Podcasts about Rochester

The Chronicle sports staff (Zach, Dylan, and Aaron) discuss the District 4 2B boys and girls basketball tournament brackets, what the 2A brackets will most likely look like, if Rochester can pull off a wild swing and slip into districts with the #3 seed, and more.Sponsored by: Elam's Home Furnishing and Mattress GalleryGoebel SepticAmericool Heating and CoolingThe Farm Store!

Join your Watson Weekly Weekend Edition hosts, Rick Watson and Jessica Lesesky, as they break down the biggest shifts in tech, retail, and e-commerce. From Pinterest's AI pivot to Starbucks' massive loyalty shakeup, we're diving deep into the news moving the needle this week.

The Break Room (FRIDAY 2/6/26) 9am Hour 1) Something about the location of this bathroom had Tommy doing some pre poo planning 2) Too cold for winter activities

The Break Room (FRIDAY 2/6/26) 8am Hour 1) Kimmy was surprised to find this item was locked up in the women's bathroom 2) Make your money while you can 3) It's been a while since we got a new one of these in Rochester

The Break Room (FRIDAY 2/6/26) 7am Hour 1) There HAS to be a safe way to make this local dad's seasonal idea a reality. 2) 365 days of school 3) Free breakfast might change your mind

The Break Room (FRIDAY 2/6/26) 6am Hour 1) If you were thinking about getting outside to shovel this weekend... DON'T 2) I can't afford to fix my kid's mistake 3) Cold pasta, warm sushi.

Hello, all you and the Relentless Health Tribe trying to figure out how to do right by patients and the folks footing the bill. Welcome to it. This is episode 499, one episode before episode 500. So, come back next week for that one. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. All right, so today, let's talk about the inches that are all around us. Let's find some. Musculoskeletal spend, otherwise known as MSK spend, for any given plan sponsor adds up to the tune of something like 20% or 30% of total plan spending, depending on the member demographic. MSK rolls in at $16 PMPM, I just saw, according to a report Keith Passwater sent me a couple of weeks ago. It's the third most costly spend apparently overall. And it's easy to see why, right? On any given day, odds are good any given plan member is gonna do something that, in hindsight, was fairly obviously a bad idea and wind up getting hurt in some low-acuity way. For example, I remember that one time I twisted my ankle on a curb getting outta my car. Given the right space, enough time, and concentration, I can do the worst parking job you've ever seen in your life and manage to twist my ankle in the process. But I digress. Here's the point. MSK spend adds up really fast. Add to that something like 50% of spine surgeries are said to be unnecessary. The same thing goes true from injuries like twisted ankles, for example, that would have healed themselves without an ER visit, without any intervention aside from ice, rest, and elevate. Because it turns out that something like 80% of those twisted-ankle, banged-up-the-back types of MSK injuries are actually low acuity, and a huge percentage of those will heal by themselves. On that point, let me bring in some context here, some late-breaking news. I was reading Dana Prommel's newsletter. She wrote, and I'm reading this, she wrote, "The 2026 National Healthcare Expenditure data reports are out, and it is another sobering reflection of our current system. Personal healthcare spending has surged by over 8%, and our healthcare spend as a share of the GDP has followed that same aggressive trajectory." Then Dana writes, "The most troubling takeaway from the 2026 report is the lack of a 'health dividend.' Despite [this] 8% increase in spending, we aren't seeing a corresponding 8% increase in longevity, wellness, or chronic disease management. People aren't getting significantly healthier; they are just getting more 'care.' And that 'care' isn't always good care, or the right care, or care by the right type of clinician, at the right time, in the right setting." Is that not the perfect segue or what? Because this is what we're talking about on the show today in regard to, again, MSK care—care that can wind up costing millions of dollars across plan members, and it might be unnecessary because, again, the twisted ankle or the pain in the lower back would have healed itself without any care, without an ER visit. But if an ER visit was had, that patient probably is gonna wind up with a bunch of imaging. Probably is gonna wind up with a referral to a surgeon. And now there's a surgery scheduled, and the patient has been off work for however long all that took. There's a lot of direct and indirect costs that may or may not add up to any given health dividend or health span or whatever you wanna call it—better quality of life.   Why does all this happen? How does it happen? One reason is what Dr. Jay Kimmel calls the white space of MSK care. This is where a patient does a truly breathtaking job parking the car, twists her ankle, starts to swell up, and now a decision has to be made: Go to the ER. Go to urgent care. Go home. Or what if it's a parent making this choice for a kid? In the olden days, maybe that patient would've called up his or her longtime family doctor and asked what to do, and maybe if that longtime family doctor didn't know, he or she would have called up the local ortho and gotten their opinion. Or maybe the two were sitting together in the doctor's lounge at the time, or maybe they rounded together in the hospital and, and, and … There used to be lots of opportunities for spontaneous questions and answers and curbside consults. But not today most of the time, really, unless you're a patient with a doctor in the family. But even for a PCP, who wants an ortho consult? Amy Scanlan, MD, and I discussed this quite a bit in an earlier episode (EP402). There's no doctor lounges anymore. There's no coffee klatch down in radiology either. There's just a lot of cultural shifts, in other words. But all of this, everything I have said thus far, all adds up to one big takeaway: These excess costs that don't have commensurate improved clinical outcomes, they happen because patients are on their own to triage themselves. They look at their black-and-blue whatever, or they're standing there listening to their kid cry and they are deciding what to do. And the thing is, if they choose the ER—because, again, they don't have a doctor, anybody they can just call with the right kind of clinical background—once they head into that ER and sit there for six hours and demand an MRI because now it has to be worth their time because they sat there for six hours; but now there's a false positive and the ER docs are being conservative because of malpractice or whatever and they refer them to some sort of surgeon … Look, everybody's doing their best with the information that they have at the time, but you can see how easy it is for a person to avoidably wind up costing a lot of money for a musculoskeletal injury that would have healed by itself. So, yeah, let's talk about how we can get patients some help in that so-called white space. How can we get them, triage before the triage, as I managed to say more than once in the conversation that follows? Let's get them on a good trajectory to start. Today, my guest is Dr. Jay Kimmel. Dr. Kimmel is an orthopedic surgeon, and he's been in practice in Connecticut for over 35 years. He and Steve Schutzer, MD, co-founded Upswing Health. I talked with Dr. Steve Schutzer about Centers of Excellence in an earlier episode (EP294). Upswing Health provides members with the opportunity to talk with an athletic trainer within 15 minutes and an orthopedic specialist within 24 hours. So, instead of having a panic attack of indecision and ultimately winding up in the ER, getting coughed on in the waiting room, members have somebody helping them in this white space so they can get triaged before the triage. I need to thank Upswing Health. I am so appreciative they donated some financial support to cover the costs of this episode. This podcast is sponsored by Aventria Health Group with an assist from Upswing Health. Also mentioned in this episode are Upswing Health; Keith Passwater; Dana Prommel; Amy Scanlan, MD; Steve Schutzer, MD; Eric Bricker, MD; Al Lewis; Nikki King, DHA; Matt McQuide; Christine Hale, MD, MBA; and Chris Deacon. For a list of healthcare industry acronyms and terms that may be unfamiliar to you, click here.   You can learn more at upswinghealth.com and follow Dr. Kimmel on LinkedIn.   Jay Kimmel, MD, is the president and co-founder of Upswing Health, the country's first virtual orthopedic clinic. He founded Upswing with Steve Schutzer, MD, to rapidly assess, triage, and manage orthopedic conditions in a cost-effective, high-value manner, helping patients avoid unnecessary imaging, procedures, and delays in care. Dr. Kimmel had a long and distinguished career as a practicing orthopedic surgeon with Advanced Orthopedics New England. He earned his undergraduate degree from Cornell University and his medical degree from the University of Rochester. He completed his orthopedic residency at Columbia Presbyterian Medical Center, where he trained with leaders in shoulder surgery, followed by a sports medicine fellowship at Temple University Center for Sports Medicine, where he participated in the care of Division I collegiate athletes. He is board-certified in orthopedic surgery and is a Fellow of the American Academy of Orthopedic Surgeons. Dr. Kimmel specializes in sports medicine with an emphasis on shoulder and knee injuries and holds a subspecialty certificate in orthopedic sports medicine from the American Board of Orthopedic Surgery. He is also a member of the American Orthopedic Society for Sports Medicine. Dr. Kimmel co-founded the Connecticut Sports Medicine Institute at Saint Francis Hospital, a multidisciplinary center dedicated to providing high-quality care for athletes at all levels, and served as its co-director for many years. He has a strong commitment to education and served for over 20 years as an assistant clinical professor in both family medicine and orthopedics at the University of Connecticut. He has also served as a team physician at the professional, collegiate, and high school levels.   07:49 EP472 with Eric Bricker, MD, on high-cost claimants. 08:01 What is the "white space" in MSK spend? 10:43 Statistics on Connecticut's spending on plan members with low-acuity MSK injuries. 13:30 How back pain also easily transitions from a low-acuity issue to a high-acuity problem. 15:11 How plan sponsors can detect their white space downstream spend. 16:58 EP464 with Al Lewis. 17:02 EP470 with Nikki King, DHA. 18:15 Why where patients start their journey often dictates where they wind up and how costly that medical pathway is. 20:48 Where PCPs fit into this MSK spend issue. 25:26 EP468 with Matt McQuide. 25:34 EP471 with Christine Hale, MD, MBA. 25:39 Why access is key.   You can learn more at upswinghealth.com and follow Dr. Kimmel on LinkedIn.   Jay Kimmel, MD, of @upswinghealth discusses #MSKspend on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation #musculoskeletal   Recent past interviews: Click a guest's name for their latest RHV episode! Mark Noel, Gary Campbell (Take Two: EP341), Zack Kanter, Mark Newman, Stacey Richter (INBW45), Stacey Richter (INBW44), Marilyn Bartlett (Encore! EP450), Dr Mick Connors  

The Break Room (THURSDAY 2/5/26) 9am Hour 1) This is a Disney lover's DREAM home, if you can afford it 2) The last Pizza Hut

The Break Room (THURSDAY 2/5/26) 8am Hour 1) Tommy says if you can't spend what you want on Valentine's Day, why bother? 2) An ex with no boundaries 3) That's not beer, bro

The Break Room (THURSDAY 2/5/26) 7am Hour 1) When coworkers start losing their jobs where you work, is it time to start looking elsewhere? 2) When in doubt, GOOGLE IT! 3) I'll take the ladder, thanks.

The Break Room (THURSDAY 2/5/26) 6am Hour 1) Tommy and Kimmy can't wrap their heads around how Duffy gets by without a traditional closet 2) Pothole season 3) Stop spoiling your pets

12:30pm - Marty Biron is joined by Trevor Kuntar to discuss his season in Rochester with the Americans

As our nation navigates turbulent times, what can artists do to effect change? Award-winning composer and Rochester native Adolphus Hailstork has been outspoken about this question, especially when it comes to injustices against African Americans. "These are the tragedies and triumphs of a people who have been beaten up for 400 years. Does anyone speak for them? Who writes pieces that speak for the existence of African Americans in the United States?" he asks. "I'll take on that job.'" Hailstork's work blends African, American, and European traditions. In recent years, his pieces like “A Knee on the Neck” — an oratorio in tribute to George Floyd — have made political statements. He'll be in Rochester this weekend for a choral concert in his honor, but first, he joins us on “Connections” to discuss the intersection of art and politics. This conversation is part of WXXI's celebration of Black History Month. Our guests: Adolphus Hailstork, award-winning composer Lee Wright, director of music ministry at Downtown United Presbyterian Church, and founding artistic director of First Inversion choral ensemble The selections from "A Knee on the Neck" heard in this broadcast are attributed to:Adolphus Hailstork, composerStanford Symphony Orchestra and Stanford Symphonic ChorusPaul Phillips, conductorStephen M. Sano, chorus directorSamantha Williams, mezzo-sopranoAlexander Tate, tenorWilford Kelly, baritone---Connections is supported by listeners like you. Head to our donation page to become a WXXI member today, support the show, and help us close the gap created by the rescission of federal funding.---Connections airs every weekday from noon-2 p.m. Join the conversation with questions or comments by phone at 1-844-295-TALK (8255) or 585-263-9994, email, Facebook or Twitter. Connections is also livestreamed on the WXXI News YouTube channel each day. You can watch live or access previous episodes here.---Do you have a story that needs to be shared? Pitch your story to Connections.

The Break Room (WEDNESDAY 2/4/26) 9am Hour 1) Duffy's daughter feels the need to step up this Valentine's Day and she might need his help 2) Why would you want your liquor to burn more than it already does?

The Break Room (WEDNESDAY 2/4/26) 8am Hour 1) Let criminals be criminals as long as the crime is committed against other criminals 2) Couples are having sex WAY less than on average than you'd think 3) That song is long, even for Phish

The Break Room (WEDNESDAY 2/4/26) 7am Hour 1) If it makes things safer for people who work at this place, is it worth the pushback that comes with it? 2) When a car pulls up to take you somewhere, do you need to see a human behind the wheel? 3) How many other cities embrace this type of festival?

The Break Room (WEDNESDAY 2/4/26) 6am Hour 1) 2/3 of the room says this band did the right thing by skipping one of the most important events in their career 2) A poor man's orange juice 3) Buffalo Bills GM Brandon Beane is officially in his villain era

True Happiness Is Found in God The Gospel of the Beatitudes presents a vision of happiness that overturns ordinary human expectations. While the world associates blessedness with wealth, power, and security, Jesus proclaims the blessed as those who are poor in spirit, meek, merciful, pure of heart, and persecuted for righteousness. Drawing from Greek and Hebrew traditions, the Homily explains that “blessed” no longer means being untouched by suffering, but rather living with a heart oriented toward God. Blessed Means . . . A divided heart seeks happiness in wealth, power, pleasure, and fame, yet remains restless and unfulfilled. In contrast, a pure or undivided heart finds its fulfillment in God alone. From this God-centered heart flows mercy, justice, and love for others. True happiness, the Homily informs us, is not found in worldly achievements but in meditating on and living according to the law of the Lord, allowing God to be the sole treasure of the heart. Listen to this Meditation Media. True Happiness Is Found in God ------------------------------------------------------------------------- Gospel Reading: Matthew 5: 1-12 First Reading: Zephaniah 2: 3; 3:12-13 Second Reading: 1 Corinthians 1: 26-31 ------------------------------------------------------------------------- Art Work Snowbow: QoAHs Digital Team: 2026 Taken near Rochester, NY ------------------------------------------------------------------------- Why was this image selected: Have you ever just stopped and looked at the world and appreciate the beauty within it … the beauty God has made within this world? The QoAH digital team recently experienced a special nature moment viewing a Snowbow. Ok, is there really such a word? The answer is yes! It happens when the rising sun shines off snow crystals in the air. The above image shows the rising sun on the right and snow crystals revealing an orange and red stream of color. The vertical bands of color are straight up and down, unlike the normal arc curve of a typical rainbow. There was another upward band to the right of the sun … off camera. Just an amazingly beautiful view of nature… Happiness Found in God!

Snow may slow travel, but the calendar is heating up. We swap plans and call out standout events across the map, including BlizzCon in Columbus, AMPS Atlanta, 4M Mayhem in Michigan, Rochester's Hope It Don't Snow, and the Old Dominion Open in Richmond. For planning and entries, IPMSUSA.org remains the essential resource, with listings that stretch well into spring. That rhythm—research, build, show, repeat—keeps the hobby humming even when the weather says stay home.Community is the thread. The Plastic Model Dojo has surged past 5,600 members, and the feed is full of show flyers, build logs, and finished models that show serious skill. We highlight a new Gemini book, and we touch on current work heading to Kennedy for Artemis, a reminder that the same care we bring to scale builds echoes in real-world engineering. It's all connected: precision, patience, and the joy of making.We also set up two upcoming topics that need your voice: what stops us from starting, and what do we truly get from this hobby—calm, community, challenge, or something else entirely? Share your story and help shape the conversation around motivation and meaning at the bench.Subscribe for more modeling insights and show news, share this with a friend who needs cleaner canopies, and leave a review to help others find the pod. Got thoughts or tips to add? Send us a note and join the Dojo—your build might spark someone's next breakthrough.Model Paint SolutionsYour source for Harder & Steenbeck Airbrushes and David Union Power ToolsSQUADRON Adding to the stash since 1968Model PodcastsPlease check out the other pods in the modelsphere!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Give us your Feedback!Rate the Show!Support the Show!PatreonBuy Me a BeerPaypalBump Riffs Graciously Provided by Ed BarothAd Reads Generously Provided by Bob "The Voice of Bob" BairMike and Kentucky Dave thank each and everyone of you for participating on this journey with us.

Most owners don't think about IT until something fails and by then, the damage is already done. In this episode, Chris Sirianni (IT Insights of Rochester / GRC Insights) explains why reactive technology decisions quietly drain profit, erode trust, and put your data (and revenue) at risk. He lays out a practical, owner-friendly approach to treating IT as business continuity, not just “tech support,” so you can prevent fires instead of paying for clean-up.In this episode, you'll learn:The real cost of waiting: why “we'll fix it when it breaks” is so expensiveHidden risk, real consequences: how reactive decisions don't show up on the P&L until it's too lateBefore the breach: why most cybersecurity failures start long before an incidentContinuity > break/fix: how to run IT like an insurance policy for revenue and operationsEarly warning signs: subtle system failures owners ignore (and how to spot them)Proactive protection: planning that safeguards cash flow, reputation, and customer trustBetter questions, better outcomes: what to ask your IT provider that most owners never do

Mark and Shane talk about ROC being in the Epstein Files, crazy hit by a Knighthawks goalie, and local businesses shutting down to protest ICE. Subscribe at www.patreon.com/innerlooppodcast

The Break Room (TUESDAY 2/3/26) 6am Hour 1) There's something about calling someone this name that hurts more than the average insult 2) Wegmans makes a change 3) The Bills may have gone too far with this new product

The Break Room (TUESDAY 2/3/26) 9am Hour 1) This woman doesn't want anyone to claim to her neighborhood's no man's land 2) Take a seat, Dunkirk Dave!

The Break Room (TUESDAY 2/3/26) 8am Hour 1) Does Rochester have a bigger impact on sports or music? 2) Cold burns 3) A project almost 20 years in the making has finally begun

The Break Room (TUESDAY 2/3/26) 7am Hour 1) You have to arm this man with the information even if he doesn't want to hear it 2) Don't count on my support, kid 3) The NFL down under!

The Break Room (MONDAY 2/2/26) 9am Hour 1) Just when you thought men were starting to embrace hair loss, things may have taken a turn 2) A little late for a sequel?

The Break Room (MONDAY 2/2/26) 9am Hour 1) As iconic as this artist is, The Break Room was surprised that they were playing at a venue this large 2) West side fans 3) Good timing for bad luck

The Break Room (MONDAY 2/2/26) 7am Hour 1) When it comes to date night, your safest bet is to go with what you know! 2) Tommy is not going to be happy to hear how far his favorite grocery store has fallen!

The Break Room (MONDAY 2/2/26) 6am Hour 1) Duffy is just a simple dad trying to navigate the teenage zone 2) REAL ID fee 3) A simple measurement would've helped here?

Lauren is a grinder, having worked 16 different jobs before figuring out she was a better leader than a follower, Lauren saw a problem that needed to be solved for busy folks who are unable to take care of the tiny tasks that life requires. Lauren launched her business, muscled it to success, and today serves as the President of her business managing a team of helpers while also being nominated for awards left and right for what she has built.Mentioned in this episode:Joe Bean Coffee - Coffee that lifts everyone.Use promo code Lunchador for 15% off your order! https://shop.joebeanroasters.comGetting Real with Bossy: For Women Who Own BusinessCheck out Getting Real with Bossy: For Women Who Own Business on Lunchador! https://feeds.captivate.fm/gettingrealwithbossy/Nights and WeekendsStay connected to Rochester's local music scene with Nights and Weekends! https://feeds.captivate.fm/nightsandweekends/

The Break Room (FRIDAY 1/30/26) 9am Hour 1) It's hard to find a good argument as to why this should still be taught in school 2) Cold weather hacks

The Break Room (FRIDAY 1/30/26) 8am Hour 1) Is it possible to save your reputation after breaking a law you campaigned for? 2) The ability to run away and disappear as a kid might be even easier now than it was before 3) A Thruway pile up

The Break Room (FRIDAY 1/30/26) 7am Hour 1) If you really want to know how great your town is, ask someone who isn't from here 2) Love him or hate him, he said ALL the right things 3) No balls in my beer please.

The Break Room (FRIDAY 1/30/26) 6am Hour 1) A very PITTSSSFORRD problem 2) The fanciest food chain 3) Gym husbands

We continue our series of conversations with local state leaders about the 2026 New York State of the State address. Assemblymember Sarah Clark represents District 136. She joined us recently on "Connections" to discuss Governor Hochul's plans to expand child care programs across New York. She's back with us this hour to explore additional state business — from affordability to taxes to economic development funding for Rochester, and more. Our guest:Assemblymember Sarah Clark, District 136---Connections is supported by listeners like you. Head to our donation page to become a WXXI member today, support the show, and help us close the gap created by the rescission of federal funding.---Connections airs every weekday from noon-2 p.m. Join the conversation with questions or comments by phone at 1-844-295-TALK (8255) or 585-263-9994, email, Facebook or Twitter. Connections is also livestreamed on the WXXI News YouTube channel each day. You can watch live or access previous episodes here.---Do you have a story that needs to be shared? Pitch your story to Connections.

A number of Rochester businesses are banding together in support of anti-ICE protesters across the nation. On Friday, a group of businesses will close in a show of solidarity, while others will donate proceeds to organizations that support immigrants. Hundreds of businesses in Minnesota made similar decisions last Friday. This hour, we talk to some of the local owners about why they made this decision and what they hope it accomplishes. Our guests: Bob Hartman, co-owner of AltBar Niraj Lama, owner/operator of Happy Earth Tea Rob Nipe, owner of Grass Fed Molly Hartley, owner of Scratch Bakeshop Katarina Eddy, owner of Katboocha Jenna Kirchner, owner of The Unreliable Narrator Michael Solis, executive director of Writers & Books ---Connections is supported by listeners like you. Head to our donation page to become a WXXI member today, support the show, and help us close the gap created by the rescission of federal funding.---Connections airs every weekday from noon-2 p.m. Join the conversation with questions or comments by phone at 1-844-295-TALK (8255) or 585-263-9994, email, Facebook or Twitter. Connections is also livestreamed on the WXXI News YouTube channel each day. You can watch live or access previous episodes here.---Do you have a story that needs to be shared? Pitch your story to Connections.

The Break Room (THURSDAY 1/29/26) 7am Hour 1) How do families with this many kids make it work? 2) Welcome to Punch Court! 3) Not the same "balanced breakfast" you knew when you were a kid

The Break Room (THURSDAY 1/29/26) 6am Hour 1) Career Day didn't go as planned for one member of the Break Room 2) Most expensive impulse buy 3) Driving through the park on a suspended permit

The Break Room (THURSDAY 1/29/26) 8am Hour 1) If this happens inside your home, does it ruin the place you live in forever? 2) Let me tell you how we met... 3) Sorry, Jessica. We're mad at your dad

The Break Room (THURSDAY 1/29/26) 9am Hour 1) Kimmy realized she is only using this social media platform for one reason, and it's not what it was intended for 2) Well, at least we're not the Jets

Jan. 28, 2026- Assemblymember Sarah Clark, a Rochester-area Democrat, weighs in on Gov. Kathy Hochul's commitment to expanding child care access and considers how the Democratic majorities in the legislature may add to the plan.

Have you heard of the Rochester Urbanarium? Formed in 1970, the independent citizens' organization was dedicated to helping residents become more engaged with their local government to solve community problems. The founder, Gene DePrez, died last year, but his legacy lives on. An upcoming symposium celebrates DePrez's work and explores how residents can put the ideas of the Urbanarium into practice today. Our guests preview the event and discuss what it means to engage with government and each other — and how to encourage more of it. Simeon Banister, president and CEO of the Rochester Area Community Foundation Liz Call, former university archivist at RIT and current head of the Eberly Family Special Collections Library at Penn State University  Suzanne Mayer, co-founder of Hinge Neighbors Justin Murphy, research and communications coordinator for Our Local History William Schwappacher, creative director for the City of Rochester ---Connections is supported by listeners like you. Head to our donation page to become a WXXI member today, support the show, and help us close the gap created by the rescission of federal funding.---Connections airs every weekday from noon-2 p.m. Join the conversation with questions or comments by phone at 1-844-295-TALK (8255) or 585-263-9994, email, Facebook or Twitter. Connections is also livestreamed on the WXXI News YouTube channel each day. You can watch live or access previous episodes here.---Do you have a story that needs to be shared? Pitch your story to Connections.

The Break Room (WEDNESDAY 1/28/26) 6am Hour 1) Does career day at school actually inspire kids or are they just happy they get to skip class? 2) Everyone shouldn't love Marineland 3) Tommy says you can't get lost in the woods if you have your phone on you... Just use the compass, guys!

The Break Room (WEDNESDAY 1/28/26) 9am Hour 1) Despite the fact that everyone came to support Tommy's big night, he won't be returning the favor 2) Made In The USA... sort of

The Break Room (WEDNESDAY 1/28/26) 8am Hour 1) It's official... There's a conspiracy theory for literally everything 2) The most suspicious place your car can catch on fire 3) Sorry, Bill. Maybe next time.

The Break Room (WEDNESDAY 1/28/26) 7am Hour 1) Turns out the next man to lead the Buffalo Bills was already in the building 2) Crank Lake 3) Only one purchase should count

Coach Jim Johnson was named Coach of the Year in 2006 by several Rochester-area organizations and was also presented with a National Sportsmanship Award. These honors brought to light an impressive body of work over the past two decades. His career record is now 428-221, with divisional titles in 1996, 2002, 2003, 2006, 2007, 2008, 2009, 2013, 2014, 2015 and 2016. He was also named All-Greater Rochester Coach of the Year in 2014 and 2015. Coach Johnson has rolled his accomplishments and experiences into two speaking presentations, “Dreams Really Do Come True” and “Leadership Lessons from Half-Court”.Contact Coach Jim Johnson:website www.coachjimjohnson.comwww.youtube.com/@limitlessleadershiplounge6591 for our podcast.Two books: A Coach and a Miracle and Lessons From Thought Leaders that I wrote a chapter for. speaking, free monthly newsletter andfree weekly Blog.8) Social Medis Links: https://www.facebook.com/CoachJimJohnson https://twitter.com/CoachJimJohnson https://www.linkedin.com/in/coachjimjohnson/ https://www.instagram.com/coachjimjohnson/Dr. Kimberley LinertSpeaker, Author, Broadcaster, Mentor, Trainer, Behavioral OptometristEvent Planners- I am available to speak at your event. Here is my media kit: https://brucemerrinscelebrityspeakers.com/portfolio/dr-kimberley-linert/To book Dr. Linert on your podcast, television show, conference, corporate training or as an expert guest please email her at incrediblelifepodcast@gmail.com or Contact Bruce Merrin at Bruce Merrin's Celebrity Speakers at merrinpr@gmail.com702.256.9199Host of the Podcast Series: Incredible Life Creator PodcastAvailable on...Apple: https://podcasts.apple.com/us/podcast/incredible-life-creator-with-dr-kimberley-linert/id1472641267Spotify: https://open.spotify.com/show/6DZE3EoHfhgcmSkxY1CvKf?si=ebe71549e7474663 and on 9 other podcast platformsAuthor of Book: "Visualizing Happiness in Every Area of Your Life"Get on Amazon: https://amzn.to/4cmTOMwWebsite: https://linktr.ee/DrKimberleyLinertThe Great Discovery eLearning platform: https://thegreatdiscovery.com/kimberleyl

Clinicians and patients are in a state of prognostic uncertainty when they are unsure about the future course of an illness. By embracing uncertainty while cultivating prognostic awareness, neurologists can serve the critical role of supporting patients and families through the living and dying process. In this episode, Casey Albin, MD, speaks with Robert G. Holloway, MD, MPH, FAAN, author of the article "Managing Prognostic Uncertainty in Neurologic Disease" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Holloway is the Edward and Alma Vollertsen Rykenboer Chair and a professor of neurology in the department of neurology at the University of Rochester School of Medicine and Dentistry in Rochester, New York. Additional Resources Read the article: Managing Prognostic Uncertainty in Neurologic Disease Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Albin: Hello, this is Dr Casey Albin. Today I'm interviewing Dr Bob Holloway about his article on managing prognostic uncertainty in neurologic disease, which appears in the December 2025 Continuum issue on neuropalliative care. Welcome to the podcast, and please introduce yourself to our audience. Dr Holloway: Hi, Casey, and thank you. Again, my name is Bob Holloway. I'm a clinician and neurologist up in Rochester, New York, and I've been doing both neurology and palliative care for many years. Dr Albin: Well, that's fantastic. And I really wanted to emphasize how much I really enjoyed reading this article. I know that we're going to get into some of the pearls that you offer, but I really want to tell the listeners, like, this is a great one to read because not only does it have sort of a philosophical take, but you also really provide some pragmatic tips of how we can help our patients manage this prognostic uncertainty. But maybe just tell us a little bit, what is prognostic uncertainty? Dr Holloway: Yes, thank you. Well, I think everyone has a sense of what prognostic uncertainty is. And it's just the uncertain futures that we as clinicians and our patients face. And I would just say that a way to summarize it is just, how do we manage the "not yet" of neurologic illness? Dr Albin: I love that. In neurologic illness, there is so much "not yet" and there are so many unknowns. And what I thought was really helpful about your article is you kind of give us three buckets in which we can think about the different types of uncertainty our patients are facing. What are those? Dr Holloway: This is, I think, an area that really is of interest to me, thinking about how to organize the prognostic "not yet" or that landscape. And one way I've tried to simplify it is to think about it as data-centered. And that's the world that we mostly live in as neurologists. That's the probability distributions. We also have kind of system-level uncertainties, and that's the uncertainties that our health system affords for our patients. And then we have, also, the patient-centered uncertainties and the uncertainties that those two prior categories cause for our patients. And that's a big uncertainty that we often don't address. Dr Albin: In reading the article, I was really struck by, we spend a lot of time thinking about data uncertainty. Can we get population-based research? Can we sort of look at prognostication scoring? I live in the ICU, and so we think a lot about these, like, scoring metrics and putting patients into buckets and helping us derive their care based on where their severity index is. And I'm sure that is true in many of the divisions of neurology. But what I did not really appreciate---and I thought you did a really fantastic job of kind of drawing our attention to---is there's a lot of system-centered uncertainty. Can you give us a little bit of examples, like, what is system-based uncertainty? Dr Holloway: I think system-level uncertainties just encompass the practical information gaps that may arise during our healthcare encounter. And a lot of, I think, the uncertainty that our patients face and families, they actually describe it as they feel captive by the uncertainty. And it's just the unknowns, not just what affords from the actual information about the disease and its prognosis in the future, but actually the level of the system, like, who's going to take care of them? How do you manage arranging for nurses to come into the home or all those practical-level uncertainties that the system provides that sometimes we don't do a good job of road-mapping for patients. Dr Albin: Absolutely. Because I feel like we have a little bit of a gap in that often as physicians. Like, the family asks, what will hospice at home look like? Well, you know, that's a question for case management. I think they'll come in and they'll tell you. But it strikes me that that's a real gap of my being able to walk patients through. Will they get home health care? Will they have transportation set up? Will there be a nurse who comes in to check? How often are they available? What's the cost going to be? All of these practical aspects of dealing with an illness that are beyond sort of our scope of knowledge, but probably have a huge practical impact to the patient. Dr Holloway: Without question, every encounter patients wonder about, that kind of future wish landscape that we- all our future-oriented desires and hopes. And so much of that is the practical aspects of our health system, which is often fragmented, kind of unknown, uncertain. And that's a huge source of uncertainty for our patients and families. And then that leads to many other uncertainties that we need to address. Dr Albin: Absolutely. I think another one that we, again, maybe don't spend quite as much time thinking about is this patient-level uncertainty. What's going on there? Dr Holloway: Yeah. So, I think patient-level uncertainty is that uncertainty that they experience when confronted with the two other types of uncertainty: the actual data-centered uncertainty and the system-level uncertainty. And that's that, kind of, very huge kind of uncertainty about what it means for them and their family and their future futures. And that's a source of huge stress and anxiety, and often frankly bordering on dread and fear for our patients and families. That actually gets into very levels of uncertainty that I would call maybe over even in the existential realm. Patient-level uncertainty in the actual existential questions or the fear and the dread or the kind of just unnerving aspect of it is actually even more important to patients than the scientific or data-centered uncertainty that we focus most of our attention on. Dr Albin: Yeah, I think this is, to me, was getting towards that, like, what does the patient care about and how are they coping with what is in many times a really dramatic shift in their life expectancy or morbidity expectations and this sort of radical renegotiation about what it means to have a neurologic illness? And how does that shift their thinking about who they are and their priorities in the world? Is that right? Dr Holloway: One thousand percent, and in fact, I will say---and I think is one of the main take home messages is that, you know, managing prognostic certainty is not an end in itself. It really is to help patients and families adaptively cope to their new and often harsh new reality, that we could help them adapt to their new normal. I think that is one of our main tasks as neurologists in our care teams is to help patients find and ultimately maybe achieve existential or spiritual or well-being even in their new health states. You know, that you certainly often see in the intensive care unit, but we often always see in the outpatient realm as well, and all our other diseases. Dr Albin: I think that's really hard to do. I think those conversations are incredibly difficult and trying to navigate where patients want to be, what would bring meaning, what would bring value. I think many of us struggle to have these pretty real and intense conversations with families about what really is important. And one of the things I really liked about this article is you kind of walk us through some steps that we as clinicians can take to get a little bit more comfortable. Maybe just walk us through, what are some of the things that you have found most helpful in trying to get families and patients to open up about what brings them meaning? How are they navigating this new, really uncertain time in their life? Dr Holloway: Yeah, so I do kind of have a ten-point recommendations of how to help cultivate a more integrated awareness of an uncertain future. I mean, I think the most important thing is actually just recognizing that embracing uncertainty as an amazingly remarkable cognitive tool. I mean, let's face it, uncertainty, when it happens with neurologic illness and disease, is often fearful. It's scary. It kind of changes our world. But on the flip side of it, it's a remarkable cognitive tool that actually can help us find new ways and new paths and new creativity. And I think we can use that kind of opposites to help our patients find new meaning in very difficult situations. So, thinking about uncertainty, kind of being courageous, leaning into it and recognizing that it does create anxieties and fear, but it also can kind of help create new solutions and new ideas to help people navigate. Dr Albin: I was hoping that maybe you could give us an example of, like, how would you do that? If a patient comes in and they're dealing with, you know, a new diagnosis and they're navigating this new uncertainty, what are some of the things that you ask to help them reframe that, to kind of take some of the good about that uncertainty? How do you navigate that? Dr Holloway: One of the other recommendations is actually just resetting the timeline and expectations for these conversations. That it shouldn't be expected that patients should accept their harsh new reality immediately, that it takes time in a trusted environment. And that there's this, like, oscillating nature of hopes and fears and dread, and you've just got to work with them over time. And with time, and once you understand who the patient and family are and understand where they find meaning and where they find, actually, joy in their life, or what actually brings them meaning, you can start recasting their futures into credible narratives in their kind of future landscape in ways that I think can help them enter into their new realities within the, you know, framework of disease management that you can offer them within your healthcare team or your healthcare system or wherever you are in the world and the available resources that you have to offer patients and families. Dr Albin: So, this sounds like a lot to me like active listening and really trying to get to know what is important to the family, what is important to the patient. And I guess probably just creating that space even in that busy clinical environment. Do I have that right? Dr Holloway: You can absolutely do that, right. You know, and honestly, active listening, we are challenged in our busy healthcare system to do this, but I think with the right listening skills and the appropriate ways of paying attention, you can definitely illuminate these possible, kind of future-oriented worlds for patients and help them navigate those new terrains with them. Frankly, I think that's a real new space for us in neurology. We don't think about and train how to create credible narratives for patients and families. We do it on the fly, but I think there's so much more work to do. How do you actually keep, you know, that best-case, worst-case, most likely credible narratives for patients that can help them adapt to their new realities and support them on their new journeys? Dr Albin: I love that best-case, worst-case, most likely case. I find that framework really helpful. But you talk in your article, it's not just about using that best case or worst case or most likely, but it's actually building some forecasting into that and having some real data to kind of support what you're saying. And there's a lot of growth towards actually becoming good as a medical forecaster. Can you describe a little bit, what did you mean by that? Dr Holloway: You're absolutely right. I think, actually, one of the skillsets of becoming and managing prognostic uncertainty is actually becoming a skilled medical forecaster. And it's a really tall order. So, we've got to be both good medical forecasters as well as helping patients adaptively cope to their new reality. But the good medical forecasting is actually now going more quantitative in thinking about the data that's available to help think about the important outcomes for patients and families and then predicting what their probabilities are so you can shape those futures around. So, yes, we do have to have an open mindset. We do have to actually look at the data that's available and actually think about, what are those long-term probabilities and outcomes? And we can be honest about those and even communicate them with families. But it's a really good skill set to have. Dr Albin: Yeah. This to me was a little bit about, how do you bring in the data knowledge that we try to get over time as we develop our expertise? You're developing not just a reliance on population-based data, but in my experience, I have seen this. And that sort of ability to kind of look at the patient in front of you, think about the big picture, but also a little bit about their unique medical comorbidities or prior life experiences. So, some of that database knowledge, and then bringing in and getting to know what is important to the patient. And so, sort of marrying that data-centric/patient-centric mindset. Dr Holloway: I love it. I guess the other way of saying that, too, is we need to think with precision, but communicate in narratives. And it's okay to gently put more precise estimates on our probability predictions with patients and families, what we think is the most likely case, best and worst case. Because patients and families want us to be more precise. We often shy away from it, but- so, it's okay to think in precisions, but we've got to put those in narratives in the most likely, best-, and worst-case scenarios. And don't be afraid if you think in terms of ninety percents, ten percents, fifty percents; most patients and families don't mind that. And what they're telling us is they actually want to hear that, if you are comfortable talking in those terms. Dr Albin: Yeah, absolutely. And giving a sense of the humility to say, like, this is my best guess based on medical data and my experience, I would say, but again, none of us have a crystal ball. And I do think families, as long as you're sort of couching your expectations into the sort of imperfect, but I'm doing my best, really appreciate that. Dr Holloway: They totally do all the time. Just say, I simply don't know for certain, but these are my best estimates. That's a good way of just phrasing that. Dr Albin: Yeah. So powerful. I don't know for certain. And then I wanted to just kind of close out, because there's this one term that you use that I thought was so interesting. And I wanted you to kind of tell our listeners a little bit about what you mean here, which is that, when you're actively open-minded, you're using this, quote, "dragonfly eyes." What do you mean by that? Dr Holloway: So, the dragonfly eyes, as you know, they can look at three sixty around them and they just, they move in all directions. Being actively open minded, I guess the biggest example I would say is, I don't like the term prognostic discordance, which means that there's a difference of subjective estimates of prognosis between patients and families. Being openly minded is actually embracing the potential information that the family has about prognosis and incorporating that into your estimates. So, I wouldn't say it's discordances, per se; I think being really actively open-minded is taking that all in and utilizing that as, you know what, they know more than you do about the patient and their loved ones, and they may have insights that can inform your best estimates of prognosis. So, the true dragonfly prognosticator actually is one who embraces and doesn't consider it discord, but considers it kind of new, useful information that I just need to weigh in so I can help the family in my best professional way in terms of developing a prognosis, whatever the condition may be. Dr Albin: I can imagine this is just so challenging and something that takes a long time to sort of perfect all of this. I think you say right below that, you need a growth mindset to do this because it is hard, and it's going to take an active participation and an active desire to get better at these conversations with our families. Dr Holloway: One thousand percent. You are so right that it takes time, effort, and not feeling like you're being challenged, but that actually you are including them in your entire body of knowledge, that you're just- it's part of all you're collecting. And even, I was on service last week, and I talked to residents and students about that very issue. It's like take their prognosis. And someone who came in, we thought CJB, very sad, tragic case, but we were thinking about what the future may look like and how do we actually work with the family who had very what we thought was unrealistic expectations. I said, well, no, this is not discordance. This is just useful information that we can take understand where they're coming from and incorporate that into the ways we want to build relationships, build trust, and over time we'll get to a point where we hopefully can work with them and have them have that fully integrated awareness of their future. Dr Albin: Yeah, that's beautiful. It really is this ongoing negotiation that really requires so much listening, understanding, and then obviously information and expertise about the data that we're presenting and the likelihood outcome, recognizing that there's a lot of uncertainty in all of this. Which, you know, again, this is kind of a 360 talk. At every level there is uncertainty, and that's what makes it so hard. Dr Holloway: Yeah, you're absolutely right. And actually, even in the article I kind of used the term radical uncertainty as that, no matter how resolvable all this uncertainty is, there will always still remain that radical element of our existence which we have to actually incorporate and be prepared for. And actually, not only of ourselves, but actually for patients and families and helping manage that. Using narratives and credible narratives and kind of ranges of possibilities is the best way to do that in a personalized way. Dr Albin: Well, this has been a fantastic conversation, and I know that we are running a bit short on time. So, as we wrap up and you think about this topic, are there any key take-home messages that you hope our listeners will walk away with? Dr Holloway: I think one main emphasis is that despite all the successes we feel we have in neurology, is that we all have to recognize that prognostic uncertainty is just going to increase in the future. But this is going to be for several reasons. One is that, just, the illness uncertainty of all of our great therapies are just going to be creating more uncertainty for the future. And precision medicine is paradoxical, and that actually it creates more uncertainty. So, I think we need to be prepared that we have to manage prognostic uncertainty better, because it's definitely going to increase. And two, it's what I said earlier, is that actually managing prognostic uncertainty is not an end to itself. It's actually helping patients and families adapt to their new and sometimes harsh new reality and actually help them to ultimately get to a place where maybe either their condition is neither dreaded, but actually they can accept it as their new reality and actually achieve some sort of existential well-being and existential health. I think that we have a lot more to emphasize in this area. And for far too long, we've focused on the certainty aspect of our field and not enough on the uncertainty in the world of medicine to help our patients and families. Dr Albin: And gosh, isn't there just so much uncertainty? And I think this has been beautiful. So, thank you again for coming and sharing your expertise. Dr Holloway: Thank you very much. It's been a pleasure. Dr Albin: For all of our listeners out there, this is a truly fantastic article, and I would just like to direct you to going to read the cases because not only do the cases offer a little bit of practical advice, but there's one that's actually sort of a philosophical discussion about, what does it mean to be alive and confront death? There's some beautiful artwork that's featured as well. So this is just a really unique article, and I'm excited for our listeners to have a chance to check it out. So again, today I've been interviewing Dr Bob Holloway about his article on managing prognostic uncertainty in neurologic disease, which appears in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this and other issues. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

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