Policy

Why direct primary care (DPC) models fail

Policy

October 13, 2025

I’m going to say something controversial: the DPC community’s obsession with “purity” is missing the point. After two decades designing health care financial models, negotiating payer & vendor contracts, and building compliance frameworks, I’ve learned that most alternative payment models don’t fail because they’re impure. They fail because someone forgot to do the math.

When $1 million can’t save a bad idea

The University of Houston medical school launched a direct primary …

Why doctors are losing the health care culture war

Rusha Modi, MD, MPH

Policy

October 12, 2025

The interview ends. The line goes dead. A senior CDC official has resigned, not because the science changed, but because the room did. Within forty-eight hours, CDC Director Monarez is fired by tweet, three senior leaders walk out, and a deputy from HHS (Jim O’Neill, a Silicon Valley investor turned political enforcer) is slotted in as acting CDC chief.

The headlines say turmoil. That is the polite word for capture.

Meanwhile, the …

The smart way to transition to direct care

Dana Y. Lujan, MBA

Policy

October 6, 2025

Physicians tell me they want out of the insurance grind, but they’re terrified to actually do it. That fear is costing them years of autonomy they could already have.

As someone who supports both DPC and concierge physicians, I believe in the purity of the DPC model, but I also believe in practical pathways to get there. Hybrid models aren’t the compromise position; they’re the strategic bridge that makes the transition …

Bearing witness to the gun violence epidemic

Michelle Weiss

Policy

October 6, 2025

I stare down at the ground below me, closing my eyes tight, trying to hold back the tears. “Push it down. Deep breath in. Breathe it out … slowly … again …” The mantra I say in my head whenever it suddenly becomes too much.

I open my eyes to the view of the ground, unwillingly taking a snapshot of the view that surrounds me. Like the slow click of a …

The false link between Tylenol and autism

Anonymous

Policy

October 5, 2025

The 9/22 White House press conference regarding acetaminophen raises two serious concerns. First, the scientific accuracy of the purported link between acetaminophen and Autism Spectrum Disorder (ASD) is dubious. Additionally, the norms of public communication concerning whether a President should offer medical advice existed for good reason. The heads of CMS, NIH, and FDA were present, but did not dispute in real time the essential claim that Tylenol causes autism.

Second, …

Why doctors are leaving insurance-based care

Dana Y. Lujan, MBA

Policy

October 2, 2025

For years, concierge medicine and direct primary care (DPC) were viewed as fringe alternatives, reserved for affluent patients or entrepreneurial physicians willing to step outside the insurance system. But in my opinion, these models are no longer “nice-to-have” side projects. They’re becoming essential pathways for physicians to reclaim careers, reduce burnout, and meet patient expectations in an evolving health care landscape.

Burnout is pushing physicians to the edge.

The pandemic only magnified …

Congress must make telemedicine permanent now

Ryan Nadelson, MD

Policy

September 30, 2025

On October 1, unless Congress acts, millions of Americans will lose access to telemedicine. A proven tool that has kept patients safe, doctors present, and costs down will vanish not because it failed, but because lawmakers failed to make it permanent. That would not just be bad policy. It would be malpractice by Congress.

I think of a patient of mine in northeast Georgia who lives 90 minutes from my clinic. …

Why we need national nurse-to-patient ratios

Brendan Fasick, RN and Abby Ehrhardt, RN

Policy

September 28, 2025

My current feeling as a nurse is more closely related to those of a line cook than to what I imagined nursing would be. Patients arrive with complex medical needs, yet we are forced to see them as checklists to be processed before the next shift arrives. Turnover feels like moving products down a line instead of treating people with care and dignity. This is not a failure of individual …

Treating the economy like a crashing patient

Larry Kaskel, MD

Policy

September 27, 2025

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 …

The crisis of antisemitism in our hospitals

Carrie Friedman, NP

Policy

September 26, 2025

On October 7, 2023, more than 1,200 people were murdered in a single day in the Hamas-led terror attacks in southern Israel, and over 250 individuals were taken hostage. This was the deadliest antisemitic attack since the Holocaust. For many Jewish health care workers, it marked a devastating shift: Our hospitals and clinics were no longer safe, not because of external conflict, but simply because we are Jewish. We had …

A lawyer’s guide to physician side gigs

Contract Diagnostics

Policy

September 19, 2025

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 …

Read more…

A lawyer’s guide to physician side gigs

How physician burnout and system reform are shaping the future of U.S. health care

Irim Salik, MD

Policy

September 18, 2025

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 …

Why doctors must fight for a just health care system

Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD

Policy

September 18, 2025

“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 …

Unused IV catheters cost U.S. hospitals billions

Piyush Pillarisetti

Policy

September 15, 2025

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 …

Why your health care dashboard isn’t working and how to fix it

Dave Cummings, RN

Policy

September 11, 2025

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 …

Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

Robert E. White, Jr. & The Doctors Company

Policy

September 11, 2025

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 …

How new loan caps could destroy diversity in medical education

Caleb Andrus-Gazyeva

Policy

September 10, 2025

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 …

Why transplant equity requires more than access

Zamra Amjid, DHSc, MHA

Policy

September 7, 2025

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 …

Ideology, not evidence, fuels the anti-trans agenda

Andie Riffer, PhD and Shawn E. Parra, LCSW, MSW

Policy

September 7, 2025

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 …

Health equity in Inland Southern California requires urgent action

Vishruth Nagam

Policy

September 5, 2025

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. …

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