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hshanawaniMD's profile
Hasan Shanawani MD
Hasan Shanawani MD
Hasan Shanawani MD
@hshanawaniMD

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Hasan Shanawani MD

@hshanawaniMD

Director QI at @bcbsm Medicare. prev @deptvetaffairs #HealthIT. pulm/crit, quality/ safety, medical informatics. Pres of @muslimhealth Tweets mine RT≠endorse

Ann Arbor, MI
linkedin.com/in/hshanawanimd
Joined August 2010

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    1. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      how many of you knew all this about "obs status," and getting hit with another big bill?

      19 replies 11 retweets 308 likes
      Show this thread
    2. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      Back to my dad. He's in the ER. We're pretty sure he has a broken back, but u need tests for that. EXPENSIVE tests. Cat Scans & MRIs. He can't walk. One wrong move: paralyzed. Intractable pain, can't stay awake with painkillers. No solution in ER. Can he go home? Here he is:pic.twitter.com/mbOVUnQl40

      10 replies 9 retweets 243 likes
      Show this thread
    3. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      Another thing about obs: If you meet criteria--you CAN'T BE PUT INTO OBSERVATION. If you have severe pneumonia, a heart attack, or, say, a BROKEN BACK AND POSSIBLE PARALYSIS, you can't go home. It just literally takes a click of a button by the doc.

      4 replies 12 retweets 266 likes
      Show this thread
    4. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      So the ER at this "top-ranked hospital" is doing lots of tests, calling a spine surgeon, calling cancer docs. Lots of work. And after 11 hours, they tell mom and dad: "can't send you home, broken back, you're being admitted."

      5 replies 10 retweets 204 likes
      Show this thread
    5. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      But the next morning, 24 hours after he arrived 2 the ER, 12-13hrs after "admission," a hospital staff member comes in w/ papers 4 my mom & dad: "we need you 2sign this paperwork saying u agree 2 obs status." Dad's out from pain meds. Mom was ready though...She calls me.

      7 replies 12 retweets 205 likes
      Show this thread
    6. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      this is how I'm feeling about this person right now...pic.twitter.com/ccLUxL9FSq

      2 replies 9 retweets 267 likes
      Show this thread
    7. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      but although I was born & raised in NJ, I have learned after nearly 20y in the midwest how 2b nice...until it's time 2b not nice. And it's not time to be not nice yet. & everyone deserves benefit of doubt (Thanks road house/ patrick swayze/ 80's toxic male reference...)pic.twitter.com/kIAwhq8Jln

      2 replies 10 retweets 443 likes
      Show this thread
    8. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      This is how it goes: (Me/Staff Member) (BTW I don't tell people I'm a doc or what I do--it always comes up eventually) Me: "hey thanks 4 coming. Help me understand--y isn't my dad a full admission? SM: "well he's in this thing called obs" & I get mansplained what obs is.

      4 replies 14 retweets 316 likes
      Show this thread
    9. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      Me: "thanks, I understand the obs/ admit thing. Your hospital uses interqual or MCG for admission criteria, right? What criteria 4 broken back did my dad not meet 4 admission?" ...get ready for the duel, folks...pic.twitter.com/cDyhle6JcG

      3 replies 13 retweets 426 likes
      Show this thread
    10. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      side note--Interqual & MCG are published criteria hospitals use to decide if you can admit a patient. You can't see them b/c they're subscription-only. But I see them b/c I use them every day. & dear reader, guess what I'm reading as I'm on the phone w/ said staff member...

      8 replies 15 retweets 368 likes
      Show this thread
      Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

      So, IK what you're thinking: I'm an MD An MD who understands admission process/ criteria. Who is LOOKING AT THE CRITERIA AS WE SPEAK. I'm looking at criteria. We agree he meets them. I swear-SWEAR! I'm being reeaally respectful Can't go wrong! (spoiler alert--it went wrong)

      4:51 PM - 26 Apr 2019
      • 21 Retweets
      • 354 Likes
      • 🦋Jess 🌎 Sandy RN 💙🌷💙 Gerald Leung, Perm Res of the Oh-wellian Dystopia Jules Drake E. (he/him) Amber Watson Nicole Garton Covid is airborne 😷 wear N95 or better Sam Falsetti
      2 replies 21 retweets 354 likes
        1. New conversation
        2. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          SM: "well, he's observation, so we'll send it 4 review." me: "sorry-UR (review) is 2 make sure he meets admission criteria. Last nite, we were told he did. What changed? SM: "IDK" Me: "but u can find out, right?" SM: "Well, he's obs" me: "I understand. But he met criteria"

          8 replies 11 retweets 278 likes
          Show this thread
        3. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          pic.twitter.com/bjoicWPGtC

          2 replies 6 retweets 281 likes
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        4. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          me: "I'm getting really frustrated. I'm sure you are, too. Bottom line: dad meets criteria 4 admission. We were told he's being admitted as a FULL admit. Obs was never mentioned & It's not needed. I'm instructing my family 2NOT AGREE 2 obs. So do we have 2go home now?" SM: ...

          3 replies 8 retweets 306 likes
          Show this thread
        5. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          pic.twitter.com/bezHXuIqiX

          4 replies 7 retweets 208 likes
          Show this thread
        6. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          Me: "Ok, we're not agreeing on this. The surgeon is offering surgery or a brace. What outpatient clinic can my dad get the brace?" SM: "that's not possible" me: "y didn't they do the brace in the ER?: SM: "they can't put it on--it's an inpatient thing(!)" Me: ...

          6 replies 9 retweets 266 likes
          Show this thread
        7. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          Me(trying hard--SO HARD--2b nice: "OK--I need your help here. We know one click in the computer & my dad's inpatient. I trust u2 fix this 4 my dad. My mom needs your help. It's the right thing 2 do. And I trust u. (how I'm feeling on phone:)pic.twitter.com/EkrMjo148W

          1 reply 8 retweets 450 likes
          Show this thread
        8. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          SM (leaves) *fin scene* & we wait 24 hours, while they fit my dad w/ a brace During which time he gets overdosed on narcotics, develops a condition called "hospital psychosis..." & the unit mgr calls me 2re-explain obs status & "y wont we sign the paperwork..." all in obs

          9 replies 6 retweets 279 likes
          Show this thread
        9. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          In all stories of woe, you wish a hero would just SHOW up and fix stuff. Personally, I hate that we need heroes bc the SYSTEM--that I work personally to build all day--should just work for patients. But after 6-8 hours of discussions, I was drained. I needed one.pic.twitter.com/Cr38RgpNtc

          2 replies 28 retweets 419 likes
          Show this thread
        10. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          In this story, I wish there was a hero. we got two.pic.twitter.com/jYvFQSkSNf

          2 replies 10 retweets 328 likes
          Show this thread
        11. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          The 1st was the physical therapist (PT) PT: "So I see they put u in obs 4 a broken back. I don't understand that. BUT IF I DO THIS TEST & U FAIL IT DOCTOR SHANAWANI, U AUTOMATICALLY MEET CRITERIA 4 ADMISSION." I'M GOING TO DO THIS TEST NOW, LET'S SEE IF YOU PASS IT."pic.twitter.com/lEIKgYd82q

          9 replies 20 retweets 666 likes
          Show this thread
        12. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          2nd hero... who wants to guess the letters after the name of the 2nd hero, that personally sent in the PT, who addressed my dad's pain, & who called me & talked me off the ledge, saying "this is crazy--stop worrying, THIS IS MY PROBLEM NOW."pic.twitter.com/WcgwTBIByN

          16 replies 49 retweets 1,068 likes
          Show this thread
        13. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          The palliative care nurse provided ME palliation: of my own anxiety, and handled it. She took care of me, the hospital, my DAD--like a BOSS. 1-FIND OUT WHAT THEY NEED 2-GET IT FOR THEM

          7 replies 32 retweets 1,016 likes
          Show this thread
        14. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          So despite my knowledge, skill, wealth, communication skill, literacy, assertiveness... my dad & I were helpless in a system that wasn't PATIENT CENTERED, EFFICIENT, TIMELY, EFFECTIVE. PEOPLE were, but the system--MY system! still failed.

          12 replies 96 retweets 872 likes
          Show this thread
        15. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          So, my dad got his brace, and after 2days, got a decent pain plan. The only "cure" for hospital delirium/ psychosis is GET OUT OF THE HOSPITAL AS SOON AS YOU CAN, so we brought him home. His obs got changed to a full admission. And I didn't smack anyone.

          6 replies 16 retweets 558 likes
          Show this thread
        16. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          My story isn't new--I have personally addressed this w/ 100s of patients. Since my tweet 2d ago, dozens of friends have told me similar ones. As a doc, who works 2 improve patient-centered care 4 a living, I thought, maybe we're on mile 14 of the marathon But are we on 1-2?

          8 replies 26 retweets 488 likes
          Show this thread
        17. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          Fundamentally, it's an issue of justice. & other docs (@RanaAwdish ) have literally written BOOKS on their helplessness as patients. Not every patient has me in their corner. How do we provide advocacy 4 every patient, w/o having a brilliant gorgeous doctor 4 a son?

          12 replies 38 retweets 655 likes
          Show this thread
        18. Hasan Shanawani MD‏ @hshanawaniMD 26 Apr 2019

          That's all for now. Off 2C avengers & see my dad. Follow 4 my next thread in a few weeks, when I relate how a #1 hospital in America gave my dad drugs that make your heart PUMP FASTER while he was in the middle of a heart attack* *for non-docs--that's bad. Thanks for reading!

          59 replies 35 retweets 955 likes
          Show this thread
        19. Hasan Shanawani MD‏ @hshanawaniMD 27 Apr 2019

          Hasan Shanawani MD Retweeted Hasan Shanawani MD

          UPDATE Dads story getting tremendous support, likes & retweets Your support 4 my dad got attention of @NJDeptofHealth & NJ health commissioner @ShereefElnahal 2 early 2tell, but maybe some good will come from sharing this w/ u all. THANK U GOD BLESS!https://twitter.com/hshanawanimd/status/1122343968338063360?s=12 …

          Hasan Shanawani MD added,

          Hasan Shanawani MD @hshanawaniMD
          😳 OHHHH SNAP SPIDEY FANS Dr Elnahal is a former VA quality doc, & is now the health commissioner 4 the great state of NJ. @NJDeptofHealth Everyone’s support, retweets & likes may move the needle here! Sh** just got real. On behalf of my dad & me—THANK YOU 4 YOUR SUPPORT! https://twitter.com/ShereefElnahal/status/1122339943957835776 …
          17 replies 40 retweets 608 likes
          Show this thread
        20. Hasan Shanawani MD‏ @hshanawaniMD 28 Apr 2019

          More calls... I got a call fr hospital CEO! They r inviting our family 2 come debrief their leadership! Meanwhile continued support fr twitter. Sadly, dozens more stories of good people w/ resources struggling 2 navigate hospital care.

          5 replies 9 retweets 151 likes
          Show this thread
        21. Hasan Shanawani MD‏ @hshanawaniMD 28 Apr 2019

          Now an invitation from NJ state health commissioner We want to work with @CMSGov and @SeemaCMS to make navigating the complex finances, and can they use the story and can i help

          1 reply 9 retweets 125 likes
          Show this thread
        22. Hasan Shanawani MD‏ @hshanawaniMD 28 Apr 2019

          I dont know what 2 say. I was powerless in the deeply flawed system of my own design, that isnt caring 4me despite my own best effort, all my wealth, privilege, knowledge. Only when I surrendered did i find new allies & supporters from strangers who also continue 2 suffer

          3 replies 4 retweets 157 likes
          Show this thread
        23. Hasan Shanawani MD‏ @hshanawaniMD 28 Apr 2019

          Whats helping my family is the humanity of good people in the hospital... ...& the humanity of thousands of GREAT people, also struggling, who amplified my voice! im crying thinking of all these people most of who i may never meet, who made this happen So Many Thanks

          27 replies 11 retweets 246 likes
          Show this thread
        24. End of conversation

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