Delaware Health Care Reality

Episode 22: Beyond the Silos: Why Physicians Are Unionizing for Change

Join host Nicholas O. Biasotto, DO, with two special guests from ChristianaCare: Bryan Haimes, MD, MPH, Internal Medicine Hospitalist and Pediatrician and Amber Higgins, MD, Emergency Medicine and Obstetrics and Gynecology physician: Together they played a pivotal role in forming the first and largest private attending, multi-specialty physicians union in the country.
In this episode, we explore what led to this historic move — from overcrowded emergency rooms and long wait times for inpatient beds to top-down decision-making that left physicians feeling unheard. We’ll also touch on the American Medical Association’s stance on unionization.
What does collective bargaining look like in medicine? What happens when negotiations stall? You’ll learn about key terms like “Bad Faith Bargaining” and the “Union Security Clause”, and how unionization is being used as a strategy to unify physician voices and advocate for change. — ultimately aimed at improving the physician workforce and delivering better patient care.  This is an eye-opening conversation you won’t want to miss.  Let’s get into it!

Episode 21: LET'S GET REAL ABOUT POTS (Postural Orthostatic Tachycardia Syndrome)

Joining host Nicholas O. Biasotto, DO is special guest Ronald L. Lewis, DO, FACC, FACOI a Board-Certified Cardiologist, at ChristianaCare. We’re diving deep into a complex and often misunderstood condition affecting millions of Americans: Postural Orthostatic Tachycardia Syndrome, or POTS - a complex condition that affects 1 in 500 Americans, primarily women, and often goes undiagnosed.
What you’ll learn:
Is POTS a heart issue—or something else?
Can autoimmune diseases trigger it?
What symptoms should raise red flags?
What must be ruled out first?
Available treatments?
Dr. Lewis explains how autonomic dysfunction drives symptoms like rapid heart rate, breathing difficulties, and regulation issues—and what patients and clinicians need to know.
A clear, compelling look at a misunderstood syndrome—only on Delaware Health Care Reality.

Episode 20: The Future is Here: Regenerative Medicine & PRP Therapy

Join host Nicholas Biasotto, DO and special guest Joseph Straight, MD, Director of Primary Care Sports Medicine, First State Orthopaedics, and Medical Society of Delaware Past President, as they dive into the cutting-edge world of Regenerative Medicine, focusing on the powerful potential of Platelet-Rich Plasma (PRP) Therapy. From healing wounds and easing chronic pain to rejuvenating skin and restoring hair, PRP is transforming care across fields—including veterinary medicine. Already embraced around the globe, this innovative treatment is gaining momentum in the U.S. Hear why Dr. Straight says: “It’s the future.”

Episode 19: The Real Issues in Health Care!

In this episode, host Nicholas O. Biasotto, DO, and Mark B. Thompson, MHSA, Executive Director, Medical Society of Delaware, sit down to discuss the incredible momentum of the podcast and preview what’s ahead, including deep dives into POTS Syndrome and Regenerative Medicine—topics shaping the future of patient care.
Beyond the podcast, today’s conversation tackles some of the biggest issues in health care:
🔹 Prior-Authorization and its role in delaying critical patient care
🔹 Primary Care Reform Efforts and what it means for physicians and patients
🔹 Unionization & Collective Bargaining in health care
🔹 The rising cost of care in the U.S. and why Delaware is at the center of the conversation
Join us for a thought-provoking discussion on the forces driving health care challenges—and what’s being done to address them.

Episode 18 - Medical Aid in Dying: Insights From Both Sides of the Stethoscope

What does it mean to make compassionate, informed choices at the end of life? In this powerful episode of Delaware Health Care Reality, host Nicholas Biasotto, Do, welcomes two distinguished guests to explore one of the most complex and emotional health care topics. Joining the conversation are Robert Varipapa, MD, specializing in Neurology and Sleep Medicine, advocating in favor, and Michael Vest, MD, Associate Professor of Medicine, Sidney Kimmel Medical College, specializing in Critical Care Medicine, presenting concerns against legalization.  They explore end-of-life decisions, patient autonomy, and Delaware's proposed legislation that could make it the 12th state to legalize this option.
Examine key considerations such as palliative care, hospice support, and mental health resources. Hear insights on data from Oregon's long-standing Medical Aid in Dying law, where patients have reported choosing this option due to concerns like the cost of medical care and feeling like a burden on loved ones.  What safeguards exist to prevent a "slippery slope" from impacting vulnerable populations?
Tune in for an insightful discussion on patient rights, physician roles, and the ethical questions that shape this deeply personal and evolving topic.

Episode 17: Navigating Senior Care: It Takes a Village!

Nursing homes are expensive, and in-home care isn’t always affordable. So how can families help their loved ones age in place? Join host Nicholas Biasotto, DO who sits down with Frank DeMarinis, founder of Senior Advisors of Delaware, LLC. With decades of experience in nursing homes and assisted living, Frank and his team are on a mission to help seniors stay at home through valuable services offered, available resources and nonprofit support. Tune in to learn about Miller Trusts, Conditional Medicaid, Health Care Proxies, and what federal and state programs might be available to help. Because when it comes to senior care, it takes a village!

Episode 16: Shaping the Future of Medicine

Join host Nicholas Biasotto, DO, for an insightful conversation with Bhavin Dave, MD, the 179th President of the Medical Society of Delaware. Dr. Dave, a Board-Certified specialist in Internal Medicine and Gastroenterology, shares his forward-thinking vision for the future of medicine and health care. From ensuring cost-effective care and addressing the environmental impacts on medicine to the transformative role of artificial intelligence and legislative changes shaping the field, this episode dives deep into the pressing issues of today. Explore his perspectives on primary care reform, cost standardization for testing, prior-authorization challenges, and the potential of a one-party payer system to revolutionize health care delivery. Don’t miss this engaging discussion packed with thought-provoking ideas and actionable insights!

Episode 15: Sleep Apnea Effects On Your Health

Join host Nicholas Biasotto, DO, as we dive into the fascinating and critical world of sleep health with special guest, Anthony Vasile, DO. Dr. Vasile is Board Certified in Internal Medicine, Sleep Medicine, and Pulmonary Critical Care Medicine and serves as the Medical Director of the Delaware Sleep Disorder Centers.
This episode is your gateway to understanding Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA)—two sleep disorders that can have significant impacts on your health if left untreated. Dr. Vasile will unravel the hidden dangers of these conditions, including the effects of adrenaline surges and other long-term consequences.  We’ll tackle common questions like:
Does snoring always signal sleep apnea?
What are the best screening tools for physicians, patients, and caregivers?
How can you identify and implement the most effective treatments and best practices?
Whether you’re a healthcare professional, a caregiver, or someone curious about better sleep, this episode promises practical insights and expert advice to empower you.

Episode 14: Merry Yet Melancholy - Holiday Blues Are Real

Join host Nicholas O. Biasotto, DO, as he sits down with the esteemed Carol A. Tavani, MD, MS, DLFAPA, renowned neuropsychiatrist, Executive Director of Christiana Psychiatric Services, and past President of the Medical Society of Delaware. A graduate of Jefferson Medical College, Dr. Tavani brings decades of expertise to a heartfelt and insightful conversation about mental health during the holiday season.
The holidays aren’t always merry and bright. For many, this time of year is marked by the “holiday blues,” a complex mix of emotional challenges stemming from loneliness, loss, and unmet expectations. With shorter days, limited sunlight, and a decrease in outdoor activities, the winter months can also bring about biologic changes, including fatigue, mood shifts, and cravings. Dr. Tavani shares her expert perspective on the symptoms of the winter blues—why they occur and how they affect millions of Americans.
In this thought-provoking discussion, you’ll learn actionable tips to improve symptoms and hear a candid exploration of the broader state of mental health care in the U.S. Don’t miss this essential conversation, designed to inform, inspire, and shine a light on the realities of mental well-being during the most reflective time of the year.

Episode 13: Hyperbaric Oxygen, An Under-Utilized Medical Modality

Are you ready to dive into the fascinating world of Hyperbaric Oxygen Therapy? Join your host, Nicholas Biasotto, DO, for an engaging and insightful conversation with two exceptional experts: Zack Gaskill, DO, FUHM, Associate Program Director for the Penn UHM Fellowship, and Lesa Prichard, MSN, RN, HC-PD, Nurse Manager at ChristianaCare Wound and Hyperbaric Center. Together, they explore the science and potential of this often-underutilized medical therapy.
In this episode, you’ll learn:
What Hyperbaric Oxygen Therapy is and its historical roots.
The physiological benefits that make it a powerful treatment option.
How patient selection plays a key role in its effectiveness.
The commonalities linking various patient populations benefiting from this therapy.
A comparison of multiplace and monoplace chambers.
The conditions approved for Hyperbaric Oxygen Therapy and the challenges of under-utilization.
The potential side effects and relative contraindications to keep in mind.
Whether you’re a healthcare professional, a curious listener, or someone seeking innovative treatment insights, this podcast is packed with valuable knowledge and practical takeaways. Don’t miss this deep dive into the therapeutic possibilities of Hyperbaric Oxygen Therapy!