Healthcare Musings

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

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

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.

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

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.

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

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

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"

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?

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

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.