Healthcare Musings

Healing The Sick Care System: My Conversation With Gil Bashe

28 Apr 2026

Contributed by Lukas

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...

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

21 Apr 2026

Contributed by Lukas

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 eve...

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

14 Apr 2026

Contributed by Lukas

The healthcare system is supposed to be centered around just one person: the patient. According to Matthew Zachary, however, the healthcare system has...

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

07 Apr 2026

Contributed by Lukas

The 2026 Surviving Sepsis Guidelines were released last March in Chicago. Among the dozens of recommendations, there are 17 “strong” recommendatio...

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

01 Apr 2026

Contributed by Lukas

The new Surviving Sepsis Campaign guidelines were released late last month in Chicago.  This week’s episode highlights the most important changes...

The Why of CDI: Why Doctors Need to Care

24 Mar 2026

Contributed by Lukas

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...

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

17 Mar 2026

Contributed by Lukas

Both obesity and protein calorie malnutrition are major comorbid conditions (MCC), and they are frequent targets of post-discharge denials by payers. ...

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

10 Mar 2026

Contributed by Lukas

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,...

Returning Goals of Care Conversations to Where They Belong

03 Mar 2026

Contributed by Lukas

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

24 Feb 2026

Contributed by Lukas

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 fi...

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

17 Feb 2026

Contributed by Lukas

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 Res...

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

09 Feb 2026

Contributed by Lukas

There is a common perception that hospitals are nonstop, money making machine machines. Reality, however, it’s quite different.  In this episode,...

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

02 Feb 2026

Contributed by Lukas

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...

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

26 Jan 2026

Contributed by Lukas

Telecritical care is part of the future of Critical Care Medicine in the United States and world. There are various models of implementing TeleICU pro...

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

19 Jan 2026

Contributed by Lukas

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 < 30...

Get Off The SOFA: Winning the Fight Against Sepsis Denials

12 Jan 2026

Contributed by Lukas

Increasingly, insurance companies and third-party auditors are denying sepsis claims and DRGs based on the “Sepsis-3” article published almost 10 ...

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

05 Jan 2026

Contributed by Lukas

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 irreplace...

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

30 Dec 2025

Contributed by Lukas

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. ...

Can AI Chatbots Make End-of-Life Decisions?

22 Dec 2025

Contributed by Lukas

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 e...

Metabolic Encephalopathy: Essential Guide to Accurate Documentation

15 Dec 2025

Contributed by Lukas

Metabolic encephalopathy is a state of global cerebral dysfunction caused by systemic metabolic or toxic disturbances. Its presence raises the severit...

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

08 Dec 2025

Contributed by Lukas

There are two competing definitions of sepsis, called "Sepsis-2" and "Sepsis-3." They are vastly different, and it is causing enormous confusion with ...

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

01 Dec 2025

Contributed by Lukas

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...

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

24 Nov 2025

Contributed by Lukas

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 patie...

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

17 Nov 2025

Contributed by Lukas

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

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

10 Nov 2025

Contributed by Lukas

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

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

03 Nov 2025

Contributed by Lukas

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 enormo...

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

27 Oct 2025

Contributed by Lukas

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...

Women in Medicine: Challenges and Opportunities

20 Oct 2025

Contributed by Lukas

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 ...

“Surgical Consultation Recommended”

13 Oct 2025

Contributed by Lukas

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 fe...

What’s The Deal With Potassium In The ICU

06 Oct 2025

Contributed by Lukas

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

29 Sep 2025

Contributed by Lukas

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, ta...

The Travesty of “Verbal Denials”

22 Sep 2025

Contributed by Lukas

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

18 Sep 2025

Contributed by Lukas

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

15 Sep 2025

Contributed by Lukas

Patients frequently base their relationships with Doctors on their first impression. And research shows that our attire has a lot to do with that firs...

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

08 Sep 2025

Contributed by Lukas

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...

Mixed Feelings On Prior Authorization in Traditional Medicare

31 Aug 2025

Contributed by Lukas

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

Americans Are Drinking Less: That’s Amazing News!

25 Aug 2025

Contributed by Lukas

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

What Doctors Can Do That AI Cannot

11 Aug 2025

Contributed by Lukas

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

Limiting Student Loans: Penny Wise, Pound Foolish

27 Jul 2025

Contributed by Lukas

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

13 Jul 2025

Contributed by Lukas

Not too long ago, some predicted that Artificial Intelligence will render Radiologists obsolete. So, I sat down with Dr. Safwan Halabi, Associate Prof...

The Freedom Fighters of Medicine

05 Jul 2025

Contributed by Lukas

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 fie...

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

23 Jun 2025

Contributed by Lukas

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

The Vindication Of Dr. Hassabolus

16 Jun 2025

Contributed by Lukas

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

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

09 Jun 2025

Contributed by Lukas

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 ...

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

02 Jun 2025

Contributed by Lukas

A malpractice lawsuit can be very stressful for physicians - it sure was stressful for me. So, are all plaintiff attorneys bad people? What about thos...

How To Do The SEP-1 Bundle Right

27 May 2025

Contributed by Lukas

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 ...

The Man Behind PulmCCM: Great Minds in Medicine

19 May 2025

Contributed by Lukas

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 jo...

Tips For A Good Night’s Sleep

12 May 2025

Contributed by Lukas

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.  Americ...

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

05 May 2025

Contributed by Lukas

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 ar...

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

28 Apr 2025

Contributed by Lukas

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 shou...

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

21 Apr 2025

Contributed by Lukas

Dr. Adam Cifu is an award-winning Medical Educator and general internist at the University of Chicago. He also writes for the fantastic Substack, Sens...

Sleep in the ICU: The Classic Experiments

14 Apr 2025

Contributed by Lukas

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 imp...

Every Measles Death Is Too Many

09 Apr 2025

Contributed by Lukas

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 th...

Faith in the ICU: Stories of Wonder

02 Apr 2025

Contributed by Lukas

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

24 Mar 2025

Contributed by Lukas

In this latest episode of the ICU Lecture Series, Dr. Hassaballa lectures to staff about the ICU Liberation Bundle.  Link: https://sccm.org/clinica...

What Is A Blood Transfusion, Truly?

17 Mar 2025

Contributed by Lukas

Despite multiple specialty society guidelines recommending not to transfuse blood if the hemoglobin levels are above 7-8 g/dL, many physicians disrega...

ICU Lecture Series: Metabolic Acidosis

10 Mar 2025

Contributed by Lukas

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

03 Mar 2025

Contributed by Lukas

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:...

From the Appeals Desk: Coding Clinics and Sepsis

25 Feb 2025

Contributed by Lukas

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 w...

Great Minds in Medicine: Dr. Sergio Zanotti

17 Feb 2025

Contributed by Lukas

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 P...

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

10 Feb 2025

Contributed by Lukas

Given that physicians frequently make life and death decisions, especially in the ICU, does being a physician weaken one's faith? Dr. Hassaballa refle...

Most Oncologists Do Not Refer to Palliative Care. What?

03 Feb 2025

Contributed by Lukas

Despite a strong recommendation by the American Society of Clinical Oncology in its guidelines, recent surveys indicate very few, if any at all, Oncol...

Great Minds in Medicine: Dr. Mohammad Alo

27 Jan 2025

Contributed by Lukas

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 practic...

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

20 Jan 2025

Contributed by Lukas

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

Journal Club: Is Rapid Correction of Hyponatremia Dangerous?

13 Jan 2025

Contributed by Lukas

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

06 Jan 2025

Contributed by Lukas

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.

30 Dec 2024

Contributed by Lukas

Daddy misses you so much. 

Faith in the ICU: Doctors Should Not Shy Away

23 Dec 2024

Contributed by Lukas

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 as...

Journal Club: Long Term Oxygen Therapy

16 Dec 2024

Contributed by Lukas

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

09 Dec 2024

Contributed by Lukas

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

02 Dec 2024

Contributed by Lukas

This highly contagious virus can absolutely kill children. 

Journal Club: IV vs. IO in Cardiac Arrest

25 Nov 2024

Contributed by Lukas

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....

Great Minds in Medicine: Dr. Vivek Tirmal

18 Nov 2024

Contributed by Lukas

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

Beware the Potential Dangers of Cannabis

11 Nov 2024

Contributed by Lukas

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...

Go Out And Vote

04 Nov 2024

Contributed by Lukas

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

“Reducing Waste” in Healthcare

28 Oct 2024

Contributed by Lukas

If we provide care consistent with our patients’ values and preferences, we are good stewards of scarce resources and provide compassionate effectiv...

Great Minds in Medicine: Dr. Greg Johnson

21 Oct 2024

Contributed by Lukas

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. W...

How Patients and Their Families Can Prevent Clinician Burnout

15 Oct 2024

Contributed by Lukas

It is very small and goes a very long way…   Sign up here to get every episode of Healthcare Musings in your inbox. 

Journal Club: Replacing Serum Potassium

07 Oct 2024

Contributed by Lukas

In this latest Journal Club episode, Dr. Hassaballa discusses an article about potassium replacement after cardiac surgery. Could this be the beginnin...

Know Your Sepsis

30 Sep 2024

Contributed by Lukas

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

PLEASE Don’t Do THIS To Prevent Food Poisoning!

23 Sep 2024

Contributed by Lukas

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

Raising Awareness of Physician Suicide

17 Sep 2024

Contributed by Lukas

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

16 Sep 2024

Contributed by Lukas

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

13 Sep 2024

Contributed by Lukas

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

05 Sep 2024

Contributed by Lukas

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

Great Minds in Medicine: Dr. Rob Zipper

26 Aug 2024

Contributed by Lukas

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

Journal Club: Preoxygenation Prior To Intubation

20 Aug 2024

Contributed by Lukas

Dr. Hassaballa discusses a recent study about using noninvasive ventilation for preoxygenation prior to intubation. Study link: https://www.nejm.org/d...

My Advice For Those Starting Medical School

15 Aug 2024

Contributed by Lukas

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

Reflections on the Olympic Games

05 Aug 2024

Contributed by Lukas

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

31 Jul 2024

Contributed by Lukas

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

25 Jul 2024

Contributed by Lukas

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?

17 Jul 2024

Contributed by Lukas

In this latest episode of Journal Club, Dr. Hassaballa discusses the latest evidence regarding stress ulcer prophylaxis. Article link: https://www.ne...

WTF, CMS?

12 Jul 2024

Contributed by Lukas

CMS has proposed another cut in physician reimbursement. Really? This is a public episode. If you would like to discuss this with other subscriber...

Nursing Chalk Talk

03 Jul 2024

Contributed by Lukas

Dr. Hassaballa discusses a devastating case of toxic shock syndrome, and its pathology and pathophysiology. This is a public episode. If you would...

Documentation and Litigation

24 Jun 2024

Contributed by Lukas

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

Nights in the ICU - Part 4

17 Jun 2024

Contributed by Lukas

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...

An ICU Doctor Reflects On Father’s Day

14 Jun 2024

Contributed by Lukas

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 s...

Cicadapocolypse 2024 and Human Disgust

10 Jun 2024

Contributed by Lukas

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 huma...

A Tribute to Bayan

07 Jun 2024

Contributed by Lukas

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. T...

Journal Club: Adverse Events From The Covid Vaccine

03 Jun 2024

Contributed by Lukas

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