The “Time is Tissue” Paradox

0:00 – 0:54

Dr. Kevin Halow: In surgery, “Time is everything.” The reality is that the longer the patient is open on the table, the more problems that we can expect. It’s no different in other specialties. Ask any interventional cardiologist or neuro-interventionalist, and they’ll tell you the same: “Time is tissue.”

Whether we’re in the cath lab or the trauma bay, a lot of us obsess over speed. We move fast because the physiology demands it. The patient does not have time for debate. We live in a “time universe” of minutes to hours because people’s lives depend upon it.

But then, we step out of the OR. We take off the mask, and we hit a wall. We step into the administrative reality—what I call “Administrative Time.” And that reality moves at the speed of a committee meeting or slower. It moves in quarters and semi-annuals. Businesses don’t die in minutes and hours; people do that.

The Administrative Conflict

0:54 – 2:05

Here is the paradox we face: You want to fix the system. You want to streamline the workflow. You want to stop the inefficiencies that drive you crazy every single day. But the meeting to decide that workflow? Well, it’s scheduled for Tuesday at 2:00 PM.

And where are you on Tuesday at 2:00 PM? You might be scrubbing in. Could be in the clinic seeing your 20th patient. Maybe you’re rounding. You’re covering nights this week and you’re trying to get some sleep before your next shift. So once again, the meeting happens without you. The decisions get made by the people who are not caring for the patients.

Then, fast forward a month later: You’re handed a new policy that makes absolutely no sense, and you think, “Why didn’t they ask me?”

Hi, I’m Dr. Kevin Halow. On today’s episode of The ClinicianCore Podcast, we’re going to talk about clinical communication failures. And we’re not talking about dropped Wi-Fi signals. We’re talking about the systemic silence that cuts physicians and clinicians out of the loop—and the new way that we can break back in.

Case Study: The Post-Op Silence

2:05 – 3:15

In my last podcast, we discussed the idea of the “silence between the cases.” It’s that sinking feeling when I write an order to discharge a patient and then dictate my note… then there is silence.

I used the example of one of my patients in whom I had recently placed iliac stents for critical limb ischemia. The surgery went very well. Her outcome was excellent. But at the post-operative visit, she said to me, “I was so scared after I left the hospital. No one told me anything.”

Ironically, it was not that the healthcare professionals were not doing their job; they were! When the recovery room nurses went over the post-operative instructions, it may have been just a little too fast for the patient. By the time that patient was home, she was confused about what she could and could not do.

When the home healthcare nurse came in, the nurse did not have any notes or information as to what surgery was done and what should be expected in the post-operative period. The recovery room nurse did a post-op check by phone the next day, but the patient did not answer. The patient called her primary physician’s office, but could only leave a voicemail… and couldn’t get an answer.

The Failure of Phone Tag

3:15 – 4:20

So how was the patient’s care? Well, we saved the limb. But did we treat the whole patient? Is the care team really a team that is reading all from the same page, or just a series of strangers doing tasks in isolation, separated by incompatible phone systems and faxes that nobody reads?

This is an example of clinical communication failure, and it happens regularly. So, why is this so difficult to fix? After all, we live in 2026, and we have the technology. However, we have yet to apply it properly.

As I mentioned previously, the core problem is a mismatch in reality. We, as physicians and clinicians, live in a different “time universe” than the administration. I know that seems crazy, but let me explain further.

Synchronous vs. Asynchronous Time

4:20 – 5:25

The hospital administration and the support staff run in synchronous time. If they have a question, they want to call you and talk to you right now. When they have a meeting, they expect you to be there because they will be there. They meet and collaborate on their time—when it’s convenient for them. It’s how they get their work done, and they expect you to be there with them to help get that work done.

As physicians and clinicians, we live in an asynchronous time. If you call me right now to ask about that post-operative patient, I cannot answer because I’m in surgery. Or a procedure. Or with a patient in the office.

Okay, so you leave a voicemail. When I finish my case, and I try and call you back (along with the five other voicemails that I received when I was in the operating room), but now I’m on hold because you are busy with another patient. They have to put me on hold to go get the nurse out of the room so that I can talk to the nurse about the patient because he or she called me about that patient originally.

We play phone tag as I do with so many of the calls that I receive. Meanwhile, I don’t get a say in what’s going on, and it’s the patient who’s not getting the care that he or she needs.

The Source of Burnout

5:25 – 6:50

This synchronous expectation is what kills our voice. Administration schedules a one-hour focus group meeting on “improving efficiency in the hospital.” It’s gonna be at 2:00 PM on Tuesday. They need the physicians to attend. I sign up. But on that particular day—as would be expected at that time—I cannot attend the meeting even with Teams or Zoom because I have to run to the emergency room to help with a difficult airway in a patient who’s coding.

I have colleagues that want to go, but none can make it. One is in the office. Another is post-call. Still another is in the middle of procedures. So, because we can’t be there in person, the system interprets our absence as disinterest.

The prevailing thought is that, “Well, the doctors didn’t show up. They must not care.” And just like that, they made another rule without our input. This has been going on every day, of every year, in every hospital for decades. This is the source of burnout.

Burnout does not come from working hard; physicians and surgeons love working hard. Burnout is the feeling of powerlessness. It is seeing a barrier in your way and having no mechanism to remove it. So why do we have to leave our time universe of patient care to attend that meeting? Why can’t that meeting come to us on our time, when it’s convenient for us?

The ClinicianCore Solution

6:50 – 9:36

We need a way to collaborate that doesn’t require us to stop being doctors during the day. This is exactly why we built ClinicianCore. It started with a simple question: “How [do] you get a physician to go to a meeting?” Because they will not go.

As it turns out, it’s not because they don’t care. And it’s not because they don’t want a say or want to be involved. It is simply because they don’t have time. They’re too busy taking care of patients.

What followed from our initial platforms is an understanding that we, as physicians, are not just burning out because we miss a meeting. We are burning out from all of the work that is being put on our plates without our approval because we can’t make the meeting. We are burning out because we are growing weary of being cut out of the business of healthcare decision-making. We are burning out because we are tired of the telephone tag and voicemail when we try to care for our patients. We are burning out because we cannot connect, communicate, and collaborate with each other, let alone anyone else. We are burning out because we are increasingly isolated and disengaged.

We built ClinicianCore to solve these complex problems by allowing physicians to reconnect and re-engage with each other and all of the healthcare professionals and administration with whom they work—but on the physician’s time. In their asynchronous time universe.

ClinicianCore is built around the fundamental concept that physicians live in an asynchronous universe. Okay, let’s try this again. Remember that Tuesday meeting at 2:00 PM? The one where we were going to discuss efficiency and effectiveness? On the ClinicianCore network, that becomes an ongoing, private, asynchronous meeting that is held continuously over two weeks. Everyone has the opportunity to jump on with either video, audio, or text, listen to the input of others, and provide their own.

Just like that, we now have collaboration and communication. Now, we are including physicians in the business of healthcare decision-making.

Remember that patient who went home after iliac stenting? Instead of chasing voicemails, the home health nurse can send a secure, HIPAA-compliant asynchronous video message with a snapshot of the patient’s wounds right to me. She adds a quick note: “Hi Dr. Halow, is this redness concerning to you?”

Now, I don’t have to answer instantly. Remember, it’s asynchronous. I finish my surgery. I’m walking to the lounge. I look at my phone. I see the message from the home healthcare nurse. I see the photos. I see the context. I tap a button and send a quick audio message: “Hey, thanks for sending that message. That looks good to me. Please change the dressing and have the patient come see me Friday.”

With another click of a button, I loop in my medical assistant and my scheduler on the conversation to ensure that the patient follows up. Boom. Done. How nice was that?

Conclusion: Stop the Hamster Wheel

9:36 – End

ClinicianCore goes far beyond messaging. Included in its many sections is a private place just for physicians that we call the DocLounge. It’s the virtual equivalent of a real doctor’s lounge where we can actually talk to each other. It’s a private, verified space where clinicians can reconnect, share wisdom, and reclaim the sense of community we lost.

ClinicianCore is not just an app; it’s a system fix. It’s about proving that when you connect the physicians with the care team and the administration, the efficiency of patient care takes care of itself—and the physician burnout goes away.

It’s time that we stop accepting that we can’t change the system, that we can’t stop physician burnout. It’s time to stop accepting that your voice doesn’t matter and that no one cares what you think. It’s time to stop stressing and worrying that you can never make a meeting, and because of that, you will never have an input. Most of all, it’s time to stop running on the hamster wheel, just trying to keep up, only to fall more behind each and every day.

At ClinicianCore, we are building the unified communication platform that puts physicians at the center of the healthcare communication hub. It’s the communication tool designed just for you, that will help you reconnect and re-engage by giving you the tools to communicate on your time, in your time universe. It brings the meetings and the conversations to you.

We hope you’ve enjoyed this podcast. We have many more issues to cover in these series. If you want to hear more, subscribe to The ClinicianCore Podcast. You can also check out our website, cliniciancore.com, and sign up to join our waitlist to be the first to experience our latest version. The next version of ClinicianCore will be going live soon. You can follow us on LinkedIn, YouTube, Facebook, and Reddit.

I’m Dr. Kevin Halow. Thanks for listening.