Fred Mirarchi
@DocEM1
It is not just about End-of-Life. It is about safely getting it right for each patient. Founder of MIDEO (My Informed Decision on Video).
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Med-mal re Living wills, DNR & POLST R up. If Ur a #Physician U need 2 wake up. If you #Hospital U need 2 take action. If your a #Payer, then Ur paying for these medical errors & suffering from the Increased Costs as well. Embrace tech & safeguards jems.com/patient-care/f…
Depends and can kinda be wasteful really. A notary to be a witness does nothing to ensure informed decision making or to prevent discordant care. Just adds a step in the process. @ThaddeusPope
Hospitals Must Have Notary Available 24/7: Rhode Island attorney and Senator Matthew L. LaMountain has just introduced S.B. 2115. This bill would require "all hospitals in Rhode Island shall have a notary public on staff and available twenty-four (24)… dlvr.it/TQQtgQ
Payers should only have one job & that is to pay for the medical care prescribed by a physician.
“The act of signing a denial is practicing medicine.” — Dr. Tracey Hurley If a physician makes a medical decision and that decision harms a patient, we are held accountable. That is how medicine works. Yet insurance companies make treatment decisions every day through denials…
Good for the Judge! Alex’s DNR as a tattoo or POLST does not say don’t resuscitate me in a trauma. The DNR would only apply if the trauma left Alex with no pulse & dead.
Failure to Follow DNR Tattoo - Court Dismisses Case: After suffering a devastating motorcycle accident, Alex Serrano was revived on the scene by the first responding EMT Malcolm Hunter. However, Serrano sued Hunter for $65,000 because he claims he had a… dlvr.it/TQ8pZj
You first need to make sure that it’s actually a do not resuscitate order and not just a misinterpretation of the advance directive. Then you need good informed consent as to when the DNR would apply.
Ethical Considerations if Patient Undergoing Surgery or Invasive Procedures Has DNR Order: It was a pleasure to contribute to this story in Medical Ethics Advisor (Jan. 2026): "Ethical Considerations if Patient Undergoing Surgery or Invasive Procedures… dlvr.it/TQ6m19
Tom Izzo says there’s “no educational component” to college basketball anymore. He also calls out Charlie Baker for what he believes is a lack of leadership.
Tom Izzo was asked about James Nnaji enrolling at Baylor. Nnaji, 21, was selected 31st in the 2023 NBA Draft but he never signed an NBA contract, choosing instead to play professionally in Europe, before appearing with the Knicks in the 2025 Summer League. Here's Izzo's answer:
So this already exists in the private sector. MIDEO is both a national and international database/“Registry” Problem with some registries that also exist is Quality Controls. If you upload forms without patient informed decision you scale risk for medical errors to occur. So…
National U.S. Advance Directive Registry: Several states have state registries for advance directives and/or POLSTs. But we may someday have a federal nationwide registry. Spain already has one. The Legacy Act of 2025 (H.R. 5861) directs the… dlvr.it/TPpYtj
“Doctors are greedy” is the easiest narrative to sell. But physicians account for 6% of healthcare costs — so where does the other 94% go? #healthcare #doctors #medicalindustry
FSA expiring soon? HSA funds untouched? Use them to create a #MIDEO video advance directive—fast, eligible for many plans, and truly meaningful. Make your benefits count. Learn more: bit.ly/4958Kyx #FSA #HSA #MIDEO #PlanAhead
URGENT: The Republican healthcare plan includes “provider owned hospitals”! Today is a massive breakthrough for everyone who has been fighting to reverse the injustice. As quickly as I am typing this, members of the AHA and FAH will be working to protect their monopoly on…
🚨BREAKING NEWS -- HERE is the health care slide that House Republican leadership presented to the rank and file today. These are the policies that the GOP is considering passing this month.
This is the Dangers. People making life ending decision cause care is not available.
How is Medicare for All working in Canada, you ask? 🇨🇦: No surgeon available for your parathyroid surgery, but good news, you have been approved to be euthanized.
Good news for Medicare patients. We have made MIDEO available nationally under Medicare and in many states by additional insurance. Also, no matter where you live, HSA & FSA funds can help cover out-of-pocket costs. mideohealth.com #AdvanceCarePlanning #MedicareCovered
We welcome NCISA members to the 21st century. No more confusion or guessing by medical strangers when your life is at risk. mideohealth.com/resources/ncis… #patientsafety #ACP @NCISLA
Exactly. That is why AAHPM & others are worried about regulators' too easily second-guessing good faith, evidence-based (though surely fallible) determinations of TI
Many diagnosis can be terminal in the right setting & with a decision to not apply treatment. For example a UTI can be terminal in an elderly frail patient. What some see as terminal others would disagree with & it’s very subjective. @ThaddeusPope
Terminal Illness - Deference to Physician Determination: A case now being briefed to the U.S. Court of Appeals for the Sixth Circuit raises critical issues about how terminal illness is determined for hospice eligibility. (In Home Health v. Kennedy, No.… dlvr.it/TPT6Cd
Yes. I have received multiple calls from plaintiffs' counsel from around the USA -- in just the past few days -- on cases like this #AdvanceDirective #POLST
Failing to Follow POLST Is Medical Malpractice: Clinicians at the University of Rochester resuscitated Donald Tuohey contrary to his MOLST. His family successfully litigated a medical malpractice action against the hospital, resulting in a jury verdict… dlvr.it/TPPytn
An health insurer should not be able to decline a test or procedure that a physician deems medically necessary and orders. 55 year old with CP & EKG changes with a cardiac cath that the payer declines to pay. That has to be some sort of violation & if it’s not it’s just plain…
Maybe due to my years of being a traditionalist I have a problem with situations where a player in college is at a new school every year - 4 years 4 different schools - how in the world is that what college should be about ? Bluntly it is ABSURD!
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