David K. Cundiff is a physician, author, and health care reform advocate whose work centers on transforming the U.S. health care system and addressing broader societal challenges, including climate change. He is a volunteer collaborator with the Institute for Health Metrics and Evaluation.
From 1981 to 1998, Dr. Cundiff practiced, taught, and conducted clinical research in internal medicine and pain control at the Los Angeles County + USC Medical Center, where he directed the Cancer and AIDS Pain Service for nine years, and previously held an academic affiliation with Harbor-UCLA Medical Center. After exposing how systemic inefficiencies increased hospital utilization and revenue, he became a whistleblower, an experience documented in Whistleblower Doctor: The Politics and Economics of Pain and Dying.
He is the author of Grand Bargains: Fixing Health Care and the Economy, which proposes structural reforms to dramatically reduce health care costs while improving outcomes. His essay "Much Better Healthcare for Way Less Cost" explores accountable care cooperatives and community-based reform. Additional works include Money Driven Medicine: Tests and Treatments That Don't Work and Euthanasia Is Not the Answer: A Hospice Physician's View.
Outside his professional work, Dr. Cundiff values time with friends and family, including six grandchildren, and maintains his health through Hatha yoga, meditation, swimming, Zumba, biking, and a diet emphasizing minimally processed organic food. He shares updates on LinkedIn.
For decades, the medical community has accepted a foundational principle of cardiovascular care: patients with non-valvular atrial fibrillation (AFib) require aggressive, lifelong stroke prophylaxis. When a patient also presents with stable coronary artery disease (CAD), standard practice has historically gone a step further, layering an antiplatelet such as aspirin on top of an oral anticoagulant such as warfarin or a modern direct oral anticoagulant (DOAC). To frontline hospitalists and patients, …
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Is anticoagulation bleeding risk worse in the real world?
In 1997, the LA Times published my article titled “Good Medicine, Fewer Hospital Beds.” Writing as an attending internist at a large public teaching hospital, I criticized a decision to spend $900 million on a massive 600-bed replacement facility. My experience affirmed what federal, state, and county analysts already knew: Resources were poured disproportionately into expensive acute inpatient specialty services, leaving primary care and out-of-hospital services for millions of …
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The anticoagulant standard of care nobody tested
Eight years ago, motivated by concern for my six grandchildren and future generations, I began a systematic study of climate change through the assessment reports of the Intergovernmental Panel on Climate Change (IPCC). That work led me to focus on a central omission in mainstream climate modeling: The failure to model global conversion to exclusively organic agriculture.
In 2024, the preprint journal SSRN published my scenario to reduce net projected greenhouse …
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Ecovillages and organic agriculture: a scenario for global climate restoration
As of January 1, 2026, the American health care system is in crisis. People can no longer afford their health insurance premiums or even to afford to pay for any health insurance. Recently, a 62-year-old self-employed friend of mine saw his premiums increased tenfold in a single cycle. I am lucky that I am over 65 and have Medicare insurance as well as a pension from my employment. Millions of …
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Accountable care cooperatives: a 2026 vision for U.S. health care
My previous KevinMD article discussed a Cochrane Collaboration review that was completed in 2002 but was not published until 2006. This review examined three randomized controlled trials (RCTs) comparing anticoagulants with placebos or anti-inflammatory drugs for venous thromboembolism (VTE).
Along with my two co-authors, I found that across these three trials, anticoagulant-treated patients had six deaths out of 66 patients, compared to only one death out of 60 in the placebo …
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Methodological errors in Cochrane reviews of anticoagulation therapy
My partner broke her femur in a Zumba class just before Christmas 2025 and had successful surgery. Following successful surgery, physicians prescribed Lovenox (an anticoagulant) and Plavix (an antiplatelet drug), the standard regimen for preventing or treating venous thromboembolism (VTE). However, the intervention proved very risky: She lost three pints of blood into her leg and required a two-pint blood transfusion, direct complications of the Lovenox and Plavix.
Physicians adopted anticoagulants …
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The anticoagulant evidence controversy: a whistleblower’s perspective
JAMA published the long-awaited Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure-8 (JNC-8) guidelines December 18, 2013. They recommended blood pressure lowering drug treatment for patients 60 years old and over with systolic blood pressure (SBP) 150 or higher or diastolic blood pressure (DBP) 90 mm Hg or higher. For patients under 60 years old, they recommended medications for DBP 90 mm Hg or …
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A call to retract the JNC-8 hypertension guidelines
After the LA County + USC Medical Center closed my Pain and Palliative Care Service because of budget cuts in 1995, I spoke out publicly about the dysfunctional financial reimbursement system funding charity care in LA County.
For example, when my consultation service controlled the pain and distressing symptoms of over 400 terminally ill cancer and AIDS patients per year and discharged them to home hospice programs, the hospital lost about …
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The story behind a whistleblower doctor license reinstatement hearing
