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Family physician, medical device inventor, and health care entrepreneur Tod Stillson discusses the article “AI governance in health care: Why physicians must lead the design.” Tod warns that the greatest threat to …
Why physicians must lead the design of artificial intelligence in health care [PODCAST]
Many doctors hear “the United Nations Sustainable Development Goals” and assume the subject belongs to diplomats, ministers, and development agencies. It does not. Doctors advance the Sustainable Development Goals every day, often without naming them. The United Nations’ 2030 Agenda includes 17 goals designed as an integrated framework for human well-being, equity, prosperity, sustainability, and partnership. They are meant to work together, not in silos. That matters because health does …
Medicine and the United Nations Sustainable Development Goals
Globally, about $1 trillion has been spent on diabetes-related treatment, a 338 percent increase over the last 17 years, according to the International Diabetes Federation. And yet, 3.4 million deaths were related to diabetes in 2024. This shows the massive strain diabetes has placed on health systems worldwide. One of the most common and debilitating complications of diabetes is non-traumatic lower limb amputation. Diabetes …
Preventing diabetic lower limb amputation with AI and offloading
Most skilled nursing facility leaders understand the quality measures that affect their operations. They live with Star ratings and Quality Reporting Program requirements every day. What is less visible is how the clinicians caring for those same residents are evaluated under Medicare’s Merit-based Incentive Payment System (MIPS).
When facilities and clinicians are accountable for the same resident outcomes through different quality programs but lack shared visibility into how those programs are …
How Medicare’s MIPS impacts skilled nursing facilities and clinicians
For more than two decades, I have worked in health insurance, first at insurers and more recently as a consultant on Medicare policy. I have led large Medicare Advantage analytics and actuarial organizations comprising actuaries and data scientists working to improve care delivery, manage costs, and optimize revenue. Having seen firsthand the sophistication insurers bring both to improving care and to maximizing revenue within the rules, I find today’s MA …
The truth about Medicare Advantage funding and costs
As Florida’s 2026 state legislative session reaches the halfway point, there are several health care bills up for discussion. While every session seems to have its own theme, common issues repeat themselves year after year. Here are some of the top bills involving health care in the Florida Legislature today.
AI regulation in insurance
Artificial intelligence (AI) and the concern for its regulation continues to be a hot topic. Mandatory Human Reviews …
Florida health care legislation 2026: top bills to watch
I spent decades as a nurse, choosing a profession grounded in care, patience, science, and the belief that showing up for others matters, even on the hardest days.
In 2017, that belief was shattered when I was physically assaulted at work. I survived, but I carry the scars of that day, both visible and unseen.
I have worked hard to heal through therapy, reflection, and learning how to trust my body again. …
Violence against health care workers: the silence must end
In the late 1990s, a U.S.-funded study randomized HIV-positive pregnant women in Bangkok, Thailand, to either a placebo group or a group treated with a short course of AZT. At the time, AZT was the standard of care in the U.S., and researchers knew the medication protocol worked at reducing mother-to-child HIV transmission by nearly 70 percent. The study looked at whether a shortened protocol could meaningfully reduce …
Repeating history: the ethics of the new Guinea-Bissau hepatitis B study
As a practicing physician who has worked in the health care field in five different countries, I have a pretty solid idea of why health care in the U.S. is so problematic. In the U.S., many entities related to health care are owned by the same companies. This is a concept called vertical integration, where one business controls every stage of the supply chain. To understand this, imagine the car …
The dangers of vertical integration in health care
According to the Primary Care Collaborative, primary care accounts for roughly 5 percent of health care spending, yet it influences nearly 90 percent of downstream costs. That statistic is not a compliment. It is a diagnosis. And for a profession that has spent decades accepting influence as a substitute for economic ownership, it is long past time to read it that way. For decades, physicians …
The economic shift from fee-for-service to direct primary care
I read with interest HHS’s request for public input on how regulation, reimbursement, and research and development can accelerate the adoption of artificial intelligence in clinical care. As someone who began his career as a software engineer, then became a practicing physician, and later founded a clinical AI company, I welcome this moment. It is overdue, and it is also fragile.
The promise of efficiency over autonomous medicine
AI’s greatest opportunity …
Artificial intelligence in clinical care: Shaping the HHS policy landscape
America is ready for an honest conversation about health care policy before more people suffer and we go broke waiting for it to happen. Fully one-third of Americans report that in the past 12 months they have skipped or postponed getting needed health care because of the cost. Thirty percent say that they or a family member had problems paying for health care in the past year, and 41 …
American health care policy reform: Why we need a bipartisan commission
Recently, my husband and I passed through Eureka, IL (pop. 5,200). We stopped at Eureka College, which is President Ronald Reagan’s alma mater and the host of the Ronald Reagan Museum. As visitors to many presidential libraries, we …
The service of humanity: Recommitting to physicians’ ethical duties
A piece circulating in the direct primary care community made a confident claim: that the best DPC physicians will not need employer-aligned models or adjacent entities because individual consumer demand will sustain them. Fully booked by individuals, insulated from institutional complexity, answerable to no one but their patients.
It is a satisfying idea. It is also an empirically untested one.
The history of DPC is built on physicians willing to challenge entrenched …
The future of employer-aligned DPC and physician autonomy
Recently, Dr. Tara Kiran made headlines when her robust national OurCare survey revealed 5.9 million Canadians still lack a primary care provider, the point-of-entry health professional, like a family doctor or nurse practitioner, who provides routine care.
Those who do have a primary care provider often wait weeks for an appointment, then get rushed through in minutes. Emergency departments overflow with patients who have nowhere else to go.
The federal government …
From Singapore to Canada: a blueprint for primary care transformation
Health care is rapidly transitioning toward value-based care, yet many clinicians remain uncertain about what it actually means for their daily work. Despite widespread discussion of quality metrics, cost containment, and population health, clinicians are increasingly expected to deliver system-level outcomes without structured preparation to function within the systems that demand them.
If health care seeks to improve the lives of clinicians and patients while strengthening continuity of care, it must …
Value-based care workforce: Bridging the gap in clinical education
American health care has changed so profoundly in the last three to four decades that it is all but unrecognizable to those of us spending our careers in private practice. In my opinion, the root causes are not that complex. Foremost among them is the unconscionable disparity between the remuneration received by hospital-employed physicians and that of their counterparts in private practice for the same service or procedure.
This is abetted …
The death of private practice: unequal pay and hospital power
The veil of pretense was snatched long ago. So, politicians dare not brazenly declare that the U.S. has the greatest health care in the world. The system is broken. Neither Republicans nor Democrats have a remedy. It is a perverted Robin Hood system, where the rich are robbed to serve the poor poorly.
The exorbitant insurance premiums are unaffordable for many, and for others, it is as if it were a …
Curing U.S. health care: Why a fair health tax is the answer
Between 2005 and the present, 195 rural hospitals have closed, with a 50-hospital net reduction occurring just between 2017 and 2023. These closures, compounded by significantly worse measures of social determinants of health (SDOH), high prevalence of Medicaid or Medicare patients, and longer commute times, have created a crisis of access for rural Americans.
The disproportionate impact on rural residents
Compared to their urban and suburban counterparts, …
Rural health care crisis: Can telemedicine close the gap?
Single-payer health care is generally defended with “heart-wrenching” virtue signaling divorced from any cost, economic, or financial reality. The idea that any scarce service or commodity is a right and therefore should be free is fanciful, but impossible. With an indebtedness of $38 trillion and growing, adding greater than $40 trillion as estimated for the cost of “Medicare for All” would absolutely drive the country into insolvency. Even without single-payer, …
Single-payer health care vs. market-based solutions: an economic reality check
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