) healthy sperm 2) enough sperm is carried to the semen 3) the sperm is correctly shaped for motility and 4) no ejaculation problems. Causes for male infertility include varioceles (swelling of veins that drain the testes-42%), obstruction, infection, chromosome abnormalities, hormone imbalances, tumors, ejaculation problems, anti-sperm antibodies, sperm duct defects, some chronic diseases, environmental causes (exposures) and lifestyle causes (weight, stress, smoking and drug use). Male infertility evaluation often includes a semen analysis, an extensive medical history, a physical exam, lab testing and ultrasound examination.

Treatment of male infertility usually focuses on correction of the underlying problem or using treatments to help with the infertility. Possible treatments include: surgery, medications and assisted reproductive technologies such as sperm retrieval, sperm donation and cryopreservation. The process of identifying and treating male infertility can be stressful for the individual and couple. Costs can be high and this treatment is typically not covered by health insurance. The outcome is often unknown for some time period and stress can be high. There are many coping strategies and support groups for psychosocial support.

In this segment, Dr. Michael Witt, a board certified urologist and male infertility specialist (one of the few in the southeast) will discuss the a general overview of male infertility. Listeners can visit: www.rba-online.com and www.resolve.org for more information.

Dr. Michael Witt

MD obtained from Oregon Health Science University
Completed residency in urology at Boston University Hospital
Fellowship in male infertility completed at Baylor College of Medicine in TX
Board-certified in urology
Featured on CNN, The Learning Channel, named one of Atlanta’s Top Doctors
Now in private practice at Reproductive Biology Associates in Atlanta

Year End Planning for Medical Practices

October 31, 2013 by christa

The Doctors Roundtable

Year End Planning for Medical Practices

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The healthcare environment changes daily and physicians often struggle to keep up with regulatory changes, competition and reimbursement changes. There are many challenges looming: Obamacare, ICD-10 and Meaningful Use. Providers must spend time working on their practices as well as in their Atlanta Business Radio practices to thrive and not just survive. However, practices do not have to stay in a reactive mode. Taking time to plan can put a practice in a proactive mode to be able to anticipate and appropriate respond to opportunities, changes and challenges.

Quarter 4 is the perfect time to take action to minimize tax burden, maximize retirement plans, reconcile inventory, create the coming year’s budget and evaluate the coming year’s capital needs. Taking inventory, updating depreciation schedules, retirement planning, fee schedule analysis, A/R cleanup, tax planning, productivity and compensation evaluation are just some of the year end financial activities that can really make a difference in achieving solid financial performance.

Planning for retention of market share and growth is key to future practice viability yet how many practices have a formal, annual marketing plan. Marketing is often viewed as an expense vs. an investment yet new patients are a critical piece of revenue generation for every practice. The same marketing plans often do not yield different results and how providers reach, communicate with and message to current and potential patients is changing. Year end is a great time to acknowledge referral sources and examine the ROI of existing marketing efforts, brand cohesiveness, content relevancy and process, social media effectiveness and to make adjustments as needed. In a recent poll, 51% of patients said that digital communications would make them feel more valued as a patient and 41% said social media would affect their choice of healthcare providers. Is your practice keeping up with the interactive“new word of mouth” ?

An overall strategic plan can be the differentiating for success. Yet, many providers either don’t know how or feel they don’t need it. Yet, evaluation of Key Performance Indicators (KPI’s) to show the current standing of a practice, a SWOT analysis, a competitive overview and then making and implementing a strategic plan will help all businesses be positioned to recognize and capitalize on growth opportunities, assist in overcoming challenges and help protect market share for any business. Why should the business of medical practices be different?

In this segment of The Doctor’s Roundtable, three industry subject matter experts will weigh in on tips, strategies and considerations for year end planning for 2014 for medical practice success. Join Sharon Allred of LW Consulting ( a healthcare strategic planning expert), Beth McCauley of McCauley Marketing and Mark Estroff, CPA and medical practice tax expert as they share their best advice for positioning your practice for success in 2014. Listeners can visit: www.lw-consulting.com , www.mccauleyadvertising.com and www.pyagatesmoore.com for more information.

Mark Estroff