Vance Alm, MD
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Physician voices

Earl Haskell doesn't exist. But thousands of patients exactly like him do. They live in counties where the nearest hospital is more than an hour away. Where the local clinic closed years ago. Where a chest pain isn't just a…
Earl Haskell doesn’t exist. But thousands of patients exactly like him do. They live in counties where the nearest hospital is more than an hour away. Where the local clinic closed years ago. Where a chest pain isn’t just a symptom, it’s a logistical problem. Earl is a composite. His reality is not.
He lives in Loving County, Texas, the least populated county in the United States. On a map, it …
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Rural health care delivery is not a coverage problem
Physician voices

Last year I watched a patient of mine, I will call him Raymond, navigate what should have been a straightforward referral to cardiology. He had insurance. Good insurance. The kind politicians point to when they say the system is working.…
Last year I watched a patient of mine, I will call him Raymond, navigate what should have been a straightforward referral to cardiology. He had insurance. Good insurance. The kind politicians point to when they say the system is working. It took 11 weeks, four phone calls, two prior authorizations, and one emergency department (ED) visit to get him seen. He was not uninsured. He was not poor. He was …
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Why we must fix our fragmented health care system architecture
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