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Physician, author, and health care reform advocate David K. Cundiff discusses his article “Accountable care cooperatives: a 2026 vision for U.S. health care.” David analyzes the severe funding crisis affecting American families …
Community cooperatives offer a solution to the affordable health care crisis [PODCAST]
Steven couldn’t remember when he first noticed the spot on his toe, only that it began as a blister a few weeks earlier. He finally saw his doctor, but only when the entire toe had turned black. His doctor referred him to me, but he missed the appointment because the drive was 90 minutes, and he couldn’t take the day off work.
Two weeks later, half of his foot was dead, …
The vascular surgeon shortage: Why amputations are rising
When I told ProPublica that it was too expensive to protect us, I was naming what every number in this piece confirms. The system made a calculation about what our lives were worth, and it got the math catastrophically wrong.
I have been a nurse for almost 20 years, working in emergency departments, intensive care units, and eventually the back of a helicopter as a flight nurse. I have watched the …
The shadow ledger: Uncovering the financial cost of nursing turnover
Sometimes, the smallest failures expose the largest truths. At a remote Air Force base hospital, a silent pager revealed not my incompetence, but my supervisor’s lack of leadership, and set in motion a chain of events that reshaped the hospital’s command structure and ultimately influenced the future of Air Force pediatrics.
What began as a malfunction during an award ceremony became the catalyst for decisive leadership, a reorganization of medical services, …
Leadership in action: How a broken pager fixed a hospital
If you want to understand what “profits before patients” means in American health care, don’t start with a spreadsheet. Start with a story.
During residency, I cared for a middle-aged mother of two who came to our community hospital emergency room struggling to breathe. It didn’t take long to realize she needed something we couldn’t offer: urgent heart surgery at a larger hospital.
After a 30-hour shift, I filed the transfer request …
Profits before patients: the hidden cost of U.S. health care
If you asked ten physicians to explain how they maintain board certification, you’d get at least ten different answers, maybe more. Some take quarterly quizzes. Some submit CME attestations every five years. Some do both. Others, grandfathered in before time-limited certification existed, do nothing at all. Yet every one of them carries the same professional label: board-certified physician.
That simple title, once synonymous with competence, now hides a dizzying patchwork of …
Why maintenance of certification varies widely: a system in crisis
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Practicing anesthesiologist and the physician co-founder of Marit Health Rob Anderson discusses his article “Why can’t finding a doctor job be like Zillow.” Rob shares his personal journey through divorce and house …
Modern technology must revolutionize the archaic physician job search [PODCAST]
What do old people die from?
Ella passed away last week at age 84. I have cared for her since she was admitted to the nursing home two years ago. Her granddaughter called me wanting to know the cause of death. In old age, the cause of death is often the wrong question, as the end is usually not a single cause but a slow convergence of many.
Ella had a list …
Why death certificates fail to capture the reality of aging
Artificial intelligence is no longer approaching medicine. It is already embedded inside it. It drafts our notes. It summarizes research. It suggests differentials. It triages messages. It promises efficiency, scale, and relief from burnout. Physicians are adopting it quickly. That speed should give us pause.
The greatest threat facing physicians in 2026 is not resisting artificial intelligence. It is allowing artificial intelligence in health care to be designed without us. Every …
AI governance in health care: Why physicians must lead the design
After I got diagnosed with celiac disease when I was 19, I faced a difficult choice every time friends invited me out: I could either stay home, or I could risk getting terribly sick.
I was a college volleyball player at West Virginia University when I started experiencing severe migraines and stomach issues. I could not eat anything without getting sick, which resulted in me losing 40 pounds in just two …
Managing celiac disease: Overcoming the hidden social burden
It is said that we live in difficult times, and that reality is unavoidable for anyone who does not live as a hermit in a cave somewhere. For patients and their doctors, the signs of impending failure are equally unavoidable.
Health care consumes 18 percent of U.S. gross domestic product and continues to rise faster than the rate of inflation. Consumer confidence in the goodwill and scientific integrity of U.S. health …
Military leadership lessons for the U.S. health care crisis
For years, patients did not complain about their surgical care. They complained about not getting calls back.
The frustrating part was that my staff was calling them back. Messages were left. Voicemails filled up. Phone trees were in place. And still, patients felt ignored, staff felt defensive, and I found myself on a constant apology tour.
I assumed this was just how modern medical offices worked.
We had three people answering phones. We …
Surgical practice efficiency: How to fix a broken system
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
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Fertility specialist Oluyemisi Famuyiwa discusses her article “Uterine aging in IVF: Why the ‘soil’ matters as much as the seed.” Oluyemisi explains that while clinicians often focus on egg quality, the aging …
Uterine aging plays a critical hidden role in IVF outcomes [PODCAST]
Yesterday morning, I learned that one of my teachers had passed away. He was only 63, a devoted, tireless oncologist who spent his life teaching and training many oncologists across Pakistan. Many of his students went on to work abroad as senior oncologists and professors, carrying his legacy far beyond borders.
He was not my direct teacher, but rather the teacher of my supervisor, a teacher of a teacher. Yet distance …
A tribute to an oncologist: the power of mentorship in medicine
By presidential order, marijuana has been rescheduled from Schedule I to Schedule III. This is not a subtle bureaucratic shift. It is a historic decision with major medical, regulatory, and cultural implications. Yet, astonishingly, much of the medical community has responded with near silence. There has been little serious discussion, no broad professional debate, and minimal effort to educate clinicians or the public about what this change does, and does …
Marijuana rescheduling: Why the medical community’s silence is dangerous
I recently wrote a four-part series examining AI and the future of medicine. The response confirmed something important. Physicians are not merely curious about artificial intelligence. They are unsettled. The headlines are loud. Automation. Disruption. Replacement. It is reasonable to ask whether doctors will lose jobs, whether surgeons will be replaced, whether this is the beginning of a profession fundamentally reshaped.
The answers are neither triumphalist nor catastrophic. AI replaces tasks. …
Future of AI in medicine: Will algorithms replace doctors?
As my first rotation in surgery draws to a close, I’ve been reflecting not only on anatomy and technique, but on the structure of medicine itself. Surgery teaches hierarchy not as an obstacle but as a rhythm, one that protects patients and preserves excellence. In that rhythm, I found clarity about my role as a PA student: to learn medicine deeply while honoring the lineage of those who have mastered …
Why PAs are masters in medicine, not competitors to MDs
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