We all know the look of a patient about to crash. The monitor has not flatlined yet, but the story is already in the vitals: The pulse is racing, the pressure is dropping, the skin is clammy.
That is the U.S. economy right now. Debt overload looks like a chronic hemorrhage. High interest rates are a sustained hypertensive crisis. Political paralysis is the family arguing in the hallway while the patient deteriorates. All we are missing is the shock that tips the system over the edge.
Step 1: Stabilize the bleed
When we see a GI bleed, we do not wait until cirrhosis is treated. We stabilize first. For the economy, that means capping runaway spending, stretching out debt maturities, and putting a permanent IV line into the financial system in the form of reliable liquidity support.
Step 2: Fix the underlying disease
The real disease is structural, and as physicians we live inside its most expensive organ system every day: health care. We know the waste, the price opacity, and the misaligned incentives. Moving to site-neutral payments, demanding real drug and hospital price transparency, and shifting from coding to outcomes would begin to bend the curve. Broader reforms: indexing entitlements, widening the tax base, and allowing more workers into the labor force, are the consultations this complex patient needs.
Step 3: Build resilience
Once the bleed is controlled and the underlying disease addressed, you build resilience. Long term, the cure is productivity. That means sustained investment in AI, biotech, energy infrastructure, and reskilling our workforce. Think of it as cardiac rehab after the stent, the ongoing work that prevents the next code.
What physicians can do now
We cannot run Treasury or Congress, but we can act as financial first responders in our own lives and practices. That begins with checking our own vital signs, our assets, liabilities, and debt service, on a regular basis. It means having a crash cart ready in the form of a liquid reserve and a credit line. It means adopting a barbell strategy that combines safe cash equivalents with durable, cash-flowing investments, while avoiding fragile balance sheets. And it means running our own code drills: asking ourselves now, not during the chaos, what we would buy, sell, or hold if the market fell thirty percent overnight. Finally, we should educate our teams, from partners to residents, because financial literacy is as critical as clinical literacy.
Closing
We understand systems in crisis better than anyone. America’s financial patient is not pulseless yet, but it is unstable. When the shock comes, and it will, we need our own crash carts stocked.
We cannot fix Washington. But we can make sure we are not the ones coding when the system crashes.
Larry Kaskel is an internist and “lipidologist in recovery” who has been practicing medicine for more than thirty-five years. He operates a concierge practice in the Chicago area and serves on the teaching faculty at the Northwestern University Feinberg School of Medicine. In addition, he is affiliated with Northwestern Lake Forest Hospital.
Before podcasts entered mainstream culture, Dr. Kaskel hosted Lipid Luminations on ReachMD, where he produced a library of more than four hundred programs featuring leading voices in cardiology, lipidology, and preventive medicine.
He is the author of Dr. Kaskel’s Living in Wellness, Volume One: Let Food Be Thy Medicine, works that combine evidence-based medical practice with accessible strategies for improving healthspan. His current projects focus on reevaluating the cholesterol hypothesis and investigating the infectious origins of atherosclerosis. More information is available at larrykaskel.com.
