Advances In Long Term Care Medicine

Guest: Peter Hollmann, MD Guest: Ronald Crossno, MD Host: Eric Tangalos, MD Guest: Charles Cefalu, MD MS What are the most significant issues to be addressed in long term care medicine, and how will long term care medicine be affected by healthcare reform in the years ahead? Tune in to hear host Dr. Eric Tangalos reporting from the 2009 American Medical Association House of Delegates Meeting, where he is joined by Dr. Ronald Crossno, from the American Academy of Hospice and Palliative Medicine; Dr. Peter Hollmann, from the Rhode Island Medical Association; and Dr. Charles Cefalu, from the American Geriatrics Society. How will one of the American Medical Directors Association's resolutions about nurse as agent that passed at the AMA meeting help improve efficiency in long term care facilities? Hear ReachMD's complete coverage of the 2009 AMA House of Delegates Meeting: AMA President Dr. J. James Rohack's inauguration speech President Obama's keynote address to the AMA House of Delegates Dr. Rohack d

Guest: Sandra Aamodt, PhD test

Guest: Cari Levy, MD Host: Eric Tangalos, MD A growing number of young physicians are choosing to work in long term care medicine— a specialty in which high job satisfaction is generally reported. Dr. Cari Levy, assistant professor and director of palliative care at the Denver Veterans' Affairs Medical Center, tells host Dr. Eric Tangalos what she finds most appealing about working in long term care medicine. They take a wide-angle look at the field, from how physicians working in long term care facilities stay connected to a network of fellow geriatricians, to the financial viability of the specialty.

Guest: Charles Cefalu, MD MS Host: Eric Tangalos, MD What are the various types of anemia found in long-term care settings, and which types are the most common? What are some of the underlying causes of both chronic and acute anemia? Dr. Charles Cefalu, clinical professor and chief of the section of geriatric medicine at Louisiana State University Health Sciences Center, talks about how physicians can be alert to symptoms of anemia, which are often non-specific. What is the relationship between falling and anemia? Dr. Eric Tangalos hosts.

Guest: Karen Leible, MD, CMD Host: Eric Tangalos, MD Does the 'culture change' model at long term care facilities involve a simple re-design of aesthetics, or does this model encourage an entirely different way of structuring long term care? How challenging is it to implement a culture change, or patient-centered model, especially at facilities that have operated under a traditional model for decades? Dr. Karen Leible, chief clinical officer for Pinon Management, a long term care management and consulting firm in Colorado, discusses these questions and more with host Dr. Eric Tangalos. How can culture change help to empower patients?

Guest: Matthew Corso, JD Host: Eric Tangalos, MD What developments in long term care litigation have there been in recent years? What types of claims are the most common, and how can physicians and medical directors best protect themselves against frivolous claims? Matthew Corso, attorney at Buchanan, Ingersoll and Rooney, discusses these and other questions about risk management, and provides some helpful tips. Dr. Eric Tangalos hosts.

Guest: Jeffrey Levine, MD, CMD Host: Eric Tangalos, MD Death certificates are essential to the creation of public health policies and determination of funding allocation. In addition, death certificates can bring public health epidemics to the forefront. Dr. Jeffrey Levine, clinical associate professor of medicine at New York Medical College, discusses how physicians can accurately report the immediate, intermediate and underlying causes of death. What medical-legal issues might be impacted by the accuracy or inaccuracy of death certificates? Dr. Eric Tangalos hosts.

Guest: Gregory Zydiak, MD Host: Eric Tangalos, MD There are quite a few misconceptions about long term care and geriatric medicine. Many young physicians shy away from long term care medicine because they fear they won't be able to make enough money, or that they will burn out quickly. But Dr. Gregory Zydiak, medical director of a skilled nursing facility in Saint Louis, thinks the opposite is true. He believes long-term care medicine is a fruitful, rewarding and challenging career. Dr. Zydiak created a practical guide for a career in long-term care medicine, available here. Dr. Eric Tangalos hosts.

Host: Eric Tangalos, MD Guest: Charles Crecelius, MD, PhD There are many different types of long term care facilities, including nursing homes, skilled nursing facilities and assisted living facilities. Dr. Charles Crecelius, clinical instructor of internal medicine and geriatrics at Washington University School of Medicine in St. Louis, explains the services these different facilities provide, and offers some suggestions to physicians about ways to assess long-term care facilities. Dr. Eric Tangalos hosts. You can visit Medicare's Nursing Home Compare website here. Additionally, senior resources for chronic pain, substance abuse, and addiction include the following: the Substance Abuse and Mental Health Services Administration, or SAMHSA, offers a search engine of more than 20,000 drug and alcohol treatment providers offering different methods and levels of care across the country. the Forterus Senior Addiction Treatment Center page provides one of the most comprehensive resource for seniors with sub

Guest: David Brechtelsbauer, MD Host: Eric Tangalos, MD When meeting a patient's family for the first time, what information should physicians be prepared to provide, and how can physicians best address the family's expectations? What are the goals of the family meeting that should be addressed? Dr. David Brechtelsbauer, associate professor of family medicine at the University of South Dakota School of Medicine, offers some communication tips for the first visit physicians have with a patient and their family. Dr. Eric Tangalos hosts.

Guest: William Smucker, MD, CMD Host: Eric Tangalos, MD Delirium often goes unrecognized, even though it is a common condition in long-term care facilities. How can we be vigilant to the symptoms that might suggest dementia? Are patients with dementia most susceptible to developing delirium? What other conditions or medications might put patients at risk for developing delirium? Host Dr. Eric Tangalos welcomes Dr. William Smucker, professor of family medicine at Northeastern Ohio Universities College of Medicine, to investigate preventative strategies physicians might use to prevent development of delirium, and how to best manage the condition.

Guest: Paul Katz, MD Host: Eric Tangalos, MD How can we address the shortage of physicians in nursing homes, and how does this relate to the broader issue of dwindling primary care physicians nationwide? Dr. Eric Tangalos addresses this topic with Dr. Paul Katz, professor of medicine at the University of Rochester School of Medicine and Dentistry in upstate New York. What are the advantages to working as a physician in a nursing home? Will a nursing home specialist model be likely in the near future?

Guest: Matthew Wayne, MD, CMD Host: Eric Tangalos, MD What risks does polypharmacy pose for elderly patients, and how should physicians manage medications in the population of their patients over age 65? Dr. Matthew Wayne, assistant professor of medicine at University Hospitals Case Medical Center in Cleveland, discusses the typical symptoms that might indicate an adverse drug reaction, and suggests ways physicians can recognize these symptoms. What factors should physicians keep in mind when prescribing medications to a patient in their last few years of life? Dr. Eric Tangalos hosts.

Host: Beverly Hashimoto, MD Guest: Jonn Cronan, MD, FACR Thanks to extremely sensitive ultrasound technology, thyroid nodules are being detected and treated at unprecedented rates. Host Dr. Beverly Hashimoto welcomes Dr. John Cronan, professor of diagnostic imaging at the Brown University School of Medicine and chairman of the diagnostic imaging department at Rhode Island Hospital, to discuss the phenomenon of over-treatment of thyroid nodules. Is this pattern of care helping or harming our patients?