Elderly Care: Geriatric Medicine and the Older Driver
Our population is aging and we’re living longer through healthier lifestyles and advanced medical technology. This demands more medical care for the elderly for longer periods of time. Is there a difference in caring for senior citizens? If so, what should the patient be aware of? What should adult children of seniors be aware of and can they contribute to healthier seniors? What are, if any, the key issues seniors should be concerned with? And what of the Older Driver? Just how much of a public health issue/concern/hazard is the Older Driver? How do you determine when to take the keys? And what do adult children do to make that loss of independence easier? What is the physician's role in all of this?

Guests:
Kate Ackerman, M.D., Chairman, Committee on Geriatrics, Mass. Medical Society
Elizabeth Roaf, M.D., Team Leader, MMS Older Driver Project 

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Health Literacy: What should the patient know?
The Institute of Medicine says that nearly half of American adults are “health illiterate,” leading to medical errors that can be prevented. What is health literacy? How does one become health literate? What is the role of the patient? What is the role of the physician and health care provider? Where can one go for help?

Guest:
Vanessa P. Kenealy, Esq., President, Massachusetts Medical Society Alliance

End of Life Care: What is it and why is it important?
Why should doctors, whose primary concern is preserving and sustaining life, be concerned about end-of-life care? What can or should families do to prepare for end of life? How should decisions be made and who should make them? What legal documents come into play? What lessons do the widely –publicized cases of former Red Sox star Ted Williams and Florida resident Terry Schiavo have for the rest of us?

Guests:
John A. Fromson, M.D., Vice President, Medical Affairs, Massachusetts Medical Society and Member, Mass. End of Life Care Commission
Rigney Cunningham, Executive Director, Hospice and Palliative Care Federation of Massachusetts

The Bare Bones of Health Care: The Rapid Rise of Osteoporosis
The US Surgeon General issued its first-ever report on bone health in October 2004, saying that by 2020 – only 15 years from now – half of all Americans over 50 will be at risk for fractures from osteoporosis and low bone mass if nothing is done now by patients, doctors, health systems. Currently, 10 million Americans over 50 have the disease, and another 34 million are at risk of developing it.   What is osteoporosis? How does it develop? Can we prevent it? If so, how? And what do we do to treat it, if we can?

Guest:
Dr. Purnima R. Sangal, A Fellow of the American College of Obstetricians and Gynecologists; a practicing gynecologist at A Woman’s Place in Chelmsford, Mass.; and President of the Middlesex North District Medical Society.

Polio: Past and Present
Before the 1950s, the fear of getting polio was widespread. A dreaded illness caused by a virus and mainly affecting children under 5, this highly infectious disease attacks the central nervous system, causing inflammation and paralysis. There is no cure, only prevention. 
April 2005 marks the 50th anniversary of the discovery of the polio vaccine, a preventive measure that marked the beginning of mass inoculation in the US and one that effectively wiped out the disease in the US. The impact of the disease went far beyond the medical community, affecting the cultural, social and political lives of the United States.
While most of us think that polio is gone, today there are more than one million polio survivors in the US alone. And nearly 50 years after the medical miracle of vaccine, the disease is resurgent in more than a dozen nations around the world. Why are we fighting an illness 50 years after developing a preventive vaccine? How have polio survivors fared? And what do we need to do today to prevent this disease from spreading?

Guests:
Julie K. Silver, M.D., Medical Director, Spaulding Rehabilitation Hospital, Framingham
Anna Rubin, Education and Outreach Coordinator, International Rehab Center for Polio

Discussing Diabetes: Types, Risks, Prevention and Treatment
According to the American Diabetes Association, diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Its cause continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

Estimates are that 18.2 million people in the United States (6.3% of the population) have diabetes: 13 million who have been diagnosed and another 5.2 million who are unaware that they have the disease. Further, indications are that adult diabetes – type 2 – is on the rise in children due to widespread obesity.

What are the symptoms of this disease? How does one get it? How does one get tested? Are there any preventive measures to take? And if you do get diabetes, what can one do to treat it? 

Guests:
Michael Thompson, M.D., Director, Diabetes Clinic, UMass Memorial Medical Center; and Diane Carter, Diabetes Nurse Practitioner and Certified Diabetes Education, UMass Memorial Medical Center

Challenges in Emergency Medicine
Emergency rooms across the state are crowded every day, causing long waits for patients seeking care. In one highly-publicized case, a patient in an emergency room called an ambulance to be taken to another emergency room. In some cases, ER’s “divert” patients to other hospital emergency departments, because they can’t take any more patients. What’s causing this? How are emergency physicians, nurses, and hospitals responding? Can the patient do anything to alleviate the situation?

Guests:
Dr. Stephen Epstein, Beth Israel Deaconess Medical Center
Dr. Joseph Currier, Emergency Physician, Milford Regional Medical Center, Milford

Infectious Disease: Threats, Transmission, Protection
West Nile Virus. SARS. Monkeypox. Rabies. Bird flu, which many experts say could be the trigger for the next world pandemic. Infectious diseases surround us, and many begin with animals. How do these start? What kinds of threat do they pose? What should we know about transmission? And what measures can we take for prevention? 

Guests:
Alfred DeMaria, M.D., State Epidemiologist, Commonwealth of Mass.
Leonard Marcus, V.M.D., M.D., Travelers Health and Immunization

On the Job: The ABC's of Occupational Medicine
The field of occupational health is directed at the prevention, treatment and management of work-related injuries and illnesses. What are the roles and responsibilities of employers in work-related injuries? What are the rights and responsibilities of employees? What should workers do when they've been injured on the job? And what can the employee and employer do to prevent work-related injuries and create a safe work environment? 

Guests:
William B. Patterson, MD, MPH, FACOEM
Chief Medical Officer, Occupational Health + Rehabilitation and Chairperson, Committee on Occupational and Environmental health, Mass. Medical Society.
Sheila Litchfield, R.N., President of the Massachusetts Association of Occupational Health Nurses

Program 10

Patient Safety: Who’s responsible?
The 1999 landmark report of the Institute of Medicine called attention to thousands of medical errors occurring every year in our health care system. Six years later, what progress have we made? Do patients feel they’re in harm’s way? How can we improve? And what are the roles of the main players - physicians, hospitals, and, yes, patients, in ensuring patient safety? The President of the Massachusetts Medical Society and [guest to be named later] will examine these and other issues on the topic of patient safety and what health care providers – and patients – can do to make it better.

Guests:
Alan M. Harvey, M.D., President, Mass. Medical Society
Allan Frankel, M.D., Director of Patient Safety, Partners Healthcare

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Public health and our common wealth
Just what do we mean by “Public Health?” Who is responsible for it? What should be the state’s role in public health? What is the physician’s role? And what is, or should be, the role of the individual citizen? What are some of the threats facing the public’s health? And how can we prepare for them? Medical Society physicians will take a close look at this most important area of health and medicine that affects every citizen in Massachusetts.

Guests:
Alan C. Woodward, M.D., Past President, Mass. Medical Society
Howard C. Koh, M.D., Harvard School of Public Health, Chairman, Public Health Committee, Mass. Medical Society
Lynda Young, M.D., President, Mass. Chapter, American Academy of Pediatrics

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The New Medicare
Medicare, a program of the Federal government, is the nation's largest health insurer, covering some 42 million Americans aged 65 and over, and is celebrating its 40th anniversary in 2005. Today, Medicare at mid-life is far advanced over its earlier years. And recently, it has added many new improvements and benefits. Join the regional administrator of Medicare for a look at what's new with Medicare, and how the changes may affect you.

Guests:
Charlotte Yeh, M.D., Regional Administrator, Centers for Medicare & Medicaid Services (CMS) in Region I, based in Boston

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All Around Us: Environmental Health
Air and water pollution. Contaminants and chemicals. Mercury and mold. These are just some of the environmental factors affecting our health. How exactly are we affected by our environment? And what can we do about making our lives and our environment healthier?

Guests:
William B. Patterson, MD, MPH, FACOEM
Chief Medical Officer, Occupational Health + Rehabilitation, Hingham, Mass. and Chairperson, Committee on Occupational and Environmental Health, Mass. Medical Society

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Noise and Hearing Loss
It’s all around us, from traffic to lawnmowers to leaf blowers to snow throwers. Young drivers, with huge woofers and tweeters in the back of their cars, drive down the street in their mobile boom boxes, literally shaking the houses they pass by. Parents buy toys for their toddlers that seemingly approach sonic boom levels. Cities and towns enact noise ordnances, with apparently little effect, and residents clamor to have noise barriers placed along highways. How is noise affecting our health? What can we do about it? Is hearing loss inevitable as we age? How can we protect ourselves from our noise addicted society?

Guests:
Dr. James Kenealy, Otolaryngologist (Ear, Nose, Throat), in private practice in the Metrowest area and member, the Massachusetts Medical Society.

Unequal Treatment: Disparities in Health Care
In 2002, the Institute of Medicine issued its report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, pointing out that racial and ethnic minorities receive poorer quality care than white patients. Even when insurance, income, age and severity of conditions are comparable among whites and non-whites, non-whites are less likely to be given the level of care that experts recommend. Disparities also exist with respect to health care providers. In Massachusetts, Blacks, Hispanics, and Native-Americans make up nearly 14 percent of the population, yet only a little more than 3 percent of the workforce. What’s causing such disparity and unequal treatment? What role, if any, does the physician play in correcting this inequity? And what can patients do to improve their health care?

Guests:
Alice Coombs, M.D., Chairperson, Massachusetts Medical Society Committee on Diversity in Medicine
Lauren Smith, M.D., Medical Director, Family Advocacy Program, Boston Medical Center

When Cancer Strikes
Cancer is the second leading cause of death in the US, exceeded only by heart disease, and it can affect just about every part of the body. According to the American Cancer Society, about 1,500 people die from cancer every day –nearly 600,000 annually. Survival rates have risen dramatically, but just how far have we come in treating – and beating – cancer? What, besides the disease itself, are the obstacles patients and their families face when confronted with a diagnosis of cancer? Where can/do patients look for help and hope? We'll hear from two physicians who not only treat patients with the disease, but are also cancer patients themselves. 

Guests:
Jack Evjy, M.D., Oncologist and Cancer Patient
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Youth Violence
From bullying to dating violence to child abuse, in schools and on the streets, youth violence is on the rise. What’s causing this phenomenon? What can parents and teachers do about it? What role can or should the physician play? And how do adults reach young people to turn the tide?

GUESTS:
Robert Sege, M.D., Ph.D., Chief of the Division of General Pediatrics at The Floating Hospital for Children at New England Medical Center, Associate Professor of Pediatrics at Tufts University School of Medicine. and Director of the Pediatric and Adolescent Health Research Center at New England Medical Center; Member, MMS Committee on Violence

Elizabeth Miller, M.D., Ph.D., Director of Adolescent Community Health, Massachusetts General Hospital Revere Health Center; Member, MMS Committee on Violence  
GUEST HOST:
Lynda Young, M.D., President, Mass. Chapter of the American Academy of Pediatrics; Physician, Chandler Pediatrics, Worcester , Mass.

Coronary Heart Disease 
Coronary heart disease is the nation’s number one cause of death, claiming more than 900,000 people each year. More than 70 million Americans have some form of cardiovascular disease, such as heart failure, high blood pressure, congenital defects, or other circulatory problems. What causes these diseases? Are there preventive steps people can take to ward off heart disease? And what steps should people take if they do get cardiovascular disease? 

GUESTS:
Samuel J. Shubrooks Jr., M.D., Cardiovascular Division, Beth Israel Deaconess Medical Center and President, Massachusetts Chapter, American College of Cardiology;
Thomas C. Piemonte, M.D., Heart and Vascular Center, The Lahey Clinic

Ear, Nose and Throat Health
Otolaryngology is the medical specialty dealing with the treatment of disorders and diseases of the ear, nose, throat, head and neck. This specialty concerns such critical functions as hearing, speech, breathing, and conditions of the head and neck area (including balance, swallowing, and cancer). How can patients ensure good ENT health? What preventive health steps can they take? Do environmental or genetic factors affect ENT health, and if so, how? What symptoms or changes in health should prompt patients to visit such a specialist? 

GUESTS:
Wendy Stern, M.D., President, Mass. Society of Otolaryngologists
Jerry Schreibstein, M.D., Ear, Nose & Throat Associates of Springfield

Keeping Your Eyes Healthy
The eye is a remarkable organ, and we’ve only got two of them. They are instruments of learning and pleasure, safety and security. How do we keep our eyes safe and healthy? What are the principal dangers to our eyes? When should we use protection and what kind of protection should it be? How can we tell if children are having problems, and do children have different concerns than adults? What should we be concerned about as we age? What about supplements that are purported to promote eye health? And what every day steps can we take to protect and preserve our precious gift of sight?

Robert Lytle, M.D., President, Mass. Society of Eye Physicians and Surgeons
Jean Ramsey, M.D., Pediatric Ophthalmologist, Boston Medical Center
Guest Host: Mavis Jaworski, M.D. 

Skin Cancer
Skin cancer is now the most common form of cancer, with more than one million people developing the disease every year. And the numbers are growing. Since the late 1970s, the incidence of basal cell and squamous cell skin cancer has tripled for women under 40 years of age, and the more serious form, melanoma, is being diagnosed at double the rate since 1986 and increasing at a rate faster than any other kind of cancer. What’s causing this increase? What can be done to reduce the rates? Are there danger signs patients should recognize? And what steps can patients take to protect themselves?

Guests: Karen Rothman, M.D., Assistant Professor of Dermatology, University of Massachusetts Medical School; and 
Robert Baler, M.D. , Clinical Professor of Dermatology, Boston University School of Medicine. 

Asthma and Allergies
Allergic conditions strike one in five Americans - some 60 million people, with asthma alone affecting 20 million individuals.  Here in New England , one in seven adults and children and nearly 10 percent of students across the state are reported to have asthma. And the numbers appear to be increasing. What causes these respiratory diseases? What are the "triggers" for asthma and allergies? And what steps can patients take to manage such conditions?

Daniel Steinberg, M.D., Director, Allergy & Asthma Center of Massachusetts ; President, Massachusetts Allergy & Asthma Society.

Neurological disorders
Migraines, stroke, Parkinson's disease, Alzheimer's, and nerve disorders are just some of the conditions treated by neurologists - physicians who specialize in treating diseases of the brain, spinal cord, and nervous system. What are the most common conditions seen by neurologists today? Are there preventive measures for people to take to avoid such conditions? And what treatment options are available for those patients suffering from such conditions?

Guests: Thomas F. Mullins, M.D., President, Massachusetts Neurological Association and Chief of Neurology, Fallon Clinic, Worcester ; and Cynthia B. Passarelli, M.D., Staff Neurologist, Fallon Clinic, Worcester .

Bones, Joints, and Muscles: Orthopedic Care
Orthopedics is the medical specialty concentrating on bones, joints, and muscles. As we age, our body parts deteriorate, slowly but surely. What can we do to keep our bones, muscles, and joints healthy and strong?  If we play sports, what precautions should we take to protect our bones and joints?  And if a hip, knee or other joint becomes severely damaged, should we consider replacement surgery – a procedure now commonplace in orthopedic care.

GUESTS:
Scott Oliver, M.D., Chief of Orthopedics, Jordan Hospital, Plymouth, Mass. and Past President, Massachusetts Orthopedic Association

Cancer: After the Treatment
Cancer is one of the most prevalent diseases we face today. It's the second leading cause of death in the US, exceeded only by heart disease, accounting for one of every four deaths. Every year, an estimated 1.4 million new cases of cancer are diagnosed, with 33,000 here in Massachusetts alone. But there is good news. Survival rates for all cancers are increasing, due earlier screening tests and better treatments. But what happens after treatment? How do men and women begin their recovery, both emotionally and physically? Can they regain the health they once had?  And if so, how do they go about it?

GUESTS:
Julie Silver, M.D., Director, RESTORE, Cancer Rehabilitation Program, Framingham, Mass.
Karen Horowitz, Ambassador, Cancer Action Network and Breast Cancer Survivor

Guest host: Mavis Jaworski, M.D., Primary Care Physician, Beverly, Mass.

The Impact of Obesity
Obesity is now a national medical problem. Data compiled by the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older—over 60 million people - are obese. Also alarming is the fact that the percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6–19 years, 16 percent - 9 million young people - are considered overweight. To many, the causes of this American epidemic are obvious. But what are the consequences of obesity - in personal and psychological health, medical costs, and economic terms?  How far into the future will they be felt?  And what can we do about it?

Stuart R. Chipkin , M.D., Chair, MMS Committee on Nutrition; Physician, Valley Medical Group, Amherst;

Caroline M. Apovian, M.D., F.A.C.N., Vice-Chair, MMS Committee on Nutrition; Director, Nutrition & Weight Management Center , Boston Medical Center  

Vaccines and Immunizations
Vaccines are some of medicine's best preventive measures. Some, like the Salk and Sabine vaccines for polio, have eradicated debilitating diseases altogether. Some prevent illness for all ages, like flu vaccines. And many have erased childhood diseases, like mumps, measles, and chickenpox. New ones - like Gardasil for cervical cancer - are added to our protective arsenal. Yet new cases of polio, whooping cough, measles and mumps have appeared, here in the United States as well as overseas. How are vaccines developed and how effective are they? What are the risks of immunizations? Who should be immunized? And how valid is the controversy surrounding some of the vaccines?    

Susan M. Lett, M.D., M.P.H., Medical Director, Immunization Program, Department of Public Health, Commonwealth of Mass.

Sean Palfrey, M.D., Founder and Director of the Immunization Initiative, Mass. Chapter, American Academy of Pediatrics; Clinical Professor of Pediatrics and Public Health, Boston University School of Medicine; Pediatrician, Boston Medical Center.

Alzheimer's Disease and Dementias
Alzheimer's disease is a progressive brain disorder that gradually destroys a person's memory, ability to learn, reason, make judgments, communicate and carry out daily activities. It is the most common form of dementias, a group of conditions that destroys brain cells and leads to diminished mental function. And it’s a disease with enormous impact on the family as well. There is no cure, but research is leading to new treatments.  What may be the causes of Alzheimer's and dementia? Are there preventive steps to take? What is the latest in research? And what is the role of - and impact on - family members? 

Sanford Auerbach, M.D., Associate Professor, Boston University School of Medicine
James Wessler, M.B.A., President and Chief Executive Officer , Massachusetts Chapter, Alzheimer's Association

Arthritis
Forty-three million Americans report that a doctor told them they have arthritis or other rheumatic conditions. According to the Centers for Disease Control, arthritis is the leading cause of disability in the United States , limiting the activities of more than 16 million adults. In Massachusetts , some 1.2 million people have the condition - nearly 26 percent of the population. And the Arthritis Foundation lists more than 100 different types of arthritis. What, exactly, is arthritis? What causes these conditions? Are there preventive steps to take to avoid getting the condition? And what treatments are available?

Martin J. Kafina, M.D., F.A.C.R., F.A.C.P., clinical instructor in medicine at Harvard Medical School at Beth Israel Deaconess Medical Center and specialist in the private practice of rheumatology at Emerson Hospital in Concord.
Judith Levine, Senior Vice President for Health Education, Arthritis Foundation, Massachusetts Chapter

The Two Sides of Plastic Surgery
Plastic surgeons performed more than 10 million cosmetic procedures and nearly 5.5 million reconstructive procedures in 2005. Cosmetic procedures jumped 11 percent from the previous year, prompting The American Society of Plastic Surgeons to note that "cosmetic surgery is the new take on 'growing old gracefully'." What should patients know about such procedures? How dangerous are they? How are they different from reconstructive procedures? And with the successful completion in France of the world's first face transplant, how far can medicine go in recreating parts of the human body?

Glen Brooks, M.D., President, Massachusetts Society of Plastic Surgery, and Surgeon, Aesthetic Plastic and Reconstructive Surgery, Longmeadow , Mass.
Theodore Calianos, M.D., Plastic Surgeon; President, Barnstable County District Medical Society

Managing Pain
Pain management has become a separate and growing field of research and treatment in the medical field, as more and more people experience pain from conditions like fibromyalgia, migraine headaches, and other areas of chronic disease. A recent report from the Centers for Disease Control, in fact, said that 10 percent of Americans experience some kind of chronic pain. The withdrawal of pain medications from the marketplace due to increased risk factors has put increased attention on how we deal with pain and what alternatives are available. What options do patients have today? What are physicians recommending? Is alternative treatment or care a viable option? 

Edgar L. Ross, M.D., Director, Pain Management Center, Brigham and Women's Hospital

Men's Health
Research has shown that men get sicker and die earlier than women. Males also account for nearly 10 times the number of occupational injuries and more than four times the number of suicides than women. And males also die prematurely at higher rates than women as a result of engaging in risky behaviors, such as smoking, excessive use of alcohol and drugs, and lack of seat belt usage. Yet males are nearly twice as likely not to have a usual source of health care.  What's causing this disparity? And what can men - and their families - do to reverse the trend?

David Dodson, M.D., Chair, Massachusetts Medical Society Committee on Men's Health; Primary Care Physician, Marino Center, Wellesley
Peter Tiffany, M.D., Mystic Valley Urological Associates, Stoneham
Host: John Fromson, M.D., Chairman of Psychiatry, MetroWest Medical Center

Gastroenterology: "GI Health" 
Gastroenterology is the medical specialty dealing with the function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts, liver, and all the digestive organs. It treats conditions such as colon polyps and cancer, hepatitis, gastroesophageal reflux, ulcers, colitis, gallbladders, irritable bowel syndrome, and pancreatitis. When should a patient see this kind of specialist? What kind of symptoms may signal a problem? Are there preventive steps a patient can take for good "GI" health?

Albert A. Crimaldi, MD, PhD, FACG, Milford Regional Medical Center, Associate Professor of Clinical Medicine, University of Massachusetts Medical School

Preventing Medication Errors
Americans spend billions of dollars every year on prescription drugs, over-the-counter medications, weight-loss products, vitamins and herbal supplements. The explosive use of these products means there is plenty of room for error, and medication errors have become far too common and costly in today's health care system. The Institute of Medicine 's landmark report, Preventing Medication Errors pointed out that medication errors injure an estimated 1.5 million people each year in the U.S. What are the roles of the physician, the patient, the pharmacist in medication safety? And what can hospitals, pharmaceutical companies, and other health care organizations do to reduce such preventable errors?

Ronald B. Goodspeed, MD, MPH, President, Massachusetts Coalition for the Prevention of Medical Errors, and President & CEO, Southcoast Hospitals Group.
John A. Fromson, MD, Chair of Psychiatry, MetroWest Medical Center , and Past President, Massachusetts Coalition for the Prevention of Medical Errors

Becoming a smarter patient
At one time or another, at any age, and perhaps when we least expect it, every one of us becomes a patient. Health care today is better than ever, as technology and discovery have expanded medical information and treatments to levels unheard of just a few years ago. With patients now also playing a greater role in their own care, they also assume more responsibility for their care, and this situation presents more questions: What should patients know about choosing and interacting with their physicians and hospitals? What preventive steps should they take to avoid illness and stay healthy? What should they consider if undergoing treatment, testing, or surgery? What, in essence, does it take to become a smarter patient to get the best care possible? 

B. Dale Magee, President, Massachusetts Medical Society

Weight-Loss Surgery Surgery: The Solution to Obesity?
Obesity in the US has been rising dramatically for years, prompting The Institute of Medicine to label it "one of the most pervasive public health problems in this country." It is associated with more than 30 other diseases and conditions and affects people of all ages. For the severely obese, bariatric surgery is becoming a popular solution to this condition. Since 1998, the number of patients undergoing bariatric surgery has soared 800 percent, according to the national Agency for Healthcare Research and Quality. And as the incidence of obesity rises, the numbers of surgeries are expected to rise as well. Who may qualify for this surgery? Why has it become so popular? How dangerous is it? And what are the aftereffects? 

Alan M. Harvey, M.D., Chair, Betsy Lehman Center Weight Loss Surgery Expert Panel, Director of Quality Assurance/Quality Improvement, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital; and
George M. Blackburn, M.D., Chair, Massachusetts Department of Public Health's Betsy Lehman Center Weight Loss Surgery Expert Panel; Physician, Department of Surgery at Beth Israel Deaconess Hospital, Boston; Associate Professor of Nutrition, Harvard Medical School, and
Rebecca Shore , M.D., Bariatric Surgeon, Lowell Surgical Associates
Host: Lynda Young, M.D.

Pathology and the patient 
Television has likely done more than anything else to put the medical specialty of pathology before the American public. Police and crime dramas and reality programs on forensics are perhaps the public's first introduction to pathology, solving crimes and performing autopsies. But physicians who practice this specialty play a critical role in the everyday diagnosis and treatment of disease of living patients. What exactly does a pathologist do? What is the connection to the patient? What are the many and varied roles do they play in medical care today?

Brinda Kamat, M.D., M.P.H., Past President, Massachusetts Society of Pathologists; Pathologist, Mt. Auburn Hospital
Donald Ross, M.D., President, Massachusetts Society of Pathologists; Pathologist, Holy Family Hospital

Medical Images: The Specialty of Radiology
CT's, PET-scans, MRIs, mammograms, and body scans are much-used terms in medicine today. They are part of the language of radiology, the medical specialty of diagnosing and treating disease and injury by using medical imaging techniques. Spurred by rapid advances in technology, radiology allows us to see deep inside the body, revealing information that we could only dream of gaining just a few years ago. 

The questions this program will examine include: How do these tests work? What exactly do they show? How definitive can they be in diagnosing conditions? Are they safe for patients? And where does the specialty of radiology fit into the care of patients?

Phyllis Kornguth, M.D., Chief, Belkin Breast Imaging Center, Boston Medical Center, Past President, Massachusetts Radiological Society, Radiologist, Boston Medical Center; and
Max Rosen, M.D., Radiologist, Beth Israel Deaconess Medical Center, Boston, Past President, Massachusetts Radiological Society, Associate Professor, Radiology, Harvard Medical School 
Host: James F.X. Kenealy, M.D., MetroWest ENT Associates

Ready or Not? Emergency Preparedness
We live in a world today when disaster can strike at any time. The threats of bioterrorism, chemical spills, flu and infectious disease pandemics, natural disasters and severe weather are real and frightening. The destruction of the World Trade Center in New York and the devastation wrought by Hurricane Katrina along the Gulf Coast, along with the threats of avian flu and other infectious diseases, have given rise to a new focus on emergency preparedness. How prepared are we for such events? What should be the roles of the Federal, State and local governments and the medical professions? And what can individuals and families do to increase their preparedness?

Paul Biddinger, M.D., Chairman of the Massachusetts Medical Society's Committee on Preparedness, Director of Pre-Hospital Care and Disaster Medicine at Massachusetts General Hospital; Lisa Stone, M.D., Massachusetts Department of Public Health

Host:  Dr. Karlin

From left: Sharon Jezard, M.D., Bruce Karlin, M.D., Paul Hart, M.D.

Primary Care
Primary care physicians represent a patient's focal point in the health care system. They coordinate overall medical care, refer to specialists when needed, provide health plans with necessary information for insurance purposes, and much more. Yet these physicians are increasingly in short supply, creating challenges for patients in getting and maintaining good care. What, exactly, are the roles of primary care physicians? What obstacles do they face in caring for patients? What's causing this shortage and are there solutions to fix it? Is the solo practitioner or small group general practice becoming extinct? And what, ultimately, will be the impact on patients?

Paul Hart, M.D., Primary Care Physician, Sterling, Mass.; Sharon Jezard, M.D., Primary Care Physician, Sturdy Memorial Hospital, Attleboro, Mass. 

Host: Bruce Karlin, M.D.

From left:

Daniele Bick, M.D., John Fromson, M.D., Eugene Fierman, M.D.

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Healthy Minds: Psychiatric Care
Psychiatry is the medical specialty of diagnosing, treating and preventing mental illness, including substance abuse and addictions. Each year, one in five Americans is diagnosed with a form of mental illness, such as depression, anxiety disorders, or substance abuse conditions, among others. What is the medical science behind psychiatry? What are the warning signs of mental illnesses? How do psychiatrists diagnose and treat psychiatric conditions? And how does psychiatry differ from other professions that provide mental health care?

Guests: Eugene Fierman, M.D., President, Massachusetts Psychiatric Society; Daniele Bick, M.D., Psychiatrist, Framingham, Mass.

Host: John Fromson, M.D., Chair of Psychiatry, MetroWest Medical Center

From left:

Janet Jankowiak, M.D.; Bruce Karlin, M.D.; Daniel Oates, M.D.

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Healthcare for the Aging: Geriatric Care
America is aging fast. Estimates are that by the year 2021, the 65-plus age group will exceed 70 million people. At the same time, we're seeing a growing shortage of physicians, especially in primary care and geriatric care. The American Geriatrics Society, for example, has warned that we only have half the number of geriatricians we currently need (7,000 vs. 14,000) and that by 2030, we will need five times the number we have now. How will we care for our aging citizens? How is geriatric medicine different from primary care? What should seniors be concerned about and prepare for? What steps can patients take for healthy aging? And what roles and responsibilities do their family members have?

Host: Bruce Karlin, M.D.

Guests: Daniel Oates, M.D., Internal Medicine and Geriatrics, Boston Medical Center; Janet Jankowiak, M.D., Neurologist, Radius Specialty Hospital, Boston

From left: Mark Josephson, M.D., and Robert Hagberg, M.D., both of Beth Israel Deaconess Medical Center in Boston

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Cardiac Alert: Atrial Fibrillation

Once thought to be harmless, atrial fibrillation - a condition of rapid and irregular heartbeats - is now considered to be one of the nation's most common cardiac malfunctions. It is recognized as a major source of strokes and a cause of a potentially fatal deterioration of the heart. Estimates are that it affects more than two million people, and the number of patients being treated for this is expected to soar. What, exactly, is atrial fibrillation? What causes this condition? Is prevention possible? How dangerous is it? What are its possible consequences? Can it be cured? And what treatments are available?

Guests: Robert Hagberg, M.D., Cardiothoracic Surgeon, Beth Israel Deaconess Medical Center, Boston; Mark Josephson, M.D., Chief of the Cardiovascular Division, Beth Israel Deaconess Medical Center

From left: Pediatricians Karen McAlmon, M.D., Lynda Young, M.D., and David Norton, M.D.

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Caring for our Children: Pediatric Care
Childhood obesity is soaring. Violence among youth is a major problem. Immunizations are being called into question. And every year, children are injured and killed accidentally by firearms and a host of other causes. Those are just a few of the many areas covered by pediatric medicine – health care for people from birth through 21. What are some of today’s major issues in pediatric care? How should parents or guardians select a pediatrician? And how does a patient make the transition from pediatric care to adult care?

Host: Lynda Young, M.D., Pediatrician, Chandler Pediatrics, Worcester 

Guests: Karen McAlmon, M.D., Past President, Mass. Chapter, American Academy of Pediatrics; Pediatrician, Winchester Hospital; David Norton, M.D., Pediatrician, Holyoke Pediatric Associates

From left: Joan W. Miller, M.D. and M. Lisa McHam, M.D.

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Age-Related Eye Diseases
Blindness ranks as one of the most feared disabilities among Americans. As our population ages, more and more citizens will experience age-related eye diseases that threaten their gift of sight. For those 40 years and older, vision care becomes critically important. Cataracts, which slowly steal vision, affect half of all Americans by age 80. Glaucoma is the second leading cause of blindness in the world, and the number one cause among African-Americans. Macular degeneration is the primary cause of blindness for those 55 and older and affects more Americans than cataracts and glaucoma combined. What causes these conditions? What are the symptoms of these diseases? What treatments or cures are available? And what can patients do, if anything, to ward off or even prevent vision loss from age-related eye diseases?

Guests: Joan W. Miller, M.D., Chair, Department of Ophthalmology, Harvard Medical School Chief of Ophthalmology, Massachusetts Eye and Ear Infirmary; M. Lisa McHam, M.D., President of the Massachusetts Society of Eye Physicians and Surgeons and Chairman of the Public Health and Education Committee of the New England Ophthalmological Society

From left: Jennifer Rosen, M.D., Boston Medical Center and Robert Driscoll, M.D., South Shore Hospital.

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Preparing for Surgery
The prospect of surgery can be unnerving, if not frightening. And, though thankfully rare, the stories of 'wrong-site surgery' are those that usually top the list of medical errors. How do we define surgical procedures? What should patients know about them? How should they prepare for surgery? What questions should they ask? What role will your primary care physician play? What should parents know and do if their children are to undergo surgery? And are there different risks for elective procedures, such as cosmetic surgery?

Host: James Kenealy, M.D.
Guests: Robert Driscoll, M.D., Chief of Trauma and Surgical Critical Care, South Shore Hospital; Jennifer Rosen, M.D., Surgical Oncologist, Boston Medical Center

From left: Virginia Merritt; M.D., John Fromson, M.D.; Don Condie, M.D.

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Healthy Minds: Child and Adolescent Psychiatry
Psychiatry is the medical specialty of diagnosing, treating and preventing mental illness, including substance abuse and addictions. Between 7 and 12 Million American youth suffer from mental, behavioral, or developmental disorders at any given time, and the number of issues facing children can be vast: divorce, eating disorders, alcohol and drug abuse, depression, child abuse, grief, bullying, and violent behavior, just to name several. How does psychiatric treatment for children differ from that for adults? How should parents address these issues? What is their impact on families and siblings? What role, if any, should schools play? And what kinds of treatments are available? 

Guests: Don Condie, M.D., Psychiatrist, Massachusetts General Hospital
Virginia Merritt, M.D., Psychiatrist, Framingham Psychiatric Counseling
Host: John Fromson, M.D., Associate Director, Postgraduate Medical Education, Massachusetts General Hospital

From left: Luis E. Palacio, M.D.; Bruce Karlin, M.D.; John C. Richmond, M.D.

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Young Athletes and Sports Injuries
The proliferation of sports programs and opportunities for young people is a great boost to physical fitness and the fight against obesity. Yet, there's a downside as well: more and more very young athletes are coming down with injuries previously confined to only professional athletes. Estimates are that more than three and half million children 14 years old and under are receiving medical treatment for sports-related injuries each year. What's behind the increase in these serious injuries? What can be done - by parents and coaches and physicians - to reduce their frequency? And how might these young athletes be affected in the future? 

Host:      Bruce Karlin, M.D.
Guests: John C. Richmond, M.D., Chairman, Dept. of Orthopedic Surgery, New England Baptist Hospital,
               Luis Palacio, M.D., Director, Primary Care Sports Medicine, Malden Family Medicine/Tufts

Left to right, Denise Rollinson, M.D., Bruce Karlin, M.D., Edward Saltzman, M.D.

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Nutrition and Your Health
The growing epidemic of obesity in America has refocused nationwide attention on nutrition. Schools have banned soda and snack machines; food manufacturers have reformulated many of their products, eliminating trans fats and reducing sugar content. The Department of Agriculture has re-created its food pyramid, recognizing that one size doesn’t fit all. Just how does nutrition affect your weight and overall health? What, exactly, constitutes a "healthy diet"? Is organic really better? What role can or do vitamins play? Why should someone care about calories, carbohydrates or saturated fats? And what are the key items individuals should know about practicing good nutrition?

Host:      Bruce Karlin, M.D.
Guests: Edward Saltzman, M.D., Chief of the Division of Clinical Nutrition, Tufts Medical Center, 
               Denise Rollinson, M.D., Chairperson, Mass. Medical Society Cmte. on Nutrition and Physical Activity

Left to right, Thomas Mullins, M.D., and Gigi Girgis, M.D.

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Stroke: The Brain Attack
Stroke is the third leading cause of death in the U.S., after heart disease and cancer, and is the number one cause of adult disability. Each year about 700,000 people suffer a stroke, according to the Centers for Disease Control. A stroke can cause paralysis, speech problems, loss of sensation, difficulties with thinking and memory, coma, and even death. Recovery can be long and is often incomplete, creating great burden on loved ones as well as patients. What, exactly, is a stroke and can it be prevented? What are the risk factors for stroke and how can they be reduced? What are the signs of a stroke? What should you do if you think someone is having a stroke? And what are the health implications for someone who has had a stroke?

Guests: Gigi Girgis, M.D., President, Massachusetts Neurologic Association; Staff Neurologist, Beth Israel Deaconess Medical Center, Needham, Thomas Mullins, M.D., Neurologist, Fallon Clinic Worcester; Past President, Massachusetts Neurologic Association

Host: James Kenealy, M.D., MetroWest ENT Associates

Left to right, From left: Liza Sirota White, Barbara Herbert, M.D., Elaine Alpert, M.D.

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Domestic Violence: Public Health Alert
In Massachusetts, domestic violence deaths were three times higher in 2007 than in 2005. Nationally, a 2003 Centers for Disease Control study estimated that each year domestic violence involving an intimate partner results in 1,200 deaths, 2 million injuries among women, and 600,000 injuries among men – at a cost of $8.5 billion annually including direct medical and mental health costs. In June of 2008, with the passage of the Violence and Intervention Bill, Massachusetts became the first state in the nation to require health care providers to link victims of violence to counseling, housing, legal and educational and other services. What will be the effect of this new effort? How will victims benefit? What role does - can - the health care provider now play? And what other steps can be taken, by physicians, public officials, and lawmakers, to address this public health problem of domestic violence?

Guests: Elaine Alpert, M.D., Senior Public Health Fellow at Massachusetts General Hospital's Division of Global Health and Human Rights, Department of Emergency Medicine. Liza Sirota White, Education Manager, Jane Doe Inc. 

Host: Barbara Herbert, M.D., Chair, Mass. Medical Society Committee on Violence Prevention and Intervention

Host Bruce Karlin, M.D., (l) and Ronald Goodspeed, M.D.

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Medicine’s “Superbugs”
Drug-resistant infections are rising dramatically, from tuberculosis to MRSA to C.diff. The war against the “superbugs” continues. In Massachusetts in 2007, the Centers for Disease Control recorded 2,500 cases of MRSA – a bacterial strain that can be fatal. CDC estimates that half a million cases of C.diff – Clostridium difficile – occur every year in the U.S., contributing to between 15,000-30,000 deaths. How prevalent are such infections?  Hospitals are known places of infection, but where else can they occur? What are the chances of such infections spreading? And what can hospitals, health officials, and patients do to reduce and even prevent these infections?

Guest: Ronald Goodspeed, M.D., M.P.H., President, Massachusetts Coalition for the Prevention of Medical Errors
Host: Bruce Karlin, M.D.

From left, Joanne Nowak, M.D., John Fromson , M.D., Lachlan Forrow, M.D.

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Guests:  JoAnne T. Nowak, M.D., Medical Director, Partners Hospice
Lachlan Forrow, M.D., Director of Ethics and Palliative Care Programs, Beth Israel Deaconess Medical Center

Host: John Fromson, M.D., Associate Director, Postgraduate Medical Education, Massachusetts General Hospital

From left: Physician Focus host Bruce Karlin, M.D., Leonard Marcus, V.M.D., M.D., Mary Labato, D.V.M.

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People, Animals, and Health
People, animals, and the environment have converged today in so many ways that the health of each group seems inextricably linked. As a result, our dependence on animals and the products they provide poses increasing risks for our health and well being. Mad cow disease and avian flu are but two examples. While veterinary and human medicine are considered separate entities, many links exist between the two. How are these professions linked? How can they come together to improve the health of both man and animal? And how do we meet the needs of disease prevention and health promotion in people, animals, and the environment?

Host:
Bruce Karlin, M.D.
Guests:
Leonard Marcus, V.M.D., M.D. Travelers Health Specialist (Ret.),
Mary Labato, D.V.M., President, Massachusetts Veterinary Medical Association

From left: Physician Focus host Bruce Karlin, M.D., Harvey Zarren, M.D.

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Integrative Medicine
Integrative medicine is a new approach to care, combining conventional or evidence-based medical therapies with complementary or alternative treatments such as acupuncture, biofeedback, stress reduction, or herbal medicines. Such an approach is growing in a variety of health care settings.  How much do we know about such methods? Are they effective? What is the current thinking of medical doctors about integrative, complimentary and alternative medicine? And how and when should a patient decide on such treatments?

Guests:
Harvey Zarren, M.D., President, Integrative Medicine Alliance

From left: Carina O’Neill, D.O., Physician Focus host Bruce Karlin, M.D., Edward Phillips, M.D.

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Physiatry: Physical Medicine and Rehabilitation
Physical disability can affect patients of any age and arise from many sources. Among the causes are sports injuries, conditions affecting the muscular and skeletal systems, neurological trauma such as head or spinal cord injury, stroke, or neck and back pain. The medical specialty that diagnoses and treats such disabilities is called physical medicine and rehabilitation or physiatry. What are the effects on patients who suffer such conditions? How are rehabilitation programs developed? What can patients expect in undergoing such regimens? How do physicians go about treating these patients and restoring them back to health?  And what are the main health concerns of people with disabilities?

Guests:
Edward Phillips, M.D., Director, Outpatient Medical Services, Spaulding Rehabilitation Hospital; Assistant Professor, Harvard Medical School
Carina O’Neill, D.O., Medical Director, Spaulding Rehabilitation Center-Braintree; Instructor, Harvard Medical School

Host:
Bruce Karlin, M.D.

From left: David Hepner, M.D., Physician Focus host: John Fromson, M.D., Michael Entrup, M.D.

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All About Anesthesiology
Most patient contact with an anesthesiologist comes as a result of undergoing surgery. Assessing the risk of a patient undergoing surgery and optimizing the patient's condition prior to, during, and after surgery – is, after all, a prime activity of this specialty and goes hand in hand with the surgeon’s skill. What should patients know about anesthesia? What kinds are available? And what are the risks to patients? Beyond surgery, the anesthesiologist plays a key role in patient care, especially in pain management and critical care medicine. And the specialty has been a leader in local and national efforts to improve patient safety. This edition of Physician Focus will take a close look the various aspects of anesthesiology and the specialty’s impact and influence on patient care.

Guests:
David Hepner, M.D., Brigham and Women’s Hospital, Boston
Michael Entrup, M.D., Mass. Society of Anesthesiologists

Host:
John Fromson, M.D., Associate Director Postgraduate Medical Education Massachusetts General Hospital

From left: Lynda Young, M.D., Alison Schonwald, M.D.

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ADHD - Attention Deficit/Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder is one of the most common neurobehavioral disorders of childhood, affecting some 4.5 million children 5-17 years of age in the United States. Here in Massachusetts, nearly 10 percent of children have been diagnosed with the condition, which affects behavior, emotions, attentiveness, and learning. What causes this disorder? What are the signs a child may have it? What should parents do if they suspect their child has ADHD? And what kinds of treatments are available?

Guest:
Alison Schonwald, M.D., Medical Director, Developmental Behavioral Outreach, Children's Hospital Boston

Host: Lynda Young, M.D.