Writer Bruce Miller was asked by the creators of Frasier to come up with a song for the show. They wanted something pretty eclectic and jazzy, but to avoid any direct references to specific subject matter. So it was necessary to stay away from words about psychiatry, radio shows, the name “Frasier”, and anything else directly indicating aspects of the show. After writing the music, Miller called his friend, actor Darryl Phinnesse and he came up with the title/theme of the song stating that those things were mixed up Like Frasier Crane’s patients.

After completion Miller wanted Mel Torme to sing it but the producers insisted on Kelsey Grammer who put his personal touches on how it should be sung to match the character.