Jeffrey Berns's guest appearances

Jeffrey Berns

Medicare Nation

Melissa Joy Dobbins

Steven Loomis

Alan Grayson

Peter Fitzgerald

Anne Fredericton

Curtis Bailey

Vincent Bufalino

Jim Jenson

OwlTail

Welcome, Medicare Nation! March is National Kidney Disease Awareness Month, so I’ve invited Dr. Jeffrey Berns on Medicare Nation. Dr. Berns is the president of the National Kidney Foundation and a professor of medicine and pediatrics at the Perelman School of Medicine at the University of Pennsylvania and the Associate Chief of the Renal Electrolyte and Hypertension Division. He is also the director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education. Dr. Berns is a busy and dedicated physician, and I’m grateful he is taking the time to inform us about kidney disease today!  Give the listeners an idea of the prevalence of kidney disease in the US.  One in three people are at risk for kidney disease, while one in nine already has some level of kidney disease. Chronic kidney disease is measured in stage 3, 4, and 5. Stage 5 is the level at which dialysis or a transplant is required. Throughout your lifetime, it’s important to avoid exposure to things that can damage the kidneys, and that includes many prescription medications.  Is it correct to say that kidney disease if most often a “silent” disease?  It is similar to high blood pressure, which is also an important risk factor for kidney disease. Kidney disease is asymptomatic until permanent damage is done. Some tests can reveal the disease to a doctor, but patients don’t often have symptoms until it’s late in the game.  What is the difference between a nephrologist and an urologist?  A nephrologist is a physician with specialized training in medical diseases of the kidney, while a urologist is trained in surgical diseases of the kidney and urinary tract.  What are signs and symptoms that would indicate late stage kidney disease?     Protein in the urine in large amounts Swelling of the feet, hands, legs, and face High blood pressure Fatigue Difficulty concentrating Sexual dysfunction Loss of appetite Metallic taste in the mouth     When should people see their doctor about kidney disease?  We all have to be aware of the risk. Most older people are at increased risk, and minorities are at a higher risk. If kidney disease is in the family history, then the risk is higher. Diabetes increases the risk, but many cases of mild kidney disease can be managed quite well by a primary care physician.  Wouldn’t it be a good idea to check blood levels for patients at yearly checkups?  That would be the perfect time and opportunity for routinely-done tests. Your doctor can monitor you for any change over time, and you can ask your doctor if you have signs of chronic kidney disease.  The National Kidney Foundation has partnered with MACC (Medicare Advantage Care Coordination) Task Force, aligned with 35 leading patient-care providers for patients with multiple disorders. Tell us more about MACC.  Many patients with kidney disease also have other issues. MACC allows for their care to be more cohesive and patient-centered instead of fragmented care coordination.  What can listeners do to improve care coordination?  Make sure each of your doctors are communicating with each other. Most providers have electronic patient records that every doctor can see. Patients should remind each of their physicians to send their medical records to their primary physician. Your Primary physician is in charge of coordinating your care. Provide your Primary physician with a list of your other providers names and phone numbers. Carry a list of up-to-date medications to every doctor.  How is Care Coordination utilized with different types of Medicare Plans ?  Original Medicare provides the most freedom in seeking physicians with no referrals. Lack of communication between physicians causes fragmented care, with no care coordination. Medicare Advantage Plans include networks of physicians, with required referrals to see specialists. This allows continuity and greater communication in care coordination. Medicare Advantage Plans are continually trying to improve payment models and care coordination. Here are several steps individuals should follow to improve care coordination:  Know your risk factors. Talk to your primary care doctor and have screening tests. Carry a list of medications with you. Keep a list of numbers and names of care providers. Make sure your plan has care coordination tools.    Learn more about Kidney Disease, find helpful resources and support on the National Kidney Foundation's website Visit www.kidney.org for more information. To learn more about the Medicare Advantage Care Coordination Task Force : Visit www.medicarechoices.org Do you have questions or feedback? I’d love to hear it! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here) Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com

Welcome, Medicare Nation! March is National Kidney Disease Awareness Month, so I’ve invited Dr. Jeffrey Berns on Medicare Nation. Dr. Berns is the president of the National Kidney Foundation and a professor of medicine and pediatrics at the Perelman School of Medicine at the University of Pennsylvania and the Associate Chief of the Renal Electrolyte and Hypertension Division. He is also the director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education. Dr. Berns is a busy and dedicated physician, and I’m grateful he is taking the time to inform us about kidney disease today! <ul> <li>Give the listeners an idea of the prevalence of kidney disease in the US.</li> </ul> One in three people are at risk for kidney disease, while one in nine already has some level of kidney disease. Chronic kidney disease is measured in stage 3, 4, and 5. Stage 5 is the level at which dialysis or a transplant is required. Throughout your lifetime, it’s important to avoid exposure to things that can damage the kidneys, and that includes many prescription medications. <ul> <li>Is it correct to say that kidney disease if most often a “silent” disease?</li> </ul> It is similar to high blood pressure, which is also an important risk factor for kidney disease. Kidney disease is asymptomatic until permanent damage is done. Some tests can reveal the disease to a doctor, but patients don’t often have symptoms until it’s late in the game. <ul> <li>What is the difference between a nephrologist and an urologist?</li> </ul> A nephrologist is a physician with specialized training in medical diseases of the kidney, while a urologist is trained in surgical diseases of the kidney and urinary tract. <ul> <li>What are signs and symptoms that would indicate late stage kidney disease?</li> </ul> <ul> <li>Protein in the urine in large amounts</li> <li>Swelling of the feet, hands, legs, and face</li> <li>High blood pressure</li> <li>Fatigue</li> <li>Difficulty concentrating</li> <li>Sexual dysfunction</li> <li>Loss of appetite</li> <li>Metallic taste in the mouth</li> </ul> <ul> <li>When should people see their doctor about kidney disease?</li> </ul> We all have to be aware of the risk. Most older people are at increased risk, and minorities are at a higher risk. If kidney disease is in the family history, then the risk is higher. Diabetes increases the risk, but many cases of mild kidney disease can be managed quite well by a primary care physician. <ul> <li>Wouldn’t it be a good idea to check blood levels for patients at yearly checkups?</li> </ul> That would be the perfect time and opportunity for routinely-done tests. Your doctor can monitor you for any change over time, and you can ask your doctor if you have signs of chronic kidney disease. <ul> <li>The National Kidney Foundation has partnered with MACC (Medicare Advantage Care Coordination) Task Force, aligned with 35 leading patient-care providers for patients with multiple disorders. Tell us more about MACC.</li> </ul> Many patients with kidney disease also have other issues. MACC allows for their care to be more cohesive and patient-centered instead of fragmented care coordination. <ul> <li>What can listeners do to improve care coordination?</li> </ul> Make sure each of your doctors are communicating with each other. Most providers have electronic patient records that every doctor can see. Patients should remind each of their physicians to send their medical records to their primary physician. Your Primary physician is in charge of coordinating your care. Provide your Primary physician with a list of your other providers names and phone numbers. Carry a list of up-to-date medications to every doctor. <ul> <li>How is Care Coordination utilized with different types of Medicare Plans ?</li> </ul> Original Medicare provides the most freedom in seeking physicians with no referrals. Lack of communication between physicians causes fragmented care, with no care coordination. Medicare Advantage Plans include networks of physicians, with required referrals to see specialists. This allows continuity and greater communication in care coordination. Medicare Advantage Plans are continually trying to improve payment models and care coordination. Here are several steps individuals should follow to improve care coordination: <ul> <li>Know your risk factors.</li> <li>Talk to your primary care doctor and have screening tests.</li> <li>Carry a list of medications with you.</li> <li>Keep a list of numbers and names of care providers.</li> <li>Make sure your plan has care coordination tools.</li> </ul> Learn more about Kidney Disease, find helpful resources and support on the National Kidney Foundation's website Visit <a href="http://www.kidney.org/" rel="nofollow" target="_blank">www.kidney.org</a> for more information. To learn more about the Medicare Advantage Care Coordination Task Force : Visit <a href="http://www.medicarechoices.org/" rel="nofollow" target="_blank">www.medicarechoices.org</a> Do you have questions or feedback? I’d love to hear it! email me: <a href="mailto:support@themedicarenation.com">support@themedicarenation.com</a> Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (<a href="https://itunes.apple.com/us/podcast/death-series-part-3-living/id1031060767?i=353068553&amp;mt=2" rel="nofollow" target="_blank">Click here)</a> Find out more information about Medicare on Diane Daniel’s website! <a href="http://www.callsamm.com/" rel="nofollow" target="_blank">www.CallSamm.com</a>

1 in 3 Americans are at risk for Kidney Disease. Dr. Jeffrey Berns shares prevention and awareness tips to avoid kidney disease.

Welcome! My guest today is Dr. Jeffrey Berns, who is the president of the National Kidney Foundation. He is a professor of Medicine and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Burns is the Associate Chief of the Renal, Electrolyte, and Hypertension Division and the Director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education. Dr. Berns addresses the following aspects of kidney disease and its risks:  What is the National Kidney Foundation (NKF), its mission, and your role? The central office is in NY, but there are offices around the country, each manned by a wonderful staff. Dr. Berns’ role is to talk about the NKF, kidney disease and be a spokesperson and advisor to the board. The mission of the NKF is to help those with chronic kidney disease (CKD) identify the diseases. About 80% of kidney function can actually be lost to CKD with no noticeable symptoms! The NKF also focuses on education about CKD, risk factors, and causes, and research to identify treatments and cures. What are the most common risk factors for CKD? One out of three adults is at risk, and up to 10% may already have CKD but be unaware of it. The most common causes are high blood pressure and diabetes; these diseases cause over 60% of all CKD that requires dialysis or transplant. Family history is a risk factor, as well as minority ethnicity and being over age 60. The ethnicity risk is tied to some socioeconomic factors and some genetic markers that seem to predispose African-Americans to CKD. Kidney disease is an important disease and is under-recognized in the US. For patients with hypertension or diabetes, what tests can be done to screen for kidney disease? The most common tests are a blood test called a Serum Creatinine Level to test kidney function and a urine test to detect protein in the urine. Simply assessing urine output is not an accurate indicator. Are urinary tract infections (UTI’s) a determinant in CKD? These infections are not really a risk factor, but recurrent kidney stones and kidney infections may be precursors to CKD. How would someone know if they have CKD? Blood and urine tests are the only way to detect the disease until symptoms advance to a very serious stage. Discolored urine and swelling of the feet and ankles may be symptoms. The blood and urine tests are most commonly done at the ER and doctors’ offices in conjunction with other exams and other issues. What kinds of resources are available through the NKF? Visit their website at www.kidney.org. You will find information there about the prevention of kidney disease as well as information about kidney function, tests, organ donation, and transplantation. NKF Cares is the patient information Helpline, available in English and Spanish. The website also includes a Peer Support program for patients, information about insurance, and My Food Coach, which has nutritional guidelines. How does Medicare coverage factor into CKD? Those over age 65 are already at higher risk for kidney disease, and Medicare is the primary payer for those patients. A co-pay of 20% is required unless you have co-insurance, and most services are covered under Medicare Part B. For people under 65, coverage is a little trickier. After 30 months, Medicare becomes the primary provider for those on dialysis, but the rules vary according to the type of dialysis that people require. Medicare coverage kicks in immediately for transplant patients, but only lasts three years. The NKF is working to change those coverage limits. For kidney donors, are exact matches required? Kidneys are matched with compatible blood types. An identical sibling is an ideal match, but any living donor is preferred over a deceased donor. Family members, friends and co-workers can be donors. How good is the function of only one kidney if you’ve become a donor? Potential donors are extensively screened to assure a very low risk for future kidney disease. There are small risks, as with any surgical procedure, but the remaining kidney will adapt and actually increase its function after the removal of one kidney. What is the name of a kidney specialist? A kidney specialist is called a “nephrologist,” not to be confused with a urologist, who is a surgeon specializing in the urinary tract. A nephrologist has studied internal medicine and chosen to specialize in kidney diseases and treatments. Visit the NKF website for more information about becoming a donor or a volunteer. You may also call 1-855-NKF-CARES.  Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)   Find out more information about Medicare on Diane Daniel’s website!  www.CallSamm.com

Welcome! My guest today is Dr. Jeffrey Berns, who is the president of the National Kidney Foundation. He is a professor of Medicine and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Burns is the Associate Chief of the Renal, Electrolyte, and Hypertension Division and the Director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education. Dr. Berns addresses the following aspects of kidney disease and its risks: <ul> <li>What is the National Kidney Foundation (NKF), its mission, and your role? The central office is in NY, but there are offices around the country, each manned by a wonderful staff. Dr. Berns’ role is to talk about the NKF, kidney disease and be a spokesperson and advisor to the board. The mission of the NKF is to help those with chronic kidney disease (CKD) identify the diseases. About 80% of kidney function can actually be lost to CKD with no noticeable symptoms! The NKF also focuses on education about CKD, risk factors, and causes, and research to identify treatments and cures.</li> <li>What are the most common risk factors for CKD? One out of three adults is at risk, and up to 10% may already have CKD but be unaware of it. The most common causes are high blood pressure and diabetes; these diseases cause over 60% of all CKD that requires dialysis or transplant. Family history is a risk factor, as well as minority ethnicity and being over age 60. The ethnicity risk is tied to some socioeconomic factors and some genetic markers that seem to predispose African-Americans to CKD. Kidney disease is an important disease and is under-recognized in the US.</li> <li>For patients with hypertension or diabetes, what tests can be done to screen for kidney disease? The most common tests are a blood test called a Serum Creatinine Level to test kidney function and a urine test to detect protein in the urine. Simply assessing urine output is not an accurate indicator.</li> <li>Are urinary tract infections (UTI’s) a determinant in CKD? These infections are not really a risk factor, but recurrent kidney stones and kidney infections may be precursors to CKD.</li> <li>How would someone know if they have CKD? Blood and urine tests are the only way to detect the disease until symptoms advance to a very serious stage. Discolored urine and swelling of the feet and ankles may be symptoms. The blood and urine tests are most commonly done at the ER and doctors’ offices in conjunction with other exams and other issues.</li> <li>What kinds of resources are available through the NKF? Visit their website at <a href="http://www.kidney.org" rel="nofollow" target="_blank">www.kidney.org</a>. You will find information there about the prevention of kidney disease as well as information about kidney function, tests, organ donation, and transplantation. NKF Cares is the patient information Helpline, available in English and Spanish. The website also includes a Peer Support program for patients, information about insurance, and My Food Coach, which has nutritional guidelines.</li> <li>How does Medicare coverage factor into CKD? Those over age 65 are already at higher risk for kidney disease, and Medicare is the primary payer for those patients. A co-pay of 20% is required unless you have co-insurance, and most services are covered under Medicare Part B. For people under 65, coverage is a little trickier. After 30 months, Medicare becomes the primary provider for those on dialysis, but the rules vary according to the type of dialysis that people require. Medicare coverage kicks in immediately for transplant patients, but only lasts three years. The NKF is working to change those coverage limits.</li> <li>For kidney donors, are exact matches required? Kidneys are matched with compatible blood types. An identical sibling is an ideal match, but any living donor is preferred over a deceased donor. Family members, friends and co-workers can be donors.</li> <li>How good is the function of only one kidney if you’ve become a donor? Potential donors are extensively screened to assure a very low risk for future kidney disease. There are small risks, as with any surgical procedure, but the remaining kidney will adapt and actually increase its function after the removal of one kidney.</li> <li>What is the name of a kidney specialist? A kidney specialist is called a “nephrologist,” not to be confused with a urologist, who is a surgeon specializing in the urinary tract. A nephrologist has studied internal medicine and chosen to specialize in kidney diseases and treatments.</li> <li>Visit the NKF website for more information about becoming a donor or a volunteer. You may also call 1-855-NKF-CARES.</li> </ul> Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (<a href="https://itunes.apple.com/us/podcast/death-series-part-3-living/id1031060767?i=353068553&amp;mt=2" rel="nofollow" target="_blank">Click here)</a> Find out more information about Medicare on Diane Daniel’s website! <a href="http://www.callsamm.com/" rel="nofollow" target="_blank">www.CallSamm.com</a>