Remember the “before times” pre-pandemic, when most doctors had a single job that they went to every day, saw patients, did surgeries, took call for the same employer or practice?
Then in March 2020, the unthinkable happened. There was a worldwide shutdown of almost everything, including physicians’ offices, except for emergency rooms, ICUs, and other essential health care functions.
Once the realization set in that medicine was going to have to change …
As a young pediatric anesthesia attending, I would often roll my eyes at resident trainees who prioritized their personal needs and required mental health days. I may have even looked down upon them as lazy, weak, and lacking grit. I prided myself on my work ethic, sacrificing time with my two children and aging parents for the sake of my patients. Medicine is a calling, not just a job, I …
“We do not have the money! You took it all!”
Startled, I moved the phone away from my ear to dampen the screaming voice on the other end. I had just explained to my patient’s son that his 95-year-old mother could walk again; she just needed surgery to repair her hip fracture. This was good news, or so I thought. His mother had insurance, “good” insurance, and needed a fairly routine …
Imagine a patient is admitted overnight for a mild UTI. In the ED, she is told that a peripheral IV catheter (PIVC) needs to be inserted. She asks why—after all, she is volume neutral, taking her daily medications by mouth without issue, and her CBC/CMP are unremarkable. “It is just a precaution,” she is told—just a benign step in the protocol. For the two days the patient is hospitalized, the …
In today’s data-rich but insight-poor health care environments, the ability to measure performance isn’t the problem. The real challenge is turning that measurement into meaningful, actionable insight—and more importantly, sustainable improvement. I’ve seen countless KPI dashboards rolled out with great fanfare, only to become screen clutter that no one trusts, understands, or uses to drive change.
To avoid that fate, you must build dashboards rooted in operational reality, tailored to the …
Physicians today face mounting challenges in the practice of medicine, including declining reimbursement, workforce shortages, administrative burdens, and the ever-present risk of litigation. The Doctors Company’s latest study, “Nuclear Verdicts and Rising Costs: How Inflation Is Impacting Medical Malpractice Claims,” highlights another pressure point: the accelerating impact of inflation on medical malpractice claims.
The research study, conducted by Moore …
You, there beyond the words of this page. Oh, how I wish I could step beyond this limited medium and have a one-on-one conversation with you, as this matter is of the utmost importance to me. Unfortunately, I can do no such thing. As a result, I must lay out the groundwork by which this spewing of feelings will work henceforth. We medical students are fond of only wasting our …
A few months ago, I met a woman who had stopped speaking at dialysis. She had grown quiet, worn thin by the rhythm of a system that seemed to talk around her but never truly to her. When she finally spoke to me, it was not about her labs or transplant status. It was a whisper — “Do you think I’ll make it in time?”
In that moment, she wasn’t asking …
Recently, The Hill published an op-ed purporting to be a measured critique of gender-affirming care for youth. In reality, it was a dangerous and misinformed piece of ideological propaganda cloaked in the language of academic concern and propped up by debunked claims and bad faith arguments.
Riffer, who has studied censorship, gender regulation, and the legislative targeting of LGBTQIA+ communities across the U.S., will say …
Inland Southern California stands as one of the most diverse and rapidly growing regions in the United States. With a rich mix of cultures, ethnicities, and socioeconomic backgrounds, it also faces significant health disparities. From disproportionate rates of chronic diseases like diabetes and hypertension to barriers in accessing essential care, marginalized communities in the region continue to suffer the consequences of a health care system that often leaves them behind. …
American medicine has mastered a perverse art: paying more to achieve less.
We call it “cost-cutting,” but it is a system of engineered backwardness. We underfund clinical staff, then spend fortunes on lawyers to defend the inevitable errors. We employ armies to process bills while insurers employ armies to deny them. We treat the eyes, the teeth, and the mind as optional accessories, as if they could be unbolted from the …
Before I started medical school, I used to pass the same government hospital every day on my way to school. It was one of those places that offered “free treatment,” but even as a teenager, I could sense that the care was often just for the name. I remember going to school the next day at around 6:30 a.m., I saw a man sitting outside the hospital, the same man …
The so-called “One Big Beautiful Bill” was passed by both houses of Congress and signed into law by the president on July 4, 2025. This bill will have a sweeping impact on the already declining health care landscape in America.
If you’ve been feeling a mix of confusion and frustration, you’re not alone. This isn’t just policy. This is your career, your practice, and your patients.
This bill brings the largest cuts …
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You may have noticed the Supreme Court announced several crucial rulings on controversial topics. Buried in most coverage was a note that the Court upheld the legality of the U.S. Preventive Services Task Force (USPSTF).
Most folks have no clue what the USPSTF is or does. To people like me, it is crucial to advancing the early detection and prevention of cancer in the United States. For now, we can be …
An excerpt from Disease Detectives: True Stories of NYC Outbreaks.
Dr. Westyn Branch-Elliman contributed to this chapter.
There exist within NYC, communities that feel more like a small town than a perspiring slab of metropolis. People know and speak to their neighbors, greet each other warmly on the street, and watch over each other’s children. Single- and two-family brick homes with small, manicured lawns line quiet streets. There is usually one …
Over the past several years, each time a periodic U.S. hospital closures report is released, the number failing financial stress tests and at extreme risk of closing rises. The number now approaches 800 nationwide.
Meanwhile, many project that the just-passed One Big Beautiful Bill will rapidly increase these closures and further degrade health care access for American citizens.
Touted reasons for accelerating hospital closures, especially impacting …
I recently spoke with close friends—both physicians—who admitted something quietly alarming: They’re not resisting change in health care. They’re just tired of constantly adapting while losing the essence of what brought them into medicine in the first place.
“I spend more time documenting than actually caring for my patients.”
“Every time I adjust to one system, a new one replaces it.”
These comments stayed with me—not as complaints, but as confessions. As a …
I understand that, in August, we will receive the prescription for the poor results of the recent Make America Healthy Again (MAHA) report focused on children’s health. As a pediatrician, I would like to offer some remedies for the child nutrition shortcomings identified in the report and provide feedback on other health concerns it raises.
Chronic disease rates among children are mentioned first in the report. Authors point to …
Rising costs are dominating kitchen table conversations across the country, and health care is no exception. In response, federal and state regulators have introduced a range of proposals to curb spending and improve efficiencies—some thoughtful, others deeply flawed. As a former emergency medicine physician and now a health care executive with over three decades of experience, I’ve seen what works and what doesn’t. If we’re serious about cost control, we …
Imagine going to a restaurant where, instead of being charged separately for your appetizer, main course, and dessert, you pay a fixed price for the entire meal. That’s the idea behind a bundled payment plan in health care. Instead of billing patients and insurers for every individual test, treatment, or doctor’s visit during a medical episode—like a knee replacement—providers receive a single, comprehensive payment for all services related to a …
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