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Physician, author, and health care reform advocate David K. Cundiff discusses his article “Accountable care cooperatives: a community-owned health care fix.” David outlines a transformative plan to replace the fragmented U.S. insurance …
Community ownership transforms the broken health care system [PODCAST]
I practice mobile wound care because it works. Treating chronic wounds in patients’ homes, skilled nursing facilities, and assisted living settings improves adherence, reduces missed visits, and often prevents avoidable hospitalizations. For medically complex patients, mobile wound care is not a convenience; it is frequently the only viable model.
But in 2026, mobile wound care is under sustained pressure. Lower local coverage determinations (LCDs), intensified CMS surveillance, and expanding documentation requirements …
Mobile wound care in 2026: Navigating regulatory pressures
In modern medicine, we like to believe that geography no longer determines outcomes. Advanced technology, integrated referral systems, and universal health coverage are supposed to ensure timely care for everyone. Yet for one woman in Taiwan, a country often praised for having one of the world’s most efficient universal health care systems, the greatest obstacle to cancer treatment was not distance. It was time.
Ms. Li, a retired woman living in …
Why smaller hospitals may be faster for cancer diagnosis
As reported in the Philadelphia Inquirer, Louis-Hunter Kean was 34 years old when he died in November 2023 at the Hospital of the University of Pennsylvania (HUP). For more than a year, he endured cyclical fevers as high as 104.5 F, drenching night sweats, profound fatigue, hepatosplenomegaly, cytopenias, and escalating inflammation. Over six months in 2023, he was hospitalized five times. His electronic medical record ballooned to …
Missed diagnosis visceral leishmaniasis: a tragedy of note bloat
I will never forget the patient I met in the emergency department who was pale, trembling, and in tears, her family in distress at her side in the trauma bay. She was suffering complications after taking medication to end her pregnancy. While such side effects can occur with medical abortions, they are markedly more likely when patients are forced to use misoprostol alone, a reality in states that restrict access …
Mifepristone restrictions: How bans force patients into riskier care
In Accra, Ghana, the ward glowed ocean blue under phototherapy lamps. Chlorhexidine lingered in the air, cardboard rustled beneath a mother’s thin blanket, and the soft gasp of a preterm infant punctuated the hum of monitors. A baby’s drool pooled at the corner of her mouth; when my gloved fingers brushed her cheek, she flinched. Her body spoke a language beyond words, and her mother translated every twitch with love.
Behind …
Pediatric care in Ghana: Addressing malnutrition and sickle cell disease
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Palliative care physician and certified physician development coach Christie Mulholland discusses her article “Why every physician needs a sabbatical (and how to take one).” Christie reveals the harsh reality that while sabbaticals …
Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]
Modern medicine has a lot to show for all our breakthroughs and biotechnology. At an astonishingly rapid rate, we have built a health care system that can map the genome, replace a heart valve, and monitor vital signs from a wristwatch. All this to show that medicine’s success has always been measured in cures, and in that pursuit, we have forgotten to care. This is where medicine fails.
A cure is …
Curing versus caring in medicine: Bridging the gap in patient trust
The moment the text message lit up my watch, I knew my life had irrevocably changed. I looked down at the miniature screen and found that I could not look away from the gray bubble and the three words that shattered my world: My aunt had passed away. An all-consuming grief overtook me as I processed a reality where my aunt’s boisterous laugh no longer echoed off the walls, along …
Flexible health care funding: Moving beyond disease eradication
An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).
“Here is the truth: I have been on a stable dose of Wellbutrin (Bupropion) for thirteen years, and despite being quite a public advocate about self-disclosure and mental health, I have never once said that out loud. If you have ever read anything I’ve written before …
Why a chief wellness officer hid her medication use for 13 years
Our nation and the health care industry have been in shock following the assassination of the CEO of one of the largest insurance companies in the U.S. in December 2024. The reaction to Brian Thompson’s death and suspected shooter Luigi Mangione appeared to have captured America’s attention. The assassination has focused public outrage toward the health care insurance industry and a lack of empathy for the victim and his …
Physician patient advocacy: Fighting insurance denials effectively
If you have watched Stranger Things, you know the premise: A quiet town appears functional on the surface while a darker, parallel world creeps into everyday life, or the Upside Down. The true danger is not just the monsters but also the refusal of adults in power to believe what is directly in front of them. Modern health care is living in its own Upside Down.
The metric trap
In my practice, …
Health care’s Upside Down: Addressing systemic dysfunction and burnout
Last year, at her annual physical, one of my patients told me that February was the hardest time of the year for her. Her husband died three years earlier in February. Her daughter lives out of state and doesn’t visit often. She has a neurologic condition which makes it difficult for her to get around. Her days are marked by TV dinners eaten alone, a phone that rarely rings, and …
How February and Valentine’s Day impact lonely patients
The looming specter of death exerts significant psychological power over the living. Perhaps the most common ways of coping with our persistent death anxiety are to ignore it, actively deny it, or deliberately distract ourselves from it; but removing our protective blinders ultimately enables us to live a more meaningful and authentic life. If we genuinely wish to live well and to die well, we must intentionally develop our emotional …
The specter of death: Why mortality gives life meaning
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Otolaryngologist Alan P. Feren discusses his article “How system strain contributes to medical gaslighting in health care.” Alan explores why encounters that patients experience as dismissive or manipulative often stem from communication …
Systemic strain creates the perfect environment for medical gaslighting [PODCAST]
It was 3:17 a.m. when the trauma pager went off. “Level 1 incoming. MVC. Hypotensive.” The trauma bay shifted instantly from stillness to choreography. Blood coolers opened. Monitors lit up. A resident’s voice tightened as he called out the vitals. The patient was young. Too young. Blood pressure in the 70s. Oxygen saturation falling. The kind of numbers that make the room feel smaller. CT was not ready. Labs were …
In the age of AI, what makes a physician REAL?
I have spent 30 years as a physical medicine and rehabilitation physician in solo practice. In three decades of treating patients, I have witnessed the slow, systematic transfer of health care decision-making from clinicians to people who have never touched a patient.
When I started my career, physicians led health care. Today, private equity firms own hospitals, insurance company algorithms override clinical judgment, and administrators whose primary loyalty is to shareholders …
The cost of clinician absence in the boardroom: a 30-year perspective
At our yearly Christmas medical staff dinner this last year, our chief of staff asked all the doctors present who had been working at our hospital for five or more years to stand up. Quite a few of us rose. He then asked those who had been there 10 years or more to remain standing. After half of us sat down, he upped the ante to 15 years, then to …
An excerpt from Still Life with Stethoscope and Typewriter: Essays and Echoes of Narrative Medicine.
Every Olympic Games eventually produces its own mythology. Not the noble kind, ancient Greeks crowned in olive leaves, but the modern variety, where rumor, technology, desperation, and money form a cocktail best consumed at a safe distance.
The 2026 Winter Olympics in Milan have already delivered one such legend: the claim that elite ski jumpers were …
2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid
“Do no harm.” Upon entering medical school, my classmates and I uttered these words with pride and joy, unaware of the deeper meaning behind them. While it may sound cliché, many of us choose to become doctors because we have a strong desire to help others in some capacity. The esteemed title M.D. fortunately allows us to wear many different hats in serving our communities. Medical doctors have expanded their …
Immigration policy and child health: a medical student’s perspective
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