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In this 304th episode I welcome Drs. Meyhoff and Breteler to the show to discuss continuous vital sign monitoring for patients on the floor and at home after surgery. We talk about the pros and cons of this kind of monitoring, what the future holds, and how Anesthesiologist and Intensivists can play an important role. Dr. Meyhoff is the founder of the WARD Clinical Support System which is awaiting FDA clearance.
CME: Link
Random Recs:
It would have been valuable if the conversation had gone deeper into how monitoring actually impacts care. The idea was touched on briefly, but I worry that with each technological advancement, we risk reducing patients to a set of variables. I see trainees today who struggle to recognize a sick patient or perform a proper physical exam. My generation was already less skilled than the one before us, and the current one seems even further removed from the bedside.
I’m not sure that’s progress.
To be clear — I’m not anti-technology. Fixing physiological derangements saves lives. Monitoring matters. But I worry we’re seeing diminishing returns. We’re pouring immense time and energy into fine-tuning variables and thresholds — and we don’t even have consensus on which parameters matter most, or what limits reliably “catch” patients going sideways. Meanwhile, we’re diverting limited resources away from people — like adequate staffing and time at the bedside — toward costly tech systems. Early sepsis warning protocols are a good example: often overfitted, while nurses and physicians remain overworked and spread thin.
The longer I do this, the more I appreciate the power of the doctor-patient relationship — even in anesthesia, where that interaction is brief. That connection still matters. Studies like Kaptchuk’s (BMJ 2008), the ORBITA trial, and others show that the therapeutic relationship has real, measurable effects on patient well-being.
I don’t mean to sound too “froo-froo,” but these things do matter — as does the ability to recognize “sick” when you see it. I’m skeptical that a heavily medicalized, tech-driven model of care will outperform a clinician with good instincts, judgment, and enough time to actually connect with their patient.
Great points!