Multiple clinical platforms.
One integrated standard.

Diagnostic confirmation, severity classification, step-therapy management, and biologic evaluation for patients with refractory or type 2 inflammatory disease. Asthma at subspecialty level means distinguishing true asthma from asthma mimics, including EGPA, ABPA, and VCD, and knowing when biologics change the trajectory.

Staging, inhaler optimization, exacerbation prevention, and pulmonary rehabilitation coordination. Early COPD is frequently undertreated and late COPD frequently undertriaged. Both failures are addressable with correct subspecialty management.

Pattern recognition and subtype differentiation across UIP/IPF, NSIP, COP, and hypersensitivity pneumonitis. Antifibrotic therapy evaluation when clinically appropriate. ILD is a field where the specific diagnosis determines whether treatment helps or harms.

Differentiation of WHO Group 1 PAH from Group 2–5 etiologies using echocardiography, PFTs, and clinical correlation. Appropriate referral when right heart catheterization or targeted PAH therapy is indicated.

A structured algorithmic approach to cough lasting more than 8 weeks: upper airway cough syndrome, GERD, asthma, non-asthmatic eosinophilic bronchitis, and ACE inhibitor-related disease. Chronic cough responds to a correct diagnosis far better than to empirical suppression.

Systematic cardiopulmonary evaluation for unexplained shortness of breath. Separating cardiac from pulmonary from deconditioning contributors requires a structured differential and targeted testing, not a scatter-approach order set.

Stage-based management including when to observe, when to treat, and when to escalate. Multisystem sarcoidosis requires longitudinal monitoring across pulmonary, cardiac, and extrapulmonary manifestations.

Airway clearance strategy, microbiology-directed antibiotic therapy, and exacerbation management. Evaluation for underlying etiologies including PCD, CVID, and NTM-associated disease when clinically suggested.

ATS/IDSA criteria-based evaluation for treatment initiation vs. observation. Species-specific antibiotic regimen selection and duration planning. NTM therapy is prolonged, toxic, and frequently unnecessary. The decision to treat requires the correct expertise.

Fleischner Society and Lung-RADS guideline-based surveillance, risk stratification, and biopsy coordination when indicated. Pulmonary nodule management requires ongoing engagement, not a single CT report and a 12-month recall.

USPSTF-criteria eligibility assessment, annual low-dose CT coordination, structured result interpretation, and shared decision-making for patients at high risk for lung cancer due to smoking history.

Evaluation of pleural effusions, pleural thickening, and recurrent pleural disease. Determination of etiology and coordination of thoracentesis or further evaluation when clinically necessary.

Assessment of persistent dyspnea, exercise intolerance, and fibrotic changes following COVID-19. A systematic workup differentiates post-infectious fibrosis, airway reactivity, deconditioning, and other contributors.

History-driven evaluation linking specific occupational and environmental exposures to pulmonary diagnoses. Accurate attribution matters for treatment, disability evaluation, and workplace modification.

Structured risk stratification and optimization for patients with lung disease preparing for elective or semi-elective surgery. Clear documentation for surgical and anesthesia teams.

Subspecialty interpretation and clinical correlation of spirometry, lung volumes, and diffusion capacity findings that primary care was not trained to contextualize within a broader clinical picture.

Resting, ambulatory, and nocturnal oxygen saturation assessment. Qualification testing for home oxygen and prescription, with ongoing monitoring and reassessment as clinical status changes.

Comprehensive evaluation including lung cancer screening coordination when indicated by USPSTF criteria, spirometry, and management of tobacco-related airway and parenchymal disease.

Home or in-lab diagnosis, PAP therapy initiation, and long-term management, including mask fit, pressure optimization, and remote data review between visits. When managed correctly, sleep apnea treatment produces measurable improvements in blood pressure, cognitive function, and long-term cardiovascular risk.

Evaluation and management of central and mixed apnea patterns, including consideration of adaptive servo-ventilation and underlying cardiac or neurological contributors. Central apnea requires a fundamentally different diagnostic and therapeutic approach than obstructive sleep apnea.

Assessment when obstructive sleep apnea persists or transforms during CPAP therapy, with therapy mode adjustment, switch to bilevel PAP, or evaluation for Inspire eligibility when appropriate.

A practical reassessment of mask fit, pressure settings, sleep study data, PAP alternatives, and Inspire eligibility when appropriate. CPAP failure is not the same as treatment failure. Most patients have more options available than they have been told.

Evaluation, activation, fine-tuning, and longitudinal management for eligible patients with obstructive sleep apnea who cannot tolerate or have failed CPAP. Dr. Halani is Inspire therapy trained and manages the full continuum of care.

Structured evaluation to determine whether clinically significant sleep-disordered breathing is present. Snoring with fatigue, morning headaches, or impaired concentration warrants objective sleep testing rather than reassurance.

Differentiation of sleep apnea, insufficient sleep, circadian rhythm disorders, medication effects, and central hypersomnia. Excessive sleepiness that persists despite adequate CPAP use requires further evaluation.

When insomnia and sleep apnea co-occur, each condition affects the other. Management requires a coordinated, sequenced approach rather than treating one in isolation.

Evaluation and management including bilevel PAP therapy, daytime CO2 monitoring, and coordination with endocrinology and bariatric medicine when appropriate. Often underdiagnosed in patients with severe obesity and sleep symptoms.

Assessment of overnight oxygen desaturation in patients with COPD, ILD, heart failure, or sleep apnea. Determination of whether supplemental oxygen during sleep is clinically indicated and physiologically appropriate.

Integrated evaluation when sleep disorders interact with lung disease, heart failure, or pulmonary hypertension. This overlap between cardiology, pulmonology, and sleep medicine is where subspecialty training in all three areas is most clinically valuable.

Diagnostic evaluation when sleep fragmentation and restlessness raise clinical concern for occult sleep apnea. Not all sleep apnea presents with classic snoring. Some patients present primarily with arousals, restlessness, and non-restorative sleep.

Ambulatory sleep testing coordination, physician interpretation, and timely follow-up. Home sleep studies are appropriate for many patients, but the result requires expert interpretation and a clear management plan, not simply a report filed in the chart.

When home testing is clinically insufficient due to complexity, comorbidities, or prior inconclusive results, in-laboratory polysomnography is arranged, interpreted, and followed with a clear treatment plan.