While we all trained at the Academy, most of the care provided to patients occurs in the Community. And it seems that, more and more, the research output from the Academy is not clinically relevant to the Community. So, I wanted to discuss this with Dr. Scott Matson, an Academic…
Six years ago, today, was the darkest day of the Covid 19 pandemic for me. And it was good for me that all my emotion came out at the time it did.
The purpose of the healthcare system is to heal the sick, and unfortunately, it seem that the system has strayed from this purpose. Gil Bashe, Chair of Global Health and Purpose for FINN Partners, reminds us of this purpose in his excellent book, "Healing the Sick Care System: Why People…
Sepsis is the number one diagnosis treated in most intensive care units across the world, and it can be very deadly in short order. Yet, is sepsis even a disease? "No," according to Dr. Rafael Olive Leite, aka, the "Thoughtful Intensivist" on Substack. According to him, the whole "sepsis epistemology"…
The healthcare system is supposed to be centered around just one person: the patient. According to Matthew Zachary, however, the healthcare system has failed miserably in its mission. Of all the voices that have been heard on this podcast, the one that hasn't been heard is that of the patient...until…
The 2026 Surviving Sepsis Guidelines were released last March in Chicago. Among the dozens of recommendations, there are 17 “strong” recommendations. In this episode, Dr. Hassaballa speaks about these 17 strong recommendations and its implications on clinical practice. Surviving Sepsis Guidelines: https://sccm.org/survivingsepsiscampaign/guidelines-and-resources/surviving-sepsis-campaign-adult-guidelines
The new Surviving Sepsis Campaign guidelines were released late last month in Chicago. This week’s episode highlights the most important changes to Dr. Hassaballa. Hint: Dr. Hassabolus is vindicated again. Read the entire guidelines here: https://www.sccm.org/survivingsepsiscampaign
Physicians’ jobs today are very hard. There are so many demands on their time, and there is not enough time in the day to do everything they need to do. So it is understandable that a busy clinician would ask “Who Cares?” When it comes to Clinical Documentation Improvement, or…
Both obesity and protein calorie malnutrition are major comorbid conditions (MCC), and they are frequent targets of post-discharge denials by payers. In this episode of Healthcare Musings, Dr. Hassaballa explains why it is so important that these diagnoses are not only documented, but why our plan to address these conditions…
It has been six years, almost to the day, since I saw my first Covid patient in the ICU. So much has changed since then. In this insightful interview, Dr. Joseph Marine, a Johns Hopkins Cardiologist and Professor of Medicine, reflects on the COVID-19 pandemic, discussing what was learned, what…
The hospital ED or ICU is the absolute worst place to have a goals of care conversation.
Primary Care is in trouble. The job is very hard, doesn’t pay as much as it should, and the numbers of PCPs is dwindling. How can we save the field? Dr. Bobby Scott has another novel idea to help reduce the burden on Primary Care Physicians. Our conversation is the…
There is a dire shortage of Primary Care Physicians, and it is projected to get even worse. We need Primary Care Physicians, and creating more Residency slots takes years to come to fruition. This week’s guest on the Healthcare Musings Podcast, Emergency Medicine physician Dr. Colleen Smith, has a novel…
There is a common perception that hospitals are nonstop, money making machine machines. Reality, however, it’s quite different. In this episode, I sit down with Mr. Ken Kaufman, a Managing Director at Kaufman Hall. He gives an eye-opening assessment of what It’s really like to run a hospital. About Ken…
There has been an uproar on the part of some over the new dietary guidelines published by the government (www.realfood.gov (http://www.realfood.gov) ). Is the uproad justified? I asked the perfect person: America's Cardiologist, Dr. Mohammed Alo (https://www.dralo.net/). We had a great conversation.
Telecritical care is part of the future of Critical Care Medicine in the United States and world. There are various models of implementing TeleICU programs, and one of them is a “hybrid” between on site and tele ICU. How can this work in the most effective manner? I asked the…
Acute hypoxic respiratory failure is diagnosed by one of these three criteria: • PaO2 less than 60 mm Hg • SpO2 less than 90% • PaO2/FiO2 ratio ＜ 300 That's it. Payers like to add all sorts of clinical criteria alongside this. This is totally wrong, and we should not…
Increasingly, insurance companies and third-party auditors are denying sepsis claims and DRGs based on the “Sepsis-3” article published almost 10 years ago. Specifically, they contend that if there is no SOFA score of 2 or greater there is no sepsis. Not so fast. The article never said that, and this…
I was honored to be a guest on the Becker’s Healthcare Podcast. During the episode, I discussed how AI is transforming clinical care; the irreplaceable human elements of medicine; and the leadership values that guide my work. I also shared insights on physician excellence, system level improvement, and what inspires…
Ever since the death of my daughter on June 7, 2009, I have written and reflected on many things that remind me of her, including many popular songs. It is one of the ways the Lord saved my life after her death. Today, on her birthday, I embark on a…
Can an AI Chatbot version of you make an end-of-life decision if you cannot make it on your own? This possibility was brought up to me on a previous episode with Eiman Abdelmoneim (https://www.healthcaremusings.com/using-ai-to-become-a-10x-doctor-my-conversation-with-eiman-abdelmoneim/) . I was so intrigued by the possibility that I sat down with Dr. Muhammad Aurangzeb…
Metabolic encephalopathy is a state of global cerebral dysfunction caused by systemic metabolic or toxic disturbances. Its presence raises the severity of illness of those patients afflicted with it, and it is a frequent denial target of payers. It is essential that clinicians document this condition in the record when…
There are two competing definitions of sepsis, called "Sepsis-2" and "Sepsis-3." They are vastly different, and it is causing enormous confusion with respect to diagnosing and coding for sepsis. I assembled a panel of experts to discuss the proper coding of sepsis. Does a UTI with fever and tachycardia really…
Scott Becker, Founder and Publisher of Becker's Healthcare (https://www.beckershospitalreview.com/) , has a unique perspective on the state of the healthcare system in the United States. So, I wanted to sit down with him and get his insights as well. He had amazing observations and thought-provoking suggestions regarding: • Healthcare Coverage…