Healthcare Musings

The True Meaning of The Word “Respect”

Tue, 23 Jun 2026 04:00:00 -0500

Traditionally, the word “respect” means “high regard.” When we delve into its Latin root, however, we get a much deeper understanding. For me, it has changed my behavior.

This week’s episode is a reflection on last week’s amazing conversation with Marion Spears Karr.

Episode Link: https://www.healthcaremusings.com/taking-gratitude-from-habit-to-ritual-my-conversation-with-marion-spears-karr/

Taking Gratitude From Habit to Ritual: My Conversation With Marion Spears Karr

Tue, 16 Jun 2026 04:00:00 -0500

As leaders, do we thank our teams sincerely? Or is it simply a habit without any purpose or meaning?

My conversation with Marion Spears Karr, CEO of Inflow Executives and founder of the Authentic Gratitude Communication Framework (AGCF) Program, really brought home those questions to me as a leader.

Marion Spears Karr on LinkedIn: https://www.linkedin.com/in/marionspearskarr

Weighed Down By Grief Over She Who Is “Weightless”

Tue, 09 Jun 2026 04:00:00 -0500

On June 7, 2009 my eldest daughter, Bayan, died from complications of lymphoma. Ever since that day, there have been songs that have helped me deal with the grief of her loss. I call them, “The Soundtrack of my Grief.” The song I reflect on here is “Weightless,” by Natasha Bedingfield.

Song on Apple Music: https://music.apple.com/us/album/weightless-less-is-more-version/402882140?i=402882221

AI, The Compass, The Hype, and The Parking Brake: My Conversation with Dr. Bobby Dubois

Tue, 02 Jun 2026 04:00:00 -0500

Will AI replace all Doctors? How good is the medical literature? What about the hype in Medicine today? I asked these and many more questions of Dr. Bobby Dubois, and our conversation was insightful and illuminating.

Dr. Bobby's Podcast: https://drbobbylivelongandwell.com/

**Please note: There was a problem with the audio in the first third of the recording, which I tried to fix as best I could. Apologies for the glitch.**

Dr. H's Verbal Hassaboluses: We've Come Full Circle on Notes That Say Nothing

Tue, 26 May 2026 04:00:00 -0500

When I first started practicing, progress notes in the medical record said nothing because physicians did not write legibly. Now, we have multi-page progress notes that are legible and also say nothing. Why are we still here?

Dr. H’s Verbal Hassaboluses: Residents and Fellows: PLEASE Stop Writing System-Based Notes Right Now

Tue, 19 May 2026 04:00:00 -0500

This is the first in a new series of soliloquies by Dr. Hassaballa called “Dr. H’s Verbal Hassaboluses.”

And for the very first one, he advises Residents and Fellows to PLEASE stop writing system-based notes.

The Tension Between The Academy and The Community: My Conversation With Dr. Scott Matson

Tue, 12 May 2026 04:00:00 -0500

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 Clinician-Scientist at the University of Kansas. Our conversation was very enlightening.

Dr. Matson’s Substack: https://substack.com/@behindtheslides

My Covid Reflection: Six Years Ago Today

Thu, 07 May 2026 04:00:00 -0500

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.

Healing The Sick Care System: My Conversation With Gil Bashe

Tue, 28 Apr 2026 04:00:00 -0500

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 Matter."

I sat down with Gil Bashe to discuss his book on this week's episode of Healthcare Musings. It was as informative as it was therapeutic for me as a physician.

Gil Bashe on LinkedIn: https://www.linkedin.com/in/gilbashe/

Book: https://www.amazon.com/Healing-Sick-Care-System-People/dp/1613431805

Is Sepsis Even A Disease?: My Conversation With "The Thoughtful Intensivist"

Tue, 21 Apr 2026 04:00:00 -0500

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" is flawed, and this is why he continuously rails against the Surviving Sepsis Campaign.

I have been following his work for quite some time, and so I thought it was high time to have him on the show and explain himself.

Our conversation was eye-opening.

The Thoughtful Intensivist Substack: https://thethoughtfulintensivist.substack.com/

"We The Patients" Are Really Pissed Off: My Conversation with Matthew Zachary

Tue, 14 Apr 2026 04:00:00 -0500

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 now.

On this week's episode, I sat down with Matthew Zachary, patient advocate and all around amazing guy. Our conversation affected me in profound ways.

Learn more about Matthew Zachary at www.matthewzachary.com

2026 Sepsis Guidelines: The 17 Strong Recommendations Everyone Needs to Know

Tue, 07 Apr 2026 04:00:00 -0500

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

2026 Sepsis Guidelines: What Changed & What Has Not — Dr. Hassabolus Vindicated Again

Wed, 01 Apr 2026 15:57:38 -0500

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

The Why of CDI: Why Doctors Need to Care

Tue, 24 Mar 2026 04:00:00 -0500

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 CDI.

In reality, Doctors need to care about this stuff. In this episode, Dr. Hassaballa explains why.

Article on physician subsidies: https://www.beckershospitalreview.com/finance/the-rising-cost-of-physician-subsidies-in-10-numbers/

Obesity or Malnutrition: Document It Every Time It’s There

Tue, 17 Mar 2026 00:00:00 -0500

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 must always be documented.

GLIM Criteria: https://www.espen.org/education/glim

Fear and the COVID Response: A Conversation with Dr. Joseph Marine

Tue, 10 Mar 2026 04:00:00 -0500

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 could have been done differently, and the future of public health responses. Gain expert perspectives on fear, masking, vaccines, and trust in health authorities.

Dr. Marine on X: https://x.com/DrJMarine

Returning Goals of Care Conversations to Where They Belong

Tue, 03 Mar 2026 04:00:00 -0600

The hospital ED or ICU is the absolute worst place to have a goals of care conversation.

Do We Need A PCP For Everything?: My Conversation with Dr. Bobby Scott

Tue, 24 Feb 2026 04:00:00 -0600

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 subject of this week's episode on Healthcare Musings.

Dr. Bobby Scott: https://substack.com/@bobbyscottmd

Sensible Medicine article: https://www.sensible-med.com/p/on-the-conservation-of-primary-care

Saving Primary Care: Dr. Colleen Smith’s Novel Idea

Tue, 17 Feb 2026 04:00:00 -0600

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 idea to help relieve the shortage.

Dr. Smith’s Substack: https://substack.com/@drcolleensmith

What’s It Really Like To Run A Hospital?: My Conversation with Ken Kaufman

Mon, 09 Feb 2026 04:00:00 -0600

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 Kaufman: https://x.com/kenkaufman12

What's the Deal With the New Dietary Guidelines? I Asked America's Cardiologist.

Mon, 02 Feb 2026 04:00:00 -0600

There has been an uproar on the part of some over the new dietary guidelines published by the government (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.

A Day in the Life of a TeleIntensivist Leader: Dr. Mirko Villanueva

Mon, 26 Jan 2026 04:00:00 -0600

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 perfect person: Dr. Mirko Villanueva of Sound Physicians. He is both a TeleIntensivist and Program Director. His insights are truly invaluable.

To know more about what it’s like to be a teleIntensivist, see my conversation with Dr. Eugene Yeh: https://www.healthcaremusings.com/a-day-in-the-life-telecritical-care-with-dr-eugene-yeh/

Acute Hypoxic Respiratory Failure: Decoding What It Is (and Isn’t) in the Face of Denials.

Mon, 19 Jan 2026 04:00:00 -0600

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 let them get away with this when they dispute the presence of acute hypoxic respiratory failure during post-discharge DRG denials.

During this episode, Dr. Hassaballa goes into the criteria of acute hypoxemic respiratory failure, so we can be better equipped to deal with the ever-increasing payer denials of this major co-morbid condition.

Get Off The SOFA: Winning the Fight Against Sepsis Denials

Mon, 12 Jan 2026 04:00:00 -0600

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 is crucial when fighting sepsis denials.

On this episode of the podcast, Dr. Hassaballa discusses this crucial fact to help hospitals and other providers fight these ever increasing sepsis denials.

Article link: https://jamanetwork.com/journals/jama/fullarticle/2492881

Leadership, Compassion, and the Future of AI in Critical Care: My Appearance on the Becker's Healthcare Podcast

Mon, 05 Jan 2026 04:00:00 -0600

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 me as I look ahead to 2026.

The Soundtrack of My Grief: "You Are The Piece of Me I Wish I Didn't Need"

Tue, 30 Dec 2025 04:00:00 -0600

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 new series on Healthcare Musings: "The Soundtrack of My Grief," where I discuss those songs that have helped me cope with her death.

The first song upon which I will reflect is "Clarity," by Zedd.

Song link: https://music.apple.com/us/song/clarity-feat-foxes/1440861976

Can AI Chatbots Make End-of-Life Decisions?

Mon, 22 Dec 2025 04:00:00 -0600

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. I was so intrigued by the possibility that I sat down with Dr. Muhammad Aurangzeb Ahmad, Resident Fellow at the Harborview Medical Center (UW Medicine). He is also Affiliate Assistant Professor in the Department of Computer Science at University of Washington Bothell and Affiliate Faculty member at Responsible AI Systems and Experiences, University of Washington.

One of his main focuses of research is LLMs and end of life. It was a fascinating conversation.

Metabolic Encephalopathy: Essential Guide to Accurate Documentation

Mon, 15 Dec 2025 04:00:00 -0600

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 it is present. In this episode, Dr. Hassaballa discusses this diagnosis and provides essential tips on how to properly document this condition.

The Sepsis Confusion: SIRS, SOFA, and CDI…Oh My!!!

Mon, 08 Dec 2025 04:00:00 -0600

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 constitute sepsis? Does CMS mandate a specific definition of sepsis? What about SOFA scores?

We delve into all of this and more. The panel for this episode is:

I learned a lot, and it has definitely affected my approach to patients with sepsis in the ICU. It has also further spawned future episodes about sepsis, so stay tuned.

Seeing Healthcare From 30,000 Feet: My Conversation with Scott Becker

Mon, 01 Dec 2025 04:00:00 -0600

Scott Becker, Founder and Publisher of Becker's Healthcare, 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 for all
Healthcare Quality
Healthcare Cost
Healthcare Access

We delved into each during this fantastic conversation.

More People Are Turning To AI Chatbots: How Doctors Can Properly Deal With This

Mon, 24 Nov 2025 04:00:00 -0600

The NY Times had an article detailing how people are turning to chatbots because they are frustrated with the medical system. As a physician and patient myself, I completely sympathize with both groups. We need to fix this problem.

In this episode, Dr. Hassaballa

Summarizes the NY Time article (linked below)
Explains why this phenomenon occurs
Suggests what physicians need to do about this fact.

NY Times article: https://www.nytimes.com/2025/11/16/briefing/meet-dr-chatgpt.html?unlocked_article_code=1.2U8.wvrB.zA5xQrxE6LSR&smid=url-share

Is American Healthcare Doomed To Be A Zero Sum Game?: My Conversation With Jeff Alter

Mon, 17 Nov 2025 06:00:00 -0600

Insurance payers have the money. Providers - hospitals and doctors - want the money. This seems to be an irreconcilable conflict. Is there a middle way?

I asked the perfect person this question: Jeff Alter of Sound Physicians. His insights were invaluable.

Jeff Alter on Linkedin: https://www.linkedin.com/in/jeffreydalter/

Sound Physicians: www.soundphysicians.com

“Poof, It’s Sepsis”: Are Doctors Using AI To Inappropriately Bill Patients?

Mon, 10 Nov 2025 06:00:00 -0600

There is a growing battle between payers and providers, each using AI to get the most money. Are doctors and hospitals using these tools inappropriately?

Articles:

AI by Doctors: https://www.statnews.com/2025/08/20/ai-scribe-use-doctors-health-insurance-bills-may-rise/

AI by Insurers: https://www.statnews.com/2025/10/31/health-insurer-ai-fights-hospital-ai-coding-billing/

Revolutionizing The Care Economy: My Conversation With Neal Shah of CareYaya

Mon, 03 Nov 2025 06:00:00 -0600

One of the most challenging aspects of our healthcare system is elder and sick care at home. Who can do it? How can you afford it? It can cause enormous stress.

Neal Shah, CEO of CareYaya, knows this challenge firsthand, and he came up with a brilliant solution that will, in my mind, revolutionize the care economy. I sit down with Neal and hear all about it.

Company: www.careyaya.org

Neal Shah: https://www.linkedin.com/in/neal-shah-careyaya/

Using AI To Become a "10x Doctor": My Conversation with Eiman Abdelmoneim

Mon, 27 Oct 2025 06:00:00 -0500

How will Artificial Intelligence affect physicians? Will it take their jobs? Will it kill all of humanity? There are so many questions with respect to AI and healthcare, and so I had the perfect guest on to get answers to all of these important questions.

Eiman Abdelmoneim on LinkedIn: https://www.linkedin.com/in/eimanabdelmoneim/

Women in Medicine: Challenges and Opportunities

Mon, 20 Oct 2025 06:00:00 -0500

I sat down with three amazing women leaders in the Medical field - Dr. Chia-Shing Yang, Dr. Simran Matta, and April Burke PA - and had a wide-ranging conversation about the challenges facing women in medicine and leadership, and the opportunities they have as well. This is, by far, one of my most favorite episodes.

“Surgical Consultation Recommended”

Mon, 13 Oct 2025 06:00:00 -0500

I understand why so many Radiologists put this phrase in their reports. It can frequently make things worse, and this is one of the many bad things fear of a malpractice suit has wrought.

What’s The Deal With Potassium In The ICU

Mon, 06 Oct 2025 04:35:45 -0500

No matter which ICU in which I work, I am asked to keep the potassium levels more than 4. Is there any evidence for this?

“They Don’t Make Them Like They Used To”: My Conversation With Dr. Richard Abrams

Mon, 29 Sep 2025 06:00:00 -0500

I have railed against some traits and trends of new students and residents these days. My conversation with one of my teachers, Dr. Richard Abrams, taught me a valuable lesson and made me change my attitude.

The Travesty of “Verbal Denials”

Sun, 21 Sep 2025 20:00:00 -0500

If an insurance payer denies a claim, and we write an appeal. The very least the payer must do is write a letter in response.

Honoring Our EVS Colleagues

Thu, 18 Sep 2025 12:11:00 -0500

This is Environmental Services Week, where we honor a crucial member of the healthcare community: those who clean hospital rooms.

Your First Impression Is Your Only Impression

Sun, 14 Sep 2025 20:00:00 -0500

Patients frequently base their relationships with Doctors on their first impression. And research shows that our attire has a lot to do with that first impression. On this week's episode, Dr. Hassaballa reviews the latest evidence on Physician attire and the patient-physician relationship.

Article: https://bmjopen.bmj.com/content/15/8/e100824

“A Day In The Life”: Telecritical Care With Dr. Eugene Yeh

Sun, 07 Sep 2025 20:00:00 -0500

What’s it like to be a Teleintensivist? I asked one of the best in the business, Dr. Eugene Yeh of Sound Physicians. He gives us an intimate view of being a remote critical care specialist.

Dr. Yeh on LinkedIn:

https://www.linkedin.com/in/eugene-yeh-39ba1844/

Mixed Feelings On Prior Authorization in Traditional Medicare

Sun, 31 Aug 2025 15:16:55 -0500

CMS unveiled the WISeR Model, a pilot of prior authorization for traditional Medicare beneficiaries. I have mixed feelings about it.

NYT Article:

https://www.nytimes.com/2025/08/28/health/medicare-prior-approval-health-care.html?smid=nytcore-ios-share&referringSource=articleShare

CMS Press Release: https://www.cms.gov/priorities/innovation/innovation-models/wiser

Americans Are Drinking Less: That’s Amazing News!

Sun, 24 Aug 2025 21:25:38 -0500

Gallup’s recent poll showed that Americans are drinking alcohol at the lowest rate ever. This is something that should be celebrated.

Poll Link: https://news.gallup.com/poll/693362/drinking-rate-new-low-alcohol-concerns-surge.aspx

What Doctors Can Do That AI Cannot

Sun, 10 Aug 2025 19:00:00 -0500

Artificial Intelligence can’t get get tired. Artificial Intelligence can’t get burned out. Artificial Intelligence can do a lot. There are things, however, that Doctors do that AI can’t.

Limiting Student Loans: Penny Wise, Pound Foolish

Sun, 27 Jul 2025 18:00:00 -0500

Limiting student loans for professional schools is so horribly shortsighted. Dr. Hassaballa explains why.

AI Has Eliminated Your Job As A Radiologist, Right?: My Conversation With Dr. Safwan Halabi

Sun, 13 Jul 2025 12:15:22 -0500

Not too long ago, some predicted that Artificial Intelligence will render Radiologists obsolete. So, I sat down with Dr. Safwan Halabi, Associate Professor of Radiology at Northwestern University and Vice-Chair of Imaging Informatics at Lurie's Children's Hospital, and asked him about the effect of AI on his field now and in the future. This conversation was one of my absolute favorites.

Dr. Halabi on LinkedIn: https://www.linkedin.com/in/safwanhalabi/

The Freedom Fighters of Medicine

Sat, 05 Jul 2025 10:50:23 -0500

On July 1, new doctors start their residency. On July 4, our nation celebrates its independence. This is fitting because, truly, we in the medical field are fighting for the freedom of our patients.

Is a Mean Arterial Pressure of 65 Harmful in Septic Shock?

Mon, 23 Jun 2025 09:31:32 -0500

Typically, we titrate Vascopressors to a mean arterial pressure of 65. Does this harm patient with septic shock? Dr. Hassabolus goes over the literature.

The Vindication Of Dr. Hassabolus

Mon, 16 Jun 2025 00:00:00 -0500

I am clearly in the aggressive fluid resuscitation camp for patients who present with septic shock or sepsis-induced hypotension. And I have been vindicated by the literature.

CLASSIC: https://www.nejm.org/doi/full/10.1056/NEJMoa2202707

CLOVERS: https://www.nejm.org/doi/full/10.1056/NEJMoa2212663

CHEST Review: https://journal.chestnet.org/article/S0012-3692(23)00637-2/fulltext

ESICM Guidelines: https://pubmed.ncbi.nlm.nih.gov/40163133/

Do Doctors Gaslight Their Patients?: My Conversation with Dr. Chailee Moss

Sun, 08 Jun 2025 22:00:00 -0500

I was taken aback by the term, "Medical Gaslighting," used in this recent article. So, I sat down with the principal author and discussed the article and its larger implications beyond Gynecology.

Article link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711

Are All Plaintiff Attorneys Bad People?: My Conversation With Dr. Jeff Willis

Mon, 02 Jun 2025 06:00:00 -0500

A malpractice lawsuit can be very stressful for physicians - it sure was stressful for me. So, are all plaintiff attorneys bad people? What about those physicians who are expert witnesses for plaintiffs? I asked this and much more of Dr. Jeff Willis, an Emergency Medicine physician who left bedside practice to do medical legal consulting full time. It was an eye-opening conversation.

Dr. Willis' Consulting Firm: https://ocmedlegal.com/

Expert Retainer: https://www.expertretainer.com/

How To Do The SEP-1 Bundle Right

Tue, 27 May 2025 06:00:00 -0500

Like it or not, compliance with the SEP-1 Bundle is here to stay, despite its questionable effect on outcomes. We can either rail against it or learn to how do it well. In this episode, to culminate Critical Care Awareness Month, Dr. Hassaballa shares tips on how to achieve good results with the SEP-1 bundle.

The Man Behind PulmCCM: Great Minds in Medicine

Mon, 19 May 2025 06:00:00 -0500

PulmCCM is one of the best Substacks out there. So, I sat down with Dr. Matt Hoffman, Critical Care physician and creator of PulmCCM to discuss his journey and evidence-based medicine in general.

Substack Link: www.pulmccm.org

When Death Comes To The Intensivist: https://www.sensible-med.com/p/when-death-comes-to-the-intensivist

Tips For A Good Night’s Sleep

Mon, 12 May 2025 06:00:00 -0500

In the last episode of the “Sleep in the ICU” series, Dr. Hassaballa goes through several easy tips to help get a good night’s sleep.

American Academy of Sleep Medicine Tips: https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/

I Was A Nurse For A Day: It Wasn’t Pretty

Mon, 05 May 2025 06:00:00 -0500

Dr. Hassaballa tells the story of when he filled in as a Tele-ICU Nurse. It wasn’t a pretty picture, and it highlights how important nurses truly are to the healthcare field.

A very Happy Nurses Week to every nurse in the world! There is no “care” in healthcare without nurses.

Sleep In The ICU: The Guidelines and What We Should Do

Mon, 28 Apr 2025 06:00:00 -0500

In Part 2 of the Sleep in the ICU series, Dr. Hassaballa discusses the SCCM guidelines with respect to sleep in critically ill adults and what we should do in the ICU.

SCCM Guidelines: https://www.sccm.org/clinical-resources/guidelines/guidelines/guidelines-for-the-prevention-and-management-of-pa

SCCM Update: https://sccm.org/clinical-resources/guidelines/guidelines/focused-update-padis-guideline

"They Don't Make Them Like They Used To": My Conversation with Dr. Adam Cifu

Mon, 21 Apr 2025 06:00:00 -0500

Dr. Adam Cifu is an award-winning Medical Educator and general internist at the University of Chicago. He also writes for the fantastic Substack, Sensible Medicine. I had a wonderful conversation with him about Medical Education and how it has changed and not changed over the years.

Dr. Cifu's books: https://www.adamcifu.com/books

Sensible Medicine Substack: https://www.sensible-med.com/

Sleep in the ICU: The Classic Experiments

Mon, 14 Apr 2025 06:00:00 -0500

In the first of a two-part series about sleep in the intensive care unit, Dr. Hassaballa discusses the classic sleep deprivation studies and their implications on our own sleep.

Every Measles Death Is Too Many

Wed, 09 Apr 2025 07:13:21 -0500

Unless one has lost a child, then he or she can never know the horror of the parents who just lost a child to measles in Texas.

For the latest on the Texas Measles Outbreak: https://www.dshs.texas.gov/news-alerts/measles-outbreak-2025

Faith in the ICU: Stories of Wonder

Wed, 02 Apr 2025 14:48:30 -0500

In the latest installment of the Faith in the ICU Series, Dr. Hassaballa recounts a story that has always stayed with him.

ICU Lecture Series: The ICU Liberation Bundle

Mon, 24 Mar 2025 06:00:00 -0500

In this latest episode of the ICU Lecture Series, Dr. Hassaballa lectures to staff about the ICU Liberation Bundle.

Link: https://sccm.org/clinical-resources/iculiberation-home/abcdef-bundles

What Is A Blood Transfusion, Truly?

Mon, 17 Mar 2025 06:00:00 -0500

Despite multiple specialty society guidelines recommending not to transfuse blood if the hemoglobin levels are above 7-8 g/dL, many physicians disregard the recommendations. Why is that? Dr. Hassaballa discusses this issue.

Article referenced in the show: https://www.pulmccm.org/p/guidelines-on-red-cell-transfusion

ICU Lecture Series: Metabolic Acidosis

Mon, 10 Mar 2025 07:00:00 -0500

In this latest ICU lecture series, Dr. Hassaballa discusses metabolic acidosis: how to diagnose it and what to do about it.

Great Minds in Medicine: Dr. Elaine Chen

Mon, 03 Mar 2025 07:00:00 -0600

What would someone who is BOTH a Critical Care and Palliative Care Doctor say about palliative care in the ICU? I asked one.

Links from the show:

The Coleman Palliative Medicine Training Program: https://colemanpalliative.org/

Research Articles referenced in the episode:

Norton SA, Hogan LA, Holloway RG, Temkin-Greener H, Buckley MJ, Quill TE. Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients. Crit Care Med. 2007;35(6):1530-1535. doi:10.1097/01.CCM.0000266533.06543.0C
https://journals.lww.com/ccmjournal/toc/2007/06000

Braus N, Campbell TC, Kwekkeboom KL, et al. Prospective study of a proactive palliative care rounding intervention in a medical ICU. Intensive Care Med. 2016;42(1):54-62. doi:10.1007/s00134-015-4098-1
https://link.springer.com/article/10.1007/s00134-015-4098-1

Ma J, Chi S, Buettner B, et al. Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial. Crit Care Med. 2019;47(12):1707-1715. doi:10.1097/CCM.0000000000004016
https://journals.lww.com/ccmjournal/fulltext/2019/12000/early_palliative_care_consultation_in_the_medical.5.aspx

Campbell JL, Piscitello GM. Does Reframing Do Not Resuscitate to Beneficial Care Only Increase Acceptance of No-CPR Orders?. Chest. 2025;167(1):211-221. doi:10.1016/j.chest.2024.08.027
https://www.sciencedirect.com/science/article/pii/S0012369224050748?via%3Dihub

Hochberg CH, Gersten RA, Aziz KB, et al. The Real-World Effect of Early Screening for Palliative Care Criteria in a Medical Intensive Care Unit: An Instrumental Variable Analysis. Ann Am Thorac Soc. 2025;22(2):247-254. doi:10.1513/AnnalsATS.202407-702OC
https://www.atsjournals.org/journal/doi/full/10.1513/AnnalsATS.202407-702OC

Piscitello GM, Lamadrid VJ, Post Z, et al. The Effect of Triggered Palliative Medicine Consults on Nurse Moral Distress in the Medical Intensive Care Unit. Am J Hosp Palliat Care. 2022;39(9):1039-1045. doi:10.1177/10499091211049398
https://journals.sagepub.com/doi/full/10.1177/10499091211049398

From the Appeals Desk: Coding Clinics and Sepsis

Mon, 24 Feb 2025 20:31:32 -0600

Many payers state that a 2016 Coding Clinics article allows them to deny sepsis DRGs. This is not true, and Dr. Hassaballa goes into the article and what is specifically says about sepsis. And, he issues an unequivocal condemnation of the murder of Brian Thompson.

Great Minds in Medicine: Dr. Sergio Zanotti

Mon, 17 Feb 2025 07:00:00 -0600

In the latest installment of the "Great Minds in Medicine" series, I sit down with Dr. Sergio Zanotti, Critical Care Chief Medical Officer for Sound Physicians. We had a wide-ranging discussion about medicine, critical care, and healthcare in general. It was, perhaps, one of my favorite conversations.

Discussed during the podcast:

The Ventilator (Hidden Brain Podcast): https://hiddenbrain.org/podcast/the-ventilator/

The Diving Bell and the Butterfly (book): https://en.wikipedia.org/wiki/The_Diving_Bell_and_the_Butterfly

Faith in the ICU: Does Being a Physician Weaken My Faith?

Mon, 10 Feb 2025 07:00:00 -0600

Given that physicians frequently make life and death decisions, especially in the ICU, does being a physician weaken one's faith? Dr. Hassaballa reflects on his own experience of faith and being a doctor.

Most Oncologists Do Not Refer to Palliative Care. What?

Mon, 03 Feb 2025 07:00:00 -0600

Despite a strong recommendation by the American Society of Clinical Oncology in its guidelines, recent surveys indicate very few, if any at all, Oncologists refer patients to Palliative Care. This is a huge disservice.

Great Minds in Medicine: Dr. Mohammad Alo

Mon, 27 Jan 2025 07:00:00 -0600

I sit down with Dr. Mohammad Alo, America's Cardiologist and great friend of mine, and we discuss all things cholesterol and social media best practices for Doctors.

Dr. Mohammad Alo on X: https://x.com/MohammedAlo

Website: dralo.net/links

What If An Unresponsive Patient Is Actually "In There"?

Mon, 20 Jan 2025 07:00:00 -0600

Recent research shows that a substantial minority of patients have cognitive motor dissociation. This has many important implications for our practice of critical care medicine.

NEJM Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2400645

NY Times Column: https://www.nytimes.com/2025/01/11/opinion/covert-consciousness-unresponsive-brain.html

Journal Club: Is Rapid Correction of Hyponatremia Dangerous?

Mon, 13 Jan 2025 07:00:00 -0600

Dr. Hassaballa discusses this recent review article and meta-analysis of the correction rate of hyponatremia and clinical outcomes.

Journal Club: Small-bore vs Large-bore Chest Tube for Hemothorax

Mon, 06 Jan 2025 07:00:00 -0600

In this episode of Journal Club, Dr. Hassaballa discusses the recent study comparing small-bore to large-bore chest tubes for hemothorax drainage.

Happy Birthday, Booboo.

Mon, 30 Dec 2024 07:00:00 -0600

Daddy misses you so much.

Faith in the ICU: Doctors Should Not Shy Away

Mon, 23 Dec 2024 07:00:00 -0600

In a new series on Healthcare Musings, Dr. Hassaballa discusses faith in the ICU and how Doctors should not shy away from faith. It can be an added asset in the right circumstance.

Journal Club: Long Term Oxygen Therapy

Mon, 16 Dec 2024 07:00:00 -0600

A recent study showed that you don’t need oxygen all day, every day. That’s welcome news for patients needing chronic oxygen.

Social Media For Doctors: A Conversation with Austan Lundeen

Mon, 09 Dec 2024 07:00:00 -0600

Marketing is literally in Austan Lundeen’s blood. So, I sat down with him to get tips on how to best use social media as a clinician.

Why We Vaccinate Against Measles

Mon, 02 Dec 2024 07:00:00 -0600

This highly contagious virus can absolutely kill children.

Journal Club: IV vs. IO in Cardiac Arrest

Mon, 25 Nov 2024 07:00:00 -0600

A study showed no difference between IV and IO access in cardiac arrest. Yet, I have some questions.

Study link: https://www.nejm.org/doi/full/10.1056/NEJMoa2407616

Great Minds in Medicine: Dr. Vivek Tirmal

Mon, 18 Nov 2024 07:00:00 -0600

Insurance companies will use obscure “Coding Clinics” articles to deny various DRGs. I asked appeal expert Dr. Vivek Tirmal of Sound Advisory Services all about this.

Beware the Potential Dangers of Cannabis

Mon, 11 Nov 2024 07:00:16 -0600

As cannabis use becomes more widespread, and more potent, clinicians need to be aware of its potential harms.

NY Times article cited in show: https://www.nytimes.com/2024/10/04/us/cannabis-marijuana-risks-addiction.html?smid=nytcore-ios-share&referringSource=articleShare

Go Out And Vote

Mon, 04 Nov 2024 07:00:39 -0600

If we clinicians are not at the table, then we will be on the menu.

“Reducing Waste” in Healthcare

Mon, 28 Oct 2024 07:00:15 -0500

If we provide care consistent with our patients’ values and preferences, we are good stewards of scarce resources and provide compassionate effective care. Sign up below to get every episode in your email: http://eepurl.com/i1xuH2

Great Minds in Medicine: Dr. Greg Johnson

Mon, 21 Oct 2024 07:00:00 -0500

In this next podcast in the “Great Minds in Medicine” series, I sit down with Dr. Greg Johnson, Chief Physician Executive at Unity Point Health. We discuss the state of healthcare and healthcare equity.

Unequal Treatment (2003): https://nap.nationalacademies.org/catalog/12875/unequal-treatment-confronting-racial-and-ethnic-disparities-in-health-care

Ending Unequal Treatment (2024): https://www.nationalacademies.org/our-work/unequal-treatment-revisited-the-current-state-of-racial-and-ethnic-disparities-in-healthcare

Subscribe below to get every episode in your email:

http://eepurl.com/i1xuH2

How Patients and Their Families Can Prevent Clinician Burnout

Mon, 14 Oct 2024 22:05:11 -0500

It is very small and goes a very long way…

Journal Club: Replacing Serum Potassium

Mon, 07 Oct 2024 07:00:00 -0500

In this latest Journal Club episode, Dr. Hassaballa discusses an article about potassium replacement after cardiac surgery. Could this be the beginning of a more sensible potassium replacement protocol?

Study link: https://jamanetwork.com/journals/jama/fullarticle/2823246

Know Your Sepsis

Mon, 30 Sep 2024 07:00:00 -0500

As we conclude Sepsis Awareness Month, Dr. Hassaballa discusses how the definition of sepsis changes depending on which insurance company the patient uses.

PLEASE Don’t Do THIS To Prevent Food Poisoning!

Mon, 23 Sep 2024 07:00:32 -0500

Some say drinking alcohol may prevent food poisoning. Umm…not really.

Raising Awareness of Physician Suicide

Tue, 17 Sep 2024 12:42:04 -0500

September 17 is Physician Suicide Awareness Day. I’ve seen the face of physician suicide, and it is devastating.

Great Minds in Medicine: Dr. Rob Bessler

Mon, 16 Sep 2024 07:30:16 -0500

Dr. Rob Bessler, CEO of Honest Health and Founder of Sound Physicians, talks with Dr. Hassaballa about where healthcare in America needs to go.

Sepsis Beware

Fri, 13 Sep 2024 08:30:00 -0500

In honor of Sepsis Awareness Month, Dr. Hassaballa remind us to always be on the lookout for sepsis, which can manifest as a variety of conditions.

Get Your Living Will Done Today

Wed, 04 Sep 2024 19:39:00 -0500

In this episode, Dr. Hassaballa discusses the utmost importance of having advanced directives in place now, when you’re healthy and of sound mind.

Living Will Link: https://www.legalzoom.com/marketing/estate-planning/living-will

Healthcare Power of Attorney: https://legaltemplates.net/form/lt/medical-power-of-attorney/

Great Minds in Medicine: Dr. Rob Zipper

Mon, 26 Aug 2024 08:00:00 -0500

With the continuing decrease in physician reimbursement from CMS, Dr. Hassaballa has a conversation with Dr. Rob Zipper, CMO of Advisory Services of Sound Physicians.

Links mentioned in episode:

Dartmouth Atlas: https://data.dartmouthatlas.org/

Documentation Rules: https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf

CPT: https://www.ama-assn.org/press-center/press-releases/ama-new-2023-cpt-code-set-includes-burden-reducing-revisions

Journal Club: Preoxygenation Prior To Intubation

Tue, 20 Aug 2024 14:35:00 -0500

Dr. Hassaballa discusses a recent study about using noninvasive ventilation for preoxygenation prior to intubation.

Study link: https://www.nejm.org/doi/full/10.1056/NEJMoa2313680

My Advice For Those Starting Medical School

Thu, 15 Aug 2024 10:16:00 -0500

Dr. Hassaballa shares advice for those students starting medical school.

Reflections on the Olympic Games

Mon, 05 Aug 2024 08:00:00 -0500

As the 2024 Summer Olympic Games enter their final week, Dr. Hassaballa reflects on how wonderful it is to watch.

The Battle Against An Ignoble Death

Wed, 31 Jul 2024 08:00:00 -0500

Just as important as battling critical illness, the battle against an ignoble death is crucial in the ICU. Dr. Hassaballa reflects.

The Battles I Wage In The ICU

Thu, 25 Jul 2024 08:00:00 -0500

As an Intensivist, I wage multiple battles in the ICU. In this latest episode, I reflect on what those battles are.

Stress Ulcer Prophylaxis - What’s the Evidence?

Wed, 17 Jul 2024 05:10:00 -0500

In this latest episode of Journal Club, Dr. Hassaballa discusses the latest evidence regarding stress ulcer prophylaxis.

Article link: https://www.nejm.org/doi/full/10.1056/NEJMoa2404245

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

WTF, CMS?

Thu, 11 Jul 2024 20:41:00 -0500

CMS has proposed another cut in physician reimbursement. Really?

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Nursing Chalk Talk

Wed, 03 Jul 2024 08:00:00 -0500

Dr. Hassaballa discusses a devastating case of toxic shock syndrome, and its pathology and pathophysiology.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Documentation and Litigation

Mon, 24 Jun 2024 08:00:00 -0500

In this latest lecture in his ICU Lecture series, Dr. Hassaballa delves into the contentious realm of litigation and how to mitigate its specter.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Nights in the ICU - Part 4

Mon, 17 Jun 2024 08:00:00 -0500

In Part 4 of his series "Nights in the ICU," Dr. Hassaballa discusses acute stroke, blood pressure management, SATs, and what a true crystalloid bolus is.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

An ICU Doctor Reflects On Father’s Day

Fri, 14 Jun 2024 08:00:00 -0500

Dr. Hassaballa reflects on what it means to be an ICU Doctor and a father.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Cicadapocolypse 2024 and Human Disgust

Mon, 10 Jun 2024 08:00:00 -0500

In this video episode of Healthcare Musings, Dr. Hassaballa shares how he is totally grossed out by cicadas and then reflects over the biology of human disgust.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

A Tribute to Bayan

Fri, 07 Jun 2024 09:28:00 -0500

Today, 15 years ago, my eldest daughter Bayan died after a brutal battle with cancer. And so, today, I wear pink at work in honor of her memory.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Journal Club: Adverse Events From The Covid Vaccine

Mon, 03 Jun 2024 08:00:00 -0500

In this latest installment of Journal Club, Dr. Hassaballa discussed a large study of COVID vaccines and adverse events of special interest.

Study link: https://www.sciencedirect.com/science/article/pii/S0264410X24001270

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

”The Job Picks the Person”

Tue, 28 May 2024 08:00:00 -0500

Continuing my series for Critical Care Awareness and Recognition Month, I have a conversation with my colleague, partner, and friend about why we chose Critical Care Medicine.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Critical Care Awareness and Recognition Month: A Conversation I Had With Credentialing Specialists

Mon, 20 May 2024 08:00:00 -0500

May is Critical Care Awareness and Recognition Month. I kick off a series of conversations about why Critical Care with a group of Credentialing Specialists.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Towards Patient and Family Centered Care

Mon, 13 May 2024 08:00:00 -0500

Dr. Hassaballa interviews patient experience executive and patient advocate Dominic Kayatta about a negative experience of a family whose loved one died in the ICU. The patient's family gave us permission to share this story, and we are eternally grateful. Thank you.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

There is No ”Care” in Healthcare Without Nurses

Tue, 07 May 2024 12:29:00 -0500

Dr. Hassaballa expresses his appreciation and gratitude to Nurses everywhere. Happy Nurses Week 2024!

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

ICU Nights - Part 3

Mon, 06 May 2024 08:23:00 -0500

In this third installment of his lecture series on nights in the ICU, Dr. Hassaballa discussed arrhythmias and abnormal laboratory studies at night.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Never Take People’s Trust For Granted

Wed, 01 May 2024 09:14:00 -0500

A recent KFF poll indicated that 95% of people, across party lines, trust physicians for accurate health information. This must never be taken for granted.

Link to poll: https://jamanetwork.com/journals/jama/fullarticle/2818265

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

In Defense of the Noncompete Clause

Thu, 25 Apr 2024 09:08:00 -0500

The FTC has just issued a ruling banning noncompete clauses in employment contracts with some exceptions. I think there is much more nuance than the FTC Chair is making it out to be.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Don’t Skimp on Your Sleep

Mon, 22 Apr 2024 08:00:00 -0500

A new Gallup poll, published April 19, 2024, shows that more Americans feel they do not get enough sleep each night. In this latest episode, Dr. Hassaballa - a Board-certified Sleep Medicine Specialist - discusses why this is so very bad for your health and wellbeing.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Journal Club: Physician Empathy and Chronic Low Back Pain

Thu, 18 Apr 2024 08:00:00 -0500

In this new series on Healthcare Musings, we discuss important journal articles in the medical literature. In this first episode of Journal Club, Dr. Hassaballa discusses this article about physician empathy and outcomes in chronic low back pain.

Article link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817441

CARE Measure: https://caremeasure.stir.ac.uk/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

From the Appeals Desk: Acute Respiratory Failure

Mon, 08 Apr 2024 08:00:00 -0500

In this latest episode in the series, "From the Appeals Desk," Dr. Hassaballa discusses acute respiratory failure and how to protect yourself and mitigate against denials of this diagnosis by insurance companies.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Getting a Job Part 4 - The Employment Agreement

Mon, 01 Apr 2024 08:00:00 -0500

You have had your interview; you have looked at the practice location; you have met the leadership and potential future coworkers. You like what you see, and you decide to accept the offer of employment. This is an exciting time, and a very crucial part comes next: the "term sheet" and employment agreement.

In this latest episode, Dr. Hassaballa talks about the employment agreement and the utmost importance of making sure you know what's inside.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Getting a Job Part 3: The Employed Model with Productivity Incentives

Mon, 25 Mar 2024 08:00:00 -0500

Continuing our series on what every Resident and Fellow needs to know about getting a job. In this episode, we explore employed models with productivity bonus or even full productivity compensation and what that means.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Cybersecurity in Healthcare: A Conversation with Matt Knox

Mon, 18 Mar 2024 08:00:00 -0500

I had a great conversation with Mr. Matt Knox, CIO of a major healthcare organization in the United States. We discussed cybersecurity and all things related to cyberattacks in healthcare.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

It’s About Time: CDC Changes COVID Isolation Guidance

Mon, 04 Mar 2024 08:30:00 -0600

Dr. Hassaballa discusses the new COVID isolation guidelines and how they make total sense.

CDC Link: https://www.cdc.gov/respiratory-viruses/prevention/precautions-when-sick.html

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Getting a Job: What Every Resident and Fellow Needs to Know - Part 2

Mon, 26 Feb 2024 08:00:00 -0600

Part 2 of the "Getting a Job" series discusses the traditional private practice model. What is it? What are the pros and cons of this increasingly uncommon practice type?

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Getting a Job: What Every Resident and Fellow Needs to Know - Part 1

Thu, 22 Feb 2024 13:35:00 -0600

Dr. Hassaballa embarks on a new series of episodes on Healthcare Musings about getting a job. First things first: if they offer you an eye-popping salary, that's a red flag.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

ICU Lecture Series: Nights in the ICU Part 2

Mon, 19 Feb 2024 08:00:00 -0600

This is part 2 of Dr. Hassaballa's lecture on common issues in the ICU at night. And it ends like it started: DON'T PANIC.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

ICU Lecture Series: Common Problems at Night in the ICU

Mon, 12 Feb 2024 08:00:00 -0600

Dr. Hassaballa gave this lecture to IM Residents about common problems they may face taking care of patients at night in the ICU.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Advice for the Match Part 2

Tue, 06 Feb 2024 08:04:00 -0600

in this latest episode, Dr. Hassaballa discusses a crucial aspect of the NRMP.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

My Advice For Students Entering the Match

Thu, 01 Feb 2024 08:00:00 -0600

As students start entering their rank order lists, Dr. Hassaballa shares advice he gives his students going into Residency.

Link: https://www.nrmp.org/match-calendars/master-calendar/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

ICU Lecture Series: ”SIMV Only Belongs in Coffee”

Wed, 24 Jan 2024 08:00:00 -0600

Synchronized Intermittent Mandatory Ventilation, or SIMV, is an older ventilator setting that we do not use anymore. In this latest ICU Lecture, Dr. Hassaballa explains why it "only belongs in coffee."

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

The ”30 Day Readmission” Denial

Tue, 16 Jan 2024 08:00:00 -0600

In this episode, Dr. Hassaballa discusses the most frustrating denial he deals with: the "30 Day Readmission" denial. It is purported to be similar to that by CMS, but this is totally false.

Reference: https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

What is the Two-Midnight Rule?

Wed, 10 Jan 2024 08:00:00 -0600

Starting in 2024, Medicare Advantage plans must follow the Two-Midnight Rule. So, it behooves all clinicians to know that this rule is and document appropriately against it.

Reference: https://www.beckerspayer.com/policy-updates/the-2-midnight-rule-and-medicare-advantage-6-things-to-know.html#:~:text=Under%20the%20final%20rule%2C%20an,necessary%20(case%2Dby%2Dcase

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

We Get Shafted Here With Our Food

Sun, 07 Jan 2024 13:45:00 -0600

Dr. Hassaballa reflects on how it is too bad that food here in the United States is so much more processed than overseas.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

If I Ever ”Found God on the Corner of First and Amistad”

Sun, 31 Dec 2023 23:00:00 -0600

Dr. Hassaballa speaks about what would have happened if he "found God on the corner of First and Amistad." It would have been so different than the interaction in the song, 'You Found Me," by The Fray.

"You Found Me" by The Fray: https://youtu.be/jFg_8u87zT0?si=YByRDT0TuLGeT9jV

“Footprints in the Sand”: https://www.umass.edu/rso/acf/Story/Footprints.htm

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

When My Daughter Became ”Weightless,” I Became the ”Owner of a Broken Heart”

Tue, 26 Dec 2023 08:00:00 -0600

In this episode, Dr. Hassaballa reflects over two of the songs God used to save his life:

"Weightless," by Natasha Bedingfield - https://youtu.be/AUxLeytLHVk?si=tYGTD8xv_JrNa2Zi

"Owner of a Lonely Heart" by Yes - https://youtu.be/SVOuYquXuuc?si=HxThkSSgOaQFQC35

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Why December is Such a Tough Month

Tue, 19 Dec 2023 08:00:00 -0600

December is a difficult month for me and my family. This is because in December, on the 30th to be exact, our eldest daughter was born in 1996. And she passed away after a brutal battle with lymphoma in June of 2009.

And to help me deal with the grief - and honor her memory - I am planning to post a number of podcast episodes talking about the songs that God used to save my life.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

“Ladies and Gentlemen, Is There a Doctor on the Plane?” - Lessons Learned

Thu, 14 Dec 2023 08:00:00 -0600

I had to tend to a sick fellow passenger recently while traveling on a plane. This incident taught me some valuable lessons.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

“Ladies and Gentlemen, Is There a Doctor on the Plane?”

Fri, 08 Dec 2023 16:36:00 -0600

Someone was ill on my flight back home from a work trip, and I recount the experience…and gratitude for being able to help.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Dr. Hassaballa is a Guest on ”Crossing the Chasm” Podcast

Thu, 30 Nov 2023 08:00:00 -0600

The original episode is here: https://soundphysicians.com/podcast-episode/?podcast_id=8173&track_id=1678458171

Check out the "Crossing the Chasm" podcast here:

Apple: https://podcasts.apple.com/us/podcast/crossing-the-chasm-with-dr-greg-johnson/id1676682379

Spotify: https://open.spotify.com/show/6uPp1Ridfcrwpa7qgjm3St?si=ABbuo0x_SIyK5lcnF06qcQ

Sound Physicians: https://soundphysicians.com/podcast/crossing-the-chasm/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Get the F@&^ Out - Part 2

Tue, 21 Nov 2023 08:00:00 -0600

It is absolutely possible to thoroughly document your patient encounter AND get out on time and go home. It is NOT mutually exclusive.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Take the Time to Document Well

Tue, 14 Nov 2023 09:04:00 -0600

It would be a travesty and a shame to have your documentation belie the truly great clinician you are. So it's high to focus on the assessment and plan, so we can really show the world the wonderful work we're doing on a daily basis.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

ICU Lecture Series: Acid Base Disorders

Wed, 08 Nov 2023 08:00:00 -0600

In this latest lecture, Dr. Hassaballa goes over acid base disorders and how to recognize them, as well as mixed acid-base disorders and chronic compensation.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Celebrating Respiratory Therapists

Wed, 25 Oct 2023 13:38:00 -0500

This week is National Respiratory Care Week (October 23-29). As an ICU medical director who works every single day hand in hand with respiratory therapists, as well as having the honor of being the Medical Director of Respiratory Therapy at the Chicago Area Hospital which serves as my base, I wanted to take some time out to really highlight the absolute importance of respiratory therapists and their role in the care of a critically ill patient.

We cannot do our jobs properly without respiratory therapists.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

We Should Abandon the Term ”DNR”

Mon, 23 Oct 2023 08:00:00 -0500

In this episode, Dr. Hassaballa discusses his feeling that the term "DNR," or "do not resuscitate, should be replaced with the term "AND," or "allow for natural death." Some institutions have adopted this change, and Dr. Hassaballa thinks this should be more widespread.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

From the Appeals Desk: Medical Necessity Denials

Mon, 09 Oct 2023 08:00:00 -0500

In this episode, Dr. Hassaballa discusses medical necessity denials: what they are and how to deal with them.

Resources:

Interqual: https://www.changehealthcare.com/clinical-decision-support/interqual

MCG: https://www.mcg.com/client-resources/news-item/mcg-27th-edition-care-guidelines/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Shock and Hemodynamics

Thu, 05 Oct 2023 10:53:00 -0500

In this episode, Dr. Hassaballa goes over the different types of shock and how to recognize their hemodynamic profiles.

Errata:

I meant to say that LVEDV is estimated by LVEDP, which is estimated by Left atrial pressure, which is estimated by pulmonary capillary wedge pressure. Also, V = IR and R = V/I.

I regret the errrors.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Get the F*^& Out…

Tue, 26 Sep 2023 08:00:00 -0500

Clinician burnout is a crisis, and it is something that needs to be addressed by everyone in leadership in healthcare. In this episode, Dr. Hassaballa shares his advice about those who feel obligated to stay after their shift is done so they don't "dump" on their partners.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

The Ruthless Monster That is Sepsis

Thu, 21 Sep 2023 21:30:00 -0500

In honor of Sepsis Awareness Month, Dr. Hassaballa recounts a case of a patient who died from sepsis in the ICU more than a decade ago, a case that has stayed with him ever since.

Resources: https://www.sccm.org/SurvivingSepsisCampaign/Home

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

To Jab or Not to Jab?

Sat, 16 Sep 2023 13:01:00 -0500

The FDA approved the latest Covid booster, and the CDC recommends everyone get it.

In this episode of the Healthcare Musings Podcast, Dr. Hassaballa shares his own thought process on whether to get the vaccine or not.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Why I Stopped Drinking Diet Coke

Mon, 11 Sep 2023 08:00:00 -0500

In this episode, Dr. Hassaballa talks about why he stopped drinking Diet Coke. And no...it has nothing do with cancer.

Links:

WHO Statement on aspartame: https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released

Microbiome and nonnutritive sweeteners: https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867422009199%3Fshowall%3Dtrue

Nonnutritive sweeteners and weight gain: https://www.cmaj.ca/content/189/28/E929

Gut-brain axis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

From the Appeals Desk: Prior Authorization Denials

Fri, 08 Sep 2023 14:09:00 -0500

Insurance company denials are terribly frustrating. There are a number of causes, and in this series, we will explore the types of denials and what we can do to mitigate them.

Resources:

"From the Appeals Desk": https://healthcaremusings.substack.com/t/from-the-appeals-desk

Association for Healthcare Appeals and Denial Management (AHDAM): https://www.ahdam.org/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Extubation With T-Piece: When and Why

Tue, 05 Sep 2023 08:00:00 -0500

Sometimes, "minimal vent settings" is not sufficient to truly test spontaneous breathing in a ventilated patient. In this episode, Dr. Hassaballa discusses why that is.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Just like the Airline Industry, Safety Has to be Nonnegotiable in Healthcare

Mon, 28 Aug 2023 08:00:00 -0500

In this episode, Dr. Hassaballa reflects over a flight delay on one of his work trips. It reminded him that compromising passenger safety for customer convenience is a nonstarter in the Airline industry. The same should be true with Medicine.

Article about medical errors: https://www.ncbi.nlm.nih.gov/books/NBK499956/

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Lectures from the ICU: Hypoxic Respiratory Failure

Mon, 21 Aug 2023 07:16:00 -0500

Dr. Hassaballa discusses hypoxic respiratory failure and oxygen delivery and why he doesn't care about pO2.

Correction: The number is 1.34 mL oxygen per gram of hemoglobin. Dr. Hassaballa regrets the error.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Lecture from the ICU: Sepsis

Mon, 14 Aug 2023 08:00:00 -0500

In this episode of Healthcare Musings podcast, we discuss sepsis: its definition and principles of management.

Relevant References:

Sepsis 3 Definition: https://jamanetwork.com/journals/jama/fullarticle/2492881

Surviving Sepsis Campaign Guidelines: https://www.sccm.org/Clinical-Resources/Guidelines/Guidelines/Surviving-Sepsis-Guidelines-2021

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

Lecture Series: Mechanical Ventilation

Wed, 09 Aug 2023 20:15:00 -0500

This lecture is about the basics of mechanical ventilation, given in the ICU on August 9, 2023.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com

The Unsustainable Math of Medicare Physician Payment Cuts

Mon, 31 Jul 2023 08:00:00 -0500

CMS is proposing another 3.34% cut in physician payments, on top of what has already been cut. The math is simply unsustainable. It is not about "greedy doctors." It is about the financial viability of medical practices. Dr. Hassaballa weighs in.

Read the accompanying article at: https://healthcaremusings.substack.com/p/the-unsustainable-math-of-medicare

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit healthcaremusings.substack.com