What if hospital-level care could safely happen in a patient’s home instead of inside a hospital building?

In this episode of PEMBA On Demand, Dr. Norman A. Chapin speaks with Dr. Mihir H. Patel about the growing hospital-at-home movement and what it means for physician leaders, health systems, and patients. Hospital at home refers to acute hospital-level care delivered in a patient’s home instead of a traditional inpatient bed, not simply remote monitoring or home health. The model has gained major momentum in recent years as health systems look for new ways to improve capacity, reduce harm, and deliver care in the right setting.

Dr. Patel explains that hospital-at-home programs are designed to address three major challenges in modern healthcare: hospital capacity strain, the risks patients face inside hospitals, and the high cost of brick-and-mortar inpatient care. He walks through the types of diagnoses that often fit the model, including conditions like pneumonia, COPD exacerbations, CHF, cellulitis, UTIs, dehydration, and similar cases where patients need acute treatment but do not require ICU-level care.

The conversation also explores how these programs actually work behind the scenes. Dr. Patel describes the mix of physicians, nurses, paramedics, pharmacists, case managers, and logistics teams needed to support care in the home. He and Dr. Chapin discuss how virtual visits, remote monitoring, medication delivery, and rapid-response workflows all play a role in making the model safe and scalable.

A major focus of the episode is outcomes. Dr. Patel shares why mature hospital-at-home programs have shown encouraging results in patient safety, patient satisfaction, and readmissions. Public-facing hospital-at-home resources likewise describe the model as a patient-centered alternative that can improve care outcomes for appropriate adults while reducing exposure to hospital-associated complications.

Dr. Chapin and Dr. Patel also discuss the business and policy side of the model, including fixed versus variable costs, reimbursement, and the importance of federal waiver support. The CMS Acute Hospital Care at Home waiver was extended for five years through 2030 in March 2026, giving health systems more certainty as they invest in infrastructure and staffing. The AMA reports that the waiver supports hospital-level home care for Medicare patients, and advocacy materials from the Advanced Care at Home Coalition show broad national participation by hospitals and health systems.

The episode also highlights the role of technology. Dr. Patel explains how tablets, wireless monitoring devices, ambient AI documentation, and logistics coordination tools are becoming increasingly important in hospital-at-home workflows. He offers a practical look at how these technologies can support earlier intervention, improve efficiency, and help teams manage care across multiple patients and locations.

Later in the conversation, Dr. Patel reflects on his own career path and why he chose to pursue the Physician Executive MBA at the University of Tennessee. He shares how the program helped him think beyond individual patient encounters and better understand finance, operations, workflow design, and system-level leadership. He also discusses his work in medical writing and his involvement with The Hospitalist, which is the Society of Hospital Medicine’s monthly newsmagazine.

This episode is both a practical overview of hospitals at home and a thoughtful reflection on physician fulfillment. Dr. Patel closes with a powerful reminder that success is not only about titles, income, or credentials. For physicians, real success also means finding a path that supports personal well-being, family life, and meaningful patient care.

Key Topics Discussed

• What hospital at home really means
• Why health systems are...

What if the skills that make a great physician aren’t enough to lead healthcare, and the real transformation begins when medicine and business finally learn to speak the same language?

This recast episode of Pemba on Demand: Leadership Odyssey Bridging Medicine and Business revisits a compelling conversation with host Dr. Norman A. Chapin and Dr. Michael Marks, Senior Medical Director at Relievant Medsystems, Inc.

Dr. Marks reflects on his professional journey from orthopedic spine surgeon to healthcare executive in the medical device industry. He shares how his experience in the Physician Executive MBA program at the University of Tennessee shaped his leadership approach, supported complex orthopedic group mergers, and prepared him for roles in hospital administration and industry leadership.

The episode explores the evolving identity of physician leaders and highlights the importance of education, mentorship, collaboration, and adaptability when navigating the intersection of medicine and business. Dr. Marks also discusses the human side of leadership, including maintaining empathy in patient care, facing personal health challenges, and advocating for patients within complex insurance and reimbursement systems.

• Transitioning from clinical practice to executive leadership roles
  
  
• The value of the Physician Executive MBA program for physicians
  
  
• Managing healthcare mergers and navigating cultural integration
  
  
• Empathy and communication as essential leadership skills
  
  
• The role of mentorship in career development and growth
  
  
• Staying connected to clinical care during personal health challenges
  
  
• Advocating for patients amid insurance and coverage barriers
  
  
• Understanding healthcare spending and its impact on Medicare and Medicaid
  
  
• The importance of continuous learning in a changing healthcare landscape
  
  
• Collaboration and shared purpose as foundations of effective leadership
  
  

Links and Resources:

• Physician Executive MBA at the University of Tennessee
• Michael Marks MD MBA
  

In this episode of PEMBA On Demand, host Dr. Norman A. Chapin sits down with Camilo R. Gomez, MD, MBA, and former FBI lead hostage negotiator Christopher Voss to explore how elite negotiation strategies can reshape leadership in healthcare.

Drawing from their new book Strategic Conversations, the conversation bridges the worlds of medicine and high stakes negotiation. Dr. Gomez and Christopher Voss explain how principles like tactical empathy, calibrated questions, ethical ambition, and disciplined curiosity can improve physician leadership, strengthen care teams, reduce burnout, and create better outcomes for patients and organizations alike.

This episode challenges traditional command and control leadership models and offers physicians a practical framework for navigating conflict, complexity, and change with clarity and confidence.

• Applying FBI hostage negotiation principles to healthcare leadership
• Tactical empathy as a leadership and communication tool
• Moving from authority based leadership to influence based leadership
• Reducing burnout through better conversations and alignment
• Ethical ambition and its role in modern medical leadership
• Improving collaboration across care teams and organizations
• Navigating high pressure conversations with patients and colleagues
• Building trust and psychological safety in clinical environments
• Creating sustainable win win outcomes in healthcare systems

Dr. Camilo R. Gomez, MD, MBA

Dr. Camilo R. Gomez is a physician, author, and healthcare executive with a focus on leadership, ethics, and system level improvement. He brings deep experience at the intersection of medicine, strategy, and communication, helping clinicians navigate complex professional environments with clarity and purpose.

Christopher Voss

Christopher Voss is a former FBI lead international hostage negotiator and the founder of Black Swan Group. He is the bestselling author of Never Split the Difference and a globally recognized expert in negotiation, communication, and decision making under pressure.

• Dr. Camilo R. Gomez on LinkedIn
  https://www.linkedin.com/in/neuroranger/
• Christopher Voss on LinkedIn
  https://www.linkedin.com/in/christophervoss/

Organizations

• Black Swan Group
  https://www.blackswanltd.com/

Books Mentioned

• Strategic Conversations by Camilo R. Gomez and Christopher Voss
  https://www.amazon.com/Strategic-Conversations-Successbooks-Publishing/dp/B0DWH4R21H
• Never Split the Difference by Christopher Voss
  https://www.amazon.com/Never-Split-Difference-Negotiating-Depended/dp/0062407805
• Empathy and Understanding in Business by Christopher Voss
  https://www.amazon.com/Empathy-Understanding-Business-Chris-Voss/dp/B0CNF6J4G8
• Empathic Reasoning for Extraordinary Results by Christopher Voss
  https://www.amazon.com/Empathic...