Steven Kalkanis MD

New Issue Out!!!! Read our latest published articles in World Journal of Nephrology and Urology https://lnkd.in/gxzhtfFD

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Download the summit outcomes report #digitalhealth

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University of Michigan Health professional on alternatives to insomnia drugs Link: https://lnkd.in/ennk5TYV If you have trouble sleeping at night, you’re not alone. Millions struggle with insomnia. Some turn to medication to turn off their brains. A sleep psychologist at the University of Michigan Health says drugs that help you sleep are not the only answer. “Prescriptions for sleep aids have doubled over the past 20 years. The problem is that over time, with repeated use of sleep aids, the effects on sleep can wane. And so, what we know is that alternative treatments or treatments like cognitive behavioral therapy, when used in addition to medications or instead of medications, is that that can be a more durable approach, where the sleep tends to improve over time, and the sleep improvements can last longer,” said Sleep Psychologist Dr. Deirdre Conroy, PhD. Cognitive Behavioral Therapy for sleep is now considered the frontline treatment for insomnia. However, Dr. Conroy says there aren’t enough sleep medicine providers to meet the demand. #sleep #insomnia #sleephealth #health #healthcare #sleep2024 #sleeptrends #sleepapnea #cpap #osa #hme #CBTi

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I first heard about the impact of private equity in medicine at the @AmerMedicalAssn  HOD meetings in Chicago.  Colleagues from diverse medical specialties openly discussed the challenges they were facing when their practices were operating under a private equity model.  They voiced their concerns about patient care and health outcomes in addition to workforce stability.  Recently @AlzAssociation #AAIC2024 meeting, my colleagues and I from the GEAR network ( https://lnkd.in/gXugPrWg ) highlighted some of these concerns as we discussed the increasing use of disease modifying drugs for Alzheimer’s disease and the potential for adverse events ( i.e. ARIA) - that may result in an emergency department (ED) visit.  We highlighted important issues regarding patients presenting to the ED who may be experiencing an adverse event. ·      Is the ED, its physicians, and healthcare teams, equipped and ready for potential visits from patients who may be having an adverse event on while on these drugs? ·      Are the communication channels in place with all members of the workforce to ensure safe health outcomes in this changing environment? Read More: https://lnkd.in/gjruHXe4  - “The Profit-Obsessed Monster Destroying American Emergency Rooms,” - and you decide. 

I first heard about the impact of private equity in medicine at the @AmerMedicalAssn  HOD meetings in Chicago.  Colleagues from diverse medical specialties openly discussed the challenges they were facing when their practices were operating under a private equity model.  They voiced their concerns about patient care and health outcomes in addition to workforce stability.   Recently @AlzAssociation #AAIC2024 meeting, my colleagues and I from the GEAR network ( https://lnkd.in/eEm6q2q3 ) highlighted some of these concerns as we discussed the increasing use of disease modifying drugs for Alzheimer’s disease and the potential for adverse events ( i.e. ARIA) - that may result in an emergency department (ED) visit.   We highlighted important issues regarding patients presenting to the ED who may be experiencing an adverse event.  ·      Is the ED, its physicians, and healthcare teams, equipped and ready for potential visits from patients who may be having an adverse event on while on these drugs?  ·      Are the communication channels in place with all members of the workforce to ensure safe health outcomes in this changing environment? Read More: https://lnkd.in/eTU-dkzr  - “The Profit-Obsessed Monster Destroying American Emergency Rooms,” - and you decide. 

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My next Signal takes a closer look at the latest antitrust probe into large dialysis companies and the shifting role of non-competes in kidney care. A recent POLITICO article provides helpful background around topics like NCAs in dialysis and impacts on the adoption of home dialysis technologies. This is an important discussion, so I'd love to hear from you. If you have something you'd like to share, whether it's an anecdote, comment or question for other readers, please leave a comment or send me a message. H/t to Tom Mueller for sharing the article last week. https://lnkd.in/e95a23JF

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The Michigan Health & Hospital Association (MHA) released a new episode of the MiCare Champion Cast exploring the current and future role of artificial intelligence (AI) in healthcare. The episode features Bruce Brandes, president of Care.ai, and Monica Holmes, a PhD candidate in bioinformatics at the University of Michigan and member of the MHA AI Task Force. Brandes and Holmes discuss the longstanding use of smart technologies in data analysis, disease diagnosis, radiology, clinical documentation, and language processing. Brandes, with over 30 years of experience, emphasizes the urgent need for strategic planning in AI adoption. Both experts agree that AI aims to optimize workflows, improve healthcare quality, advance diagnostics, and enhance medical research rather than replace human roles. Holmes highlights AI's academic benefits, leading to better research and improved patient outcomes. The episode also covers patient and provider responses to AI tools, addressing transparency, health equity, regulation, and cybersecurity concerns. Care.ai, an MHA endorsed business partner, uses AI-enabled smart sensors to monitor clinical and operational workflows in real-time, improving challenges like fall prevention, pressure injury prevention, and hand hygiene compliance. #aiinhealthcare With the Specialist combines artificial intelligence with a board certified neurologist to enhance neurological care in the primary care setting, bringing the neurology consult to the primary care provider. #withthespecialist #neurology #innovation https://lnkd.in/g9rgeevs https://lnkd.in/gExrwg2P

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We need to keep learning and improving in #healthcare. We need to share (and publish) creative care models that work well, and work #together across teams, historic silos, and locations to help our patients, communities, and each other. 📌 This is a fantastic overview of a virtual care connection model with specialists and local teams working together to care for patients. ➡️ “The clinical consultation took place in the local clinic facility, with the support of the on-site team.” ➡️ “Laboratory testing and imaging studies were coordinated through community settings, and tertiary site–based surgical, health psychology, and nutritional teams also followed up with this patient via virtual care clinic visits.” ➡️ “By providing these clinical services closer to the patient’s home through a clinical facility, numerous objectives were achieved: (1) patients received thorough clinical assessment and care plans; (2) patients were less likely to use the hospital or ED; (3) patients were more likely to remain in the workforce; and (4) community health care was off-loaded, reducing burnout and improving workforce retention.” ➡️ “This approach combines virtual care with a cooperative care delivery model, where the aim is not to shift patient care from one provider to another, but to expand access for patients and to create both new and clinically appropriate care for each care participant, with the aim that improved access will lead to enhanced care outcomes and more efficient care utilization.” #StrongerTogether #CrossTeamCollaboration #PatientCenteredCare

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Current evidence on and recommendations for management of gallstone pancreatitis. ja.ma/3LoAWA3 https://lnkd.in/e3CEHids

Increased alveolar volume and lung diffusion capacity in preterm infants randomized to two extra weeks of continuous positive airway pressure. In a recent study, Dr. Cindy McEvoy and colleagues present the findings from a six-month follow-up after discharge compared to their earlier research published in 2019 (PMID: 31519441). The original study enrolled infants born ≤ 32 GA who required at least 24 hours of respiratory support via CPAP. Once these infants were stable and no longer in need of respiratory support, they were randomized to be weaned off CPAP (dCPAP) or to continue receiving CPAP (eCPAP) for an additional two weeks. Functional residual capacity (FRC) was assessed in both groups using the nitrogen washout technique at the time of randomization, at the conclusion of the two-week extended CPAP treatment, and upon discharge. Results indicated that infants in the eCPAP group experienced a significant increase in FRC compared to those in the dCPAP group, both from randomization to the end of the two-week therapy (12.6 ml vs. 6.4 ml, p<0.03) and at discharge (27.2 ml vs. 7.1 ml, p<0.01). In this follow-up study, the authors employed a similar design but extended the follow-up period to compare alveolar volume (VA) and diffusion lung capacity (DLCO) between the two groups at six months corrected gestational age. A total of one hundred infants were randomized into either the intervention or control groups. Successful measurements of VA and DLCO were obtained for 93 out of 99 infants (46 in the dCPAP group and 47 in the eCPAP group). There were no significant differences in GA, birth weight, sex, or race between the groups. Consistent with the original study findings, the new study revealed that FRC was significantly greater in the eCPAP group compared to the dCPAP group at both the end of the two-week treatment period and at discharge. Furthermore, VA was significantly higher in the eCPAP group (492 ± 185) compared to the dCPAP group (412 ± 149), and DLCO was also significantly elevated in the eCPAP group (3.4 ± 1.1) versus the dCPAP group (2.8 ± 0.9). The authors concluded that given that premature infants often experience impaired alveolarization and vascularization, the observed increases in VA and DLCO may enhance respiratory health and improve lung function trajectories. This study is currently under review for publication in peer-reviewed journal. These findings contribute to our understanding at the Bubble CPAP Institute and may elucidate results published in PMID: 31952073, which suggested that the improved incidence of chronic lung disease (CLD) in infants treated with bubble CPAP can be partly attributed to prolonged bubble CPAP use until the weaning of respiratory support. Dr. Cindy T. McEvoy will be a guest speaker at the Bubble CPAP and Non-Invasive Respiratory Management Conference and Workshop, taking place in Washington, DC, on December 7-8, 2024. Register today at https://lnkd.in/e2UjTk3B

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Advanced prostate cancer specialists: you don't want to miss this! Register below to join our team in Chicago for what's sure to be an informative discussion on the management of #mCRPC. #LUGPA24 #LUGPA #pcsm

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I am thrilled to report that our cardiometabolic program, Statin Overprescribing Solution (S.O.S) has successfully registered with the United States Patent and Trademark Office (USPTO). This program is: ⌛ Delivered virtually over 12 weeks 👥 Group format 💯 Uses digital biomarkers 🫀 Based on the ALARA principle: As Low As Reasonably Achievable Do you offer a cardiometabolic program for your patients? Many of these patients are scouring the internet looking for solutions, especially those who are statin averse and wish to lower their risk through lifestyle modification. If you are not currently offering cardiometabolic solutions to help your patients, and are sending them out with a statin Rx that they are not filling or using, you are undertreating them. Lets explore if this program can up level your practice or organization, and save you $$$$ while providing patients with comprehensive integrative cardiovascular care. This is Holistic Cardiology for the Age of AI, happening now. Chat with us: https://lnkd.in/eXZKzBH2 #precisioncardiology #integrativemedicine #personalizedhealth #digitalbiomarkers #statins

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Here we go. Pitching novel approaches for confirming the utility of our novel anti-viral (anti-Ebola) compounds! (Love novelty…)

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Private equity has a role, but too often, it's exploiting healthcare. The WSJ highlights how these firms inflate costs, impacting patients and providers alike. In anesthesia, we witness this daily. We must champion investments that prioritize patient care over profit margins. It's time for leadership that demands ethical practices and safeguards our profession from those looking to make a quick buck. https://lnkd.in/e_akBuWV #Leadership #Anesthesia #Healthcare #PrivateEquity #EthicalInvesting

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Managing AFib should also address managing AFib risk factors. In the ARREST-AF trial, aggressive management of AF risk factors using a tailored, physician-led approach significantly reduces recurrence of AFib at 12 months vs usual care. Dr. Pathak and I discuss results of the ARREST-AF trial: https://lnkd.in/gub-Cd75

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Join me tomorrow, December 11th, at 8:00 AM PST (11:00 AM EST) for McVey Seminars’ webinar on 2025 E/M Updates! 📅 Don’t miss this opportunity to stay ahead of the changes. 👉 Register here: https://lnkd.in/gPdBgapB #McVeySeminars #TerryTuesday #WebinarWednesday

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Meet Amruti Borad and Jessica Taylor; part of the solution... of helping healthcare be a better place to work! I was honored to meet Amruti in person recently, as she presented her amazing TEDx talk, "Why we lie to our doctors (and on a first date)"! Amruti is a concierge family physician, and a coach who emphasizes supporting medical students. Jessica offers professional coaching and business development, consulting with physicians and clinicians who want to start a side business or work with a hospital. Amruti shares, "I went through my own 'burnout' journey, and I found a way to stay in medicine, and that's what I really focus on helping other people do. I feel like there's always a path that you can take, as long as you are willing to ask for help!" Jessica agrees that there are so many paths forward, and career options for physicians! Jessica's path led her to facilitating meetings where she was "leading with curiosity, letting people discover and uncover their issues, and brainstorm their own solutions." That is coaching! Amruti and Jessica are bright lights in the certified coaching and healthcare space! Reach out to them if you would like to explore coaching support. They are both so smart, warm, and easy to talk to; you'll love to meet them! website links in the comments section #physicianadvocacy #physicianwellness #physicianburnout #healthcare #burnoutprevention #physiciangrowth #physicianjourney #physiciancare #physicianempowerment #physicianwellbeing

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