Stepping Out of the Dialysis Comfort Zone
As a forward-thinking dialysis provider and interventional nephrologist, Dr. Samih’s message to his colleagues is to not be afraid to shake the traditional foundations of kidney disease care, and embrace impactful innovations like Tablo.
Dr. Mohammad Samih has been a nephrologist and interventional nephrologist for 10 years, with a focus on forward-thinking, holistic, patient-focused care. Since 2019, he has been managing patients at Cayuga Medical Center in Ithaca, NY—a 212-bed, not-for-profit, acute-care hospital in a growing urban area about 225 miles northwest of New York City. He treats those requiring dialysis, and performs interventional dialysis procedures such as new percutaneous arteriovenous (AV) fistula creation as an alternative to traditional surgical grafts, along with vascular access maintenance and renal procedures such as kidney biopsies and catheter placements.
In Samih’s view, with positive innovations finally impacting ESRD patient care, such as less-invasive AV fistulas—the lifeline for chronic patients—and versatile, next-generation dialysis technologies like Tablo, it’s time for providers in the long-stagnant dialysis field to “step up and out of the box,” he says. “I have stood by and watched many changes take place in fields such as oncology, neurology and cardiology. Why can’t we bring technology to nephrology? It’s time to shake the foundation of kidney disease care and do away with old rigid rules.”
He explains that COVID-19 has played a critical role in this optimistic new perspective. Although the pandemic has brought unprecedented challenges to nephrology, it also helped to shift many policies and procedures that he thought would never change. “That experience has opened the door for many new technologies, such as Outset Medical’s Tablo system, that helped us as our relatively small, outsourced acute program had collapsed due to the pandemic. There’s not one healthcare provider or frontline worker who felt comfortable when COVID hit. We all felt uncomfortable. But that’s how we grow, by getting uncomfortable and stepping out of our comfort zone,” says Samih.
“The machines are so user-friendly. This has been critical for us. Tablo has really made an epic impact on our patient care.”
Impact of Tablo at Cayuga
Samih says that prior to COVID, he and his Cayuga nursing team were used to the routine burden and headache of traditional outsourced dialysis care. “We couldn’t tell patients when they would be receiving their treatment, as I couldn’t control the contracted outside dialysis provider. Patients didn’t understand. This was not a good situation. But when our provider was no longer able to service us due to the pandemic, we looked for a solution other than having to transport patients out of town for in-center treatment. We found Tablo, and brought our program in-house last April. We’ve never looked back. It gave us autonomy and freedom. In the history of nephrology, I think that this is maybe the first time that many hospitals or physicians in the acute setting have had this kind of control,” he says.
Samih explains that his nursing staff was trained quickly and easily on Tablo. “The machines are so user-friendly. This has been critical for us. Tablo has really made an epic impact on our patient care. Having a fundamental piece of medical equipment available at your team’s fingertips is very important,” he says.
Samih says that along with himself, new doctors coming into his center are anxious for new dialysis technology. “They are hungry for innovation, and Tablo has really satisfied our needs. With TabloHub, for example, we’re able to go back and review patient records, and the data is safe up in the cloud. It really streamlines our workflow. Remote monitoring also allows everyone on our dialysis care team, including doctors, nurses, administration and social workers, to all be in different locations and log in to the same patient account. This has been invaluable.”
Samih is actively involved in his profession as a Fellow of the American Society of Nephrology (FASN), the American College of Physicians (FACP), and the American Society of Diagnostic and Interventional Nephrology (FASDIN). And, through his position as president of the Southern Tier district of the American College of Physicians’ New York Chapter, he is excited to have the opportunity to educate other physicians and healthcare providers about new opportunities impacting kidney disease management, and patient care. “I recommend to my colleagues to take that first step, get exposed to new devices and learn new ways of doing things. Then don’t stop. Don’t be satisfied with what you have now. Keep your eyes open, technology is changing fast, and this will really benefit our specialty.”
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Better Days Ahead for Patients – At Home
Samih is also optimistic about the growing momentum for sending chronic patients home. “I’m a big champion of home hemodialysis products. I’m excited for the future, because of the ease of training and use, and the positive outcomes with Tablo,” he says. “My feeling is, get them out of the center, and send them home. Once they taste that freedom they don’t look back. If training a patient to go home with a complex machine was a hurdle, what about training with a machine that is more user friendly? Why not?”
“Home dialysis is associated with longevity, better overall quality of life as patients control their own health, the ability for employment, less medical conditions, less fluid overload, fewer hospital readmissions and lower costs. It’s a win-win for everyone. In-center dialysis is not the answer, we have done a bad job with that. I’ve been in nephrology for 10 years, probably have 20 to go. I’m excited to see where this takes us. It’s all about the patient, and there are better days ahead.”
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