2018 Summer Conference Session Descriptions

Keynote Speaker: Brad Nieder, MD, “The Healthy Humorist®”

“LAUGHTER IS THE BEST MEDICINE” Dr. Brad Nieder’s signature keynote —“Laughter is the Best Medicine”— is funny! The healthcare humor will tickle your funny bone and have you laughing. “The Healthy Humorist” has been known to skewer such topics as healthcare lingo, diet plans, pharmaceutical ads, medical marijuana and scrubs. He’s even been known to break into song!

Not just your standard comedy show, though, the program is uplifting, too. You may find yourself committing to lightening up and laughing more. Or to adopting a new healthy habit.

It’s also educational… but not in a boring way. You’ll laugh as you learn why laughter really is good medicine… for combating stress, feeling better and living longer. And Dr. Brad always dispenses some wellness advice, too, in an entertaining manner unlike any other doctor you’ve encountered.

So that’s it in a nutshell: a funny doctor who delivers healthcare comedy, an inspiring message and valuable information. You’ll be feeling better in no time!


Day 1 — The Essence of Medicine: From Fast Track to Critical Care Thinking
John Bielinski, MS, PA-C

Urgent Care — Secrets of ID, Wound Care and Orthopedics This program involves the delivery of immediate medical care for the treatment of acute illness and injury. This course will focus on timely and practical issues involving urgent care medicine. This session will provide best practices for use in an outpatient clinical setting. We will cover infectious disease, wound care, orthopedics, and more.

Effectiveness in Medicine: Patient Satisfaction/Medical Error Reduction & Influence Understanding how we think prevents errors. When the patients like you, everything is better. Learn secrets of error reduction and extraordinary bedside manner. We are in a service industry, like it or not. Extraordinary bedside manner is essential to patient rapport and, therefore, overall medical care. This lecture will explore how to optimize the patient experience. Also, thinking is critical in how we go into a room. We need to understand our biases to limit exposure to medical errors. In a case study based curriculum, we will explore the common cognitive biases that lead to medical errors.

Advanced Case Studies in Medicine Critical thinking is key to caring for complicated patients. Critical thinking comes from intuition. Intuition not only comes from experience, but mindful education. This program is a case-based program utilizing audience response units. You will be broken into groups of two or three to answer questions that are then projected for evaluation. This is a way to learn intuition within an academic lecture.


Day 2 — Snap, Crackle, or Pop? Hands, Shoulders, Knees & Toes
Scott Frischknecht, PA-C, DFAAPA
Sheila Sander Fulcher, FN, MSN, ANP-BC

What in the Shoulder is Going on in There? Shoulder disorders continue to be a common complaint of patients presenting to health care providers. These can be due to overuse, acute injuries, or chronic pain. An understanding of shoulder anatomy is paramount in making correct diagnoses. This presentation reviews the anatomy in a simple and straightforward way. Appropriate initial history questions are reviewed, and shoulder physical examination techniques are demonstrated. Fractures and other bony abnormalities are demonstrated with radiographs. Current treatments are explained and reviewed for each diagnosis. Indications for referral to an orthopedist are also described. Practitioners will be more confident in their ability to correctly diagnose and treat shoulder disorders.

What We Need to Know About Knees Who has not fallen and skinned their knees? Knees are easily and frequently injured. Complaints of knee pain are routinely seen in every health care setting. Important medical history questions, examination techniques, and review of radiographs, will be extensively covered. Knee anatomy is displayed and described in a simple and plain fashion. A reproducible and systematic approach to knee disorders allows providers to make correct diagnoses and institute timely treatment. Differences between intra and extraarticular problems, patellofemoral alignment issues, and acute injures are addressed and displayed. Providers will be better able to diagnose and effectively treat patients with knee complaints.

You Can’t Shrug Off This Exam  – (Hands-On) Examination of the Shoulder Made Simple Most problems in the shoulder involve the muscles, ligaments, and tendons. Athletes are especially susceptible to shoulder problems. In athletes, shoulder problems can develop slowly through repetitive, intensive training routines. Blue-collar workers are susceptible to shoulder injuries similar to injuries that athletes sustain. Shoulder pain is one of the most common complaints that present to the clinic. Narrowing the differential diagnosis for the shoulder joint is a complex yet simple task. This lecture is designed to familiarize participants with evidence based physical exam techniques for the shoulder.

You’ll Get a Kick out of This Exam  – (Hands-On) Examination of the Knee Knee complaints continue to fill the clinics and emergency rooms. Clinicians must be able to formulate a differential diagnosis efficiently and effectively in order to expedite treatment options. At the conclusion of this workshop participants will demonstrate the techniques and components of a thorough Orthopaedic history and physical evaluation.

All Hands on Deck…Hands Down  – (Hands-On) Evaluation of the Hand and Wrist Many mid level practitioners have never been taught basic joint injection and aspiration techniques. Although basic musculoskeletal anatomy has been taught, hands on application of the anatomy in aspirating and injecting joints has been limited with few opportunities to demonstrate hands on skills. At the conclusion participants will feel confident with their skills in aspiration and joint injections.


Day 2 — Managing Metabolic Mayhem
Christine Kessler, MN, CNS, ANP, BC-ADM, CDTC, FAANP

Diabetes Medication Update New diabetes drugs have hit the market at a dizzying pace with new drug classes, new variants within class, new drug combinations along with conflicting MACE data and guidelines. Then there is cost. Managing diabetes can be a bit of a “head-slapper” for providers. This lively session aims to clear the treatment fog and provide attendees with a reality-based guide through the diabetes medication maze. Interactive patient cases will be utilized to highlight the use of new oral and injectable diabetes medications along with tandem use of older diabetes drugs to more safely and effectively help patients achieve desired glycemic goals. An added bonus will be a look at why cardiologists and nephrologists have become “endocrine groupies!”

The Pocket Endocrinology: When to “Play” and When to “Punt” The calcium looks high, the testosterone too low, and the prolactin is up and down. This patient has sudden hair loss, another is hirsute, and what is with that adrenal incidentaloma? What should you do with these findings and these patients? Should you refer to endocrinology in hopes the patient gets seen in 3 months? This session is your gift from those among the rare species of specialists—endocrinology. Attendees will receive specialist tips on the initial work up and intervention for commonly referred metabolic complaints and conditions (selected by endocrinologists) that may cause needless (or delayed) endocrinology consultations. It will also help you know when to treat and when to punt!

Untangling Thyroid Conundrums Thyroid disorders are one of the most frequently encountered endocrinopathies in outpatient clinical practice and often the most confusing. Conflicting thyroid management guidelines from endocrine associations and government agencies add to challenges already inherent in treating these patients. Controversies related to screening, treatment of elderly or pregnant patients, and the use of “natural” desiccated thyroid hormone are among these challenges, as well as puzzling thyroid laboratory data. Drawing upon personal decades of thyroid management practice, this lively session will use an interactive case study approach to address these challenges and help hone clinician skills treating hyper- and hypothyroid conditions, thyroiditis, and thyroid nodules. Reality-based tips from an endocrinology expert will provide attendees with highly useful “need to know” pearls to help manage and effectively treat these intriguing patients.

Weighing in on Obesity Management Over the past thirty years, America has become a “waistland.” With the increase in obesity comes a rise in over 200 associated complications, such as cancer, CV disease, diabetes, dementia and pain. Past interventions have failed. Why? For too long we have operated on the FALSE notion of obesity causation and pathology (adiposopathy)—that it just about and energy (intake & output) imbalance. Recent studies provide a new etiologic paradigm…the true nature of fat and the astonishing impact of the gut-brain-fat axis on appetite an energy metabolism. Understanding the bio-dynamic interactions between these organs is leading to more effective obesity prevention and intervention strategies. This intriguing session will explore the impact of altered gut-brain-fat interactions, gut flora and our DNA on appetite, energy metabolism, weight gain (loss & regain) and relate these to more effective weight loss strategies for IMMEDIATE use in clinical practice. Obesity is a disease and managing it is the future of health care.

The Entero-endocrine System and Chronic Health The past four decades has seen a staggering rise in obesity, autoimmune autism, food intolerances, psycho-social disorders. Why is this happening? Tantalizing new information about the entero-endocrine system, the gut-brain axis and the microbiome is refocusing prevention & intervention strategies for most metabolic disorders and shaping the new frontier in medicine. The fascinating session will explore the gut-brain-axis & the bioactivity of the microbiome related to immune, GI, metabolic, reproductive, psychological & cardiologic health through the life span. Attendees will learn reality-based strategies to promote a heathy microbiome & metabolic health and critically evaluate the effects of pro & prebiotics & selected diets for disease prevention & intervention.


Day 3 — 50 Shades of Grey: The Grey Areas of Cardiology and How Not to Get “Tied Up” in Them
Jennifer Carlquist, PA-C

12 Lead EKG Demystified In this course we will: review normal cardiac conduction, normal intervals and wave morphology, how to assess heart rate using the EKG and just a rhythm strip, limited basic rhythm interpretation, the PQRST model of EKG interpretation will be discussed, normal EKG review, trouble Shooting the EKG, to include artifact and 60 cycle interference.

Young People Don’t Have Heart Disease – Or Do They? Young people can have heart attacks. Case based review of ten patients that died or almost died and lived to tell about it. A retrospective review of these cases and how these near misses could have been prevented. Participants will walk through actual cases of cardiac arrest survivors, people who had near fatal myocardial infarctions with focus on how to prevent other patients from the same fate.

The PA’s Guide To Cardiac Bartending AF “cocktails” and treatment strategies, The Heart Failure “Martini” and how to adjust to taste, The “Cardiac Happy Meal” – post STEMI treatment regimen, common side effects of cardiac medications and how to spot them. We will also discuss strategies to combat AF and how to use the CHADS score to define risk.

How Much Should I Worry About this EKG? We are often faced with borderline EKG changes and faced to make decisions about what to do next. On symptomatic patients this is almost easier, but if they are not symptomatic, then the question becomes how much should we worry? Should send the patient to the ER, or refer them to cardiology. Participants will learn how non-specific T wave changes could be subtle ischemia that should be treated like a stemi. We will discuss how the T wave can be your biggest ally when sorting out ACS patients. Case-based discussions with real EKG and case follow through will be used to highlight various perils of non-specific changes.

Hot Topic: How To Really Prevent Cardiac Disease – The hidden risk factors and how to spot them Young people don’t have heart disease. That is what we were taught in school. So how do we explain 30 year olds having myocardial infarctions? Could there more to it than just bad luck? It turns out that there are several risk factors for heart disease and stroke that we can potentially identify early and reverse before they ever have their event – if we just know what to look for.

We know that “sitting is the new smoking” but we will discuss other risk factors like Polycystic ovarian syndrome, Rheumatoid arthritis and lack of sleep. We will also review how stress and inflammation are the new “public enemies” for anyone of any age.

Day 3 — Derm 2018: Making Dermatology Great Again
Jason Cheyney, MPAS, PA-C

So, You Want To Be A Derm Rock Star?! (Rx=.25hr) This session is going to delve into the nuts and bolts of the more common dermatology diagnoses. Its focus is to refresh and reinforce what is going on in dermatology today and get you feeling much more confident about the skin problems you will see no matter your specialty. Not only will we discuss common diagnoses but also the treatments that will leave you looking like a superstar.

Pimple Popping Made Easy (Rx=.5hr) The most sought after treatments in dermatology or related to skin and complexion. This can be a very difficult area to navigate with the number of cosmeceuticals and prescription meds available today. We will take a look at what is the pathogenesis of acne and how to logically prescribe meds and make OTC recommendations. This is a must for anyone in the general medicine field.

Hey Doc, What’s Up With My Scaly Red Scalp? Part 1 & 2 (Rx=.25hr) Over 750,000 people in the US are plagued with psoriasis and the number is steadily growing. This has also led to a explosion of new prescription meds available for therapy. Come along for this educational ride and learn the fundamentals of the disease and how to effectively diagnose and treat.

I Love The Sun Part 1 & 2 (Rx=.75hr) This is going to be a 2-hour tour of the understanding of skin cancers and the appropriate procedures to secure the diagnosis. Procedures are a large part of dermatology. This course will not only explain the complexity of skin cancer but how to biopsy and treat if necessary. Come along for this fun filled ride and there will be no unexpected shipwrecks along the way. Sorry, there will be no visits from Ginger or MaryAnn either.


Day 4 — Knocking Your Noggin: What is in Your Toolbox
Allan Platt, PA-C, MMSc, DFAAPA

Sickle Cell & Thalassemia Management According to the WHO, sickle cell disease and thalassemia are the most common genetic causes of anemia worldwide. Pain is the most common manifestation of sickle cell disease in addition to organ infarction, increased infections, anemia and stroke. The epidemiology, pathophysiology, laboratory diagnosis, and management will be discussed. Both sickle cell and thalassemia cause complications from chronic anemia and decreased hemoglobin production. Transfusions, iron overload chelation, stem cell transplants and gene therapy are management options.

Best Medical Apps for Your Smartphone Medical Apps have the potential to reduce medical errors, save clinician time looking up medical information, and improve evidence based medical care. Smart phones are the equivalent convenient bedside computers for reference. Active learning modalities are the most effective teaching tool for adult learners. Each patient encounter is a learning opportunity for practicing PAs using evidence based, point of care reference tools to actively learn every day in clinical practice. Several excellent apps are available to allow 2-minute look-ups with every patient throughout the clinical workflow. A method of lifelong learning using short information lookups at the bedside will be introduced.

How to Give Bad News the Good Way Clinician’s must deliver bad news to patients and family members on a daily basis. The patient/family receiver determines what is bad news so the clinician must be sensitive to deliver news with planning, compassion and empathy. Doing this correctly can improve patient and family emotional response, improve rapport, and reduce distress. Several methods to deliver information the best way will be demonstrated.

A Mnemonic Approach to the Medical History A complete medical history can determine the patient diagnosis in 70 – 80% of cases. Documentation of a complete history also improves the encounter coding for improved billing. A simple mnemonic approach will be presented to assist providers in completing a thorough and systematic history. A mnemonic approach to formulating a differential diagnosis for common patient presentations will be reviewed.


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