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 …
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 …
As lawmakers debate cuts to Medicaid and restrictions on care for undocumented immigrants, the question isn’t just what America covers—it’s who.
Proposals like the No Medicaid for Illegal Immigrants Act of 2025, and related attempts to embed its provisions in the One Big Beautiful Bill Act, aim to block federal funding for Medicaid services to undocumented families. Some state plans go further, threatening to remove children from CHIP if …
Brick-and-mortar stores must deal with online competition. Even health clinics face disruption from telemedicine. Yet optometrists have special protection in South Carolina.
When a telehealth company invented a safe and effective way for doctors to renew vision prescriptions remotely, political insiders rallied in Columbia to ban the service in South Carolina. Now, nine years later, the state-sponsored favoritism could end.
The South Carolina Supreme Court, which already rejected an attempt to …
President Trump signed into law the One Big Beautiful Bill Act (H.R. 1)—a 1,000+ page legislative thunderclap that had just cleared Congress, reshaping the landscape of American domestic policy as fireworks lit the sky. Branded as a domestic reset—heavy on tax cuts, defense expansion, and deregulation—it was not sold as a health care bill. But for those of us on the front lines of medicine, particularly in rural America, make …
Health care leaders don’t have a vision problem. We have an execution problem.
Over the last two decades, I’ve seen countless strategic plans crafted with care, insight, and bold ambition. Mission statements get refreshed. Core values are realigned. Retreats are held. Vision decks are created and shared from the C-suite to the frontlines. And yet — within weeks — most of those plans fade into the background.
The problem isn’t poor leadership …
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I have a great doctor. I’ve enjoyed his approach to providing care so much that I was greatly distressed when, at my last visit, he told me he was thinking of retiring early. While I consider myself fortunate to have a positive and dependable relationship with my doctor, fewer people now relate to that sentiment than before.
Gallup recently reported that America’s trust in professionals has declined, with overall trust …
In an age where bold language dominates headlines, it can be easy to overlook the real-world effects of complex legislation. But this is not just a matter of political branding. The proposed One Big Beautiful Bill Act has implications that, based on current research, could lead to substantial and preventable harm to public health.
As a fourth-year medical student with a background in public health, I’ve spent years studying how health …
As a surgery resident, I see the long shadow of poor public health every day — whether it’s a diabetic foot infection that’s gone too long without care or a hypertensive crisis that never should’ve happened. That’s why the proposed restructuring of the CDC and other federal health agencies is not just administrative news to me — it’s personal.
The argument for reform often leans on efficiency: Reduce bureaucracy, streamline oversight, …
There’s a stretch of days at the beginning of July, between Canada Day and Independence Day, when I find myself holding my breath. It’s a liminal space that I know intimately as a professional, a mother, and a dual citizen. Born Canadian and naturalized American. Over the past several years, as I have come into the full realization of who I am as a parent of a child with complex …
Medicine today is single-encounter oriented with documentation largely tailored for legal purposes rather than medical care. When an encounter ends, the physician must sign off the documentation and no further changes can be made; any corrections require another document that must also be signed off, but this is seldom done.
A further problem with current medicine is that many diagnoses are differential diagnoses instead of confirmed ones, which may be OK …
I am trapped in a circadian rhythm that I cannot escape from. I think it started when I finished my residency. And to make matters worse, this week it felt like I was also trapped in the series Squid Game. I awake about an hour before first light (sometimes as early as 4:30 a.m.) and almost instantly fall asleep about an hour after dusk if I am laying down. No …
Burnout isn’t a weakness—it’s a warning sign.
I recently spoke with a nurse practitioner looking for a lifestyle change that could give her more balance without stepping away from medicine.
“I love caring for patients,” she told me, “but I don’t even recognize my life anymore. My schedule runs me, not the other way around.”
For her, locum tenens wasn’t a detour but a lifeline. Within months, she regained control of her time, …
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