Deep Ramachandran, MD

Deep Ramachandran is a pulmonary and critical care physician, and social media co-editor, CHEST. He blogs at the Caduceus blog and ACCP Thought Leaders, and can be reached on Twitter @Caduceusblogger.

We can’t build our way out of the ventilator shortage. But there is a solution.

Conditions

March 31, 2020

“Hey buddy, can you spare some ventilators?”

No, this is not an attempt at dark humor. This is the preamble of numerous calls that are going on across the nation right now. Whether the call is made to a ventilator manufacturer or to other medical centers, hospitals are busy stocking up on the highly technical devices that are anticipated to be in short supply. Here in North Carolina, where …

When someone is not dead but not alive

Deep Ramachandran, MD

Physician

May 9, 2018

May lay in a hospital bed, her wrinkled skin covered with sensors that monitored her every breath and heartbeat. Her husband sat at her bedside gently stroking her withering gray hair as her chest moved slowly up and down accompanied by the soft whoosh-whoosh of the ventilator that breathed for her.

He stared expectantly at her face as if at any moment she would rise and free herself from the multiple …

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When someone is not dead but not alive

The hurricane in Puerto Rico is leading a shortage in saline bags

Deep Ramachandran, MD

Physician

October 17, 2017

“Doc, you mind switching that to an oral preparation?” our clinical pharmacist inquired during multi-disciplinary rounds as intravenous infusion devices beeped annoyingly in the background. Taking care of ICU patients can be extraordinarily complicated, so doing it as part of a team helps make sure that all bases are covered.

Like many hospitals, ours uses a multidisciplinary model which makes rounds on all patients in the ICU. An ICU nurse, clinical …

Repealing Obamacare faces these 7 challenges

Deep Ramachandran, MD

Policy

January 10, 2017

Republicans have been waiting a long time for this moment. After sixty previous attempts to repeal the Affordable Care Act, commonly known as Obamacare, their moment has arrived. President-elect Trump and Speaker Ryan believe that they can repeal Obamacare and roll back the clock. It won’t happen. Here’s why.

1. Millions will lose health insurance. Pre-Obamacare, nearly 20 percent of Americans went uninsured, and this disproportionately affected lower-income levels. Those are …

There’s a good reason why doctors don’t send test results

Deep Ramachandran, MD

Physician

July 17, 2015

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Recently I read an article in the New York Times by Elisabeth Rosenthal. She’s the same author of the enlightening article, “My doctor charged me $117,000 and all I got was this lousy hospital gown.” That may not have been the exact title of the article.

Following that article she wrote a follow-up about the long and difficult ordeal …

How can we reduce firearm-related deaths? Here are 6 ways.

Deep Ramachandran, MD

Physician

May 10, 2015

Like a lot of people, I get pretty numbed to gun violence on television. I stopped watching the local news because all they seem to show is news about shootings. The general public’s perception about gun violence is that it’s always somebody else, that the person who was shot had somehow been involved in crime. The numbness we feel to gun violence often ends for most of us when things …

Television ruins your sleep. Here are 5 ways how.

Deep Ramachandran, MD

Conditions

March 24, 2015

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As a sleep physician, I spend a lot of time educating patients about what sleep is and how it works. Sleep, as I often explain, is not simply the lack of being awake; any more than landing a plane is simply the lack of flying. It’s becoming increasingly understood that sleep is an actively generated state, created by a series of …

5 tips for travelling with your CPAP

Deep Ramachandran, MD

Conditions

February 22, 2015

Sleep apnea is a condition that afflicts millions of people. There are two types of sleep apnea: central, and obstructive. Obstructive is by far the most common, and is usually what is referred to when people talk about sleep apnea. Obstructive sleep apnea occurs when, during sleep, the airway passages in the throat close and block the movement of air. Common symptoms are snoring, gasping during sleep, sleepiness during the day, …

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5 tips for travelling with your CPAP

In the airport for a routine flight. And an adventure with urine and an AED.

Deep Ramachandran, MD

Physician

January 16, 2015

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I arrived at my designated gate at Chicago’s O’Hare Airport. After handing over my crumpled boarding pass for scanning, I made my way down the jetway and onto what appeared to be a small but fairly packed little jet. Passengers on each side of the aisle eyed me as I walked past, a few noticed that my jeans were soaked from …

Should ACLS certification be mandatory?

Deep Ramachandran, MD

Physician

December 22, 2014

I can recall, though it seems quite long ago, my first basic life support (BLS) course as a first-year medical student. The instructor dutifully demonstrated on a mannequin to eager young medical students what to do if someone is found unresponsive. Shaking the unmoving mannequin she said loudly, “Sir, are you OK?” Then hearing no response she showed us how to …

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Should ACLS certification be mandatory?

The ethical dilemma of saving the American Ebola patients

Deep Ramachandran, MD

Conditions

August 18, 2014

It was with much fanfare that two American aid workers were airlifted from across the world and brought to Emory University Medical Center where they began experimental treatment for Ebola. We hope for a full and speedy recovery for them and others like them who do God’s work.

But it appears to me that lost in this conversation are myriad others who need help but never get it. Right now, humanitarian work …

When patients secretly record their doctor visits

Deep Ramachandran, MD

Physician

May 5, 2014

“Doctor, can I record this conversation?”

It’s happened to me a couple of times already. But the question above was never asked. Rather I was informed later on that my conversation with a patient or family was recorded without my knowledge. Smartphones have made it all too easy for patients to secretly record conversations with their health care providers. Simply hit a button, lay it innocently down by your side in …

The population health benefits of EMR implementation done right

Deep Ramachandran, MD

Tech

April 11, 2014

I’m back at it again, talking about my continued love/hate relationship with EMRs. From my conversations with doctors at different hospitals in our region, it seems that most docs appear to be falling into the “hate” column. Meanwhile, I’m still chugging along with the EHR that’s been installed in my office. And while it works just fine for the needs of a 3 physician single-specialty outpatient practice, it’s hardly the …

When end of life care becomes a confrontation

Deep Ramachandran, MD

Physician

December 18, 2013

How dare you!

Life can change in a heartbeat. Most of us believe that our lives, our loves and all the that things that make us who we are is a gift from a higher power. One that can be taken away as swiftly as it is given. But somewhere in the shuffle of taking kids to practice, catching up on emails, worrying about bills, and the search for the perfect …

Why I stopped working with mail order pharmacies

Deep Ramachandran, MD

Meds

October 2, 2013

Mail order pharmacies like Express Scripts and Medco have become increasingly prominent players in health care. But these companies are a lot more than simply mail order pharmacies, they are in fact a new generation of pharmacy benefit managers (PBMs). PBMs are essentially middle-men between insurance and pharmacy, with companies like Express Scripts merging the dual functions of a PBM and pharmacist into one. PBMs manage and administer medication benefits …

E-cigarettes: Are they effective? Are they safe?

Deep Ramachandran, MD

Meds

August 7, 2013

Electronic cigarettes are here, settling over the country, quite literally, like a fine white fog. Smokers in turn, have been turning to them as a tool to help them quit, though the device manufacturers are are not allowed to market them that way in U.S. It seems intuitive that a device that mimics the action of smoking but without the combustion …

Determining the prognosis of patients with pulmonary fibrosis

Deep Ramachandran, MD

Conditions

July 20, 2013

Sometimes it’s the simplest things that can make all the difference. Unfortunately, when it comes to informing patients with a new diagnosis of pulmonary fibrosis what to expect, things are anything but simple.

For years, pulmonologists have dreaded the moment when we inform patients of a diagnosis of pulmonary fibrosis. The discussion invariably involves informing them that this disease (which they have probably never heard of) may either kill them or …

Bad data: When everyone breathes at the same rate

Deep Ramachandran, MD

Physician

July 7, 2013

It was my second day of residency, and something was afoot. As I made my way around my first rotation on the cardiac floor, my medical senses were tingling. There was something strange happening to all of my patients, I saw. As I peaked over my cohort’s shoulders, I secretly saw that it was happening to their patients too, though they hadn’t seemed to notice.

Only I did, and I was …