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Vance Alm is a family physician.

Rural health care delivery is not a coverage problem

Vance Alm, MD
Physician
June 11, 2026

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 …

Read more…

Rural health care delivery is not a coverage problem

Why we must fix our fragmented health care system architecture

Vance Alm, MD
Physician
May 7, 2026

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 …

Read more…

Why we must fix our fragmented health care system architecture

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  • Most Popular

  • Past Week

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      GetPracticeHelp | Physician Finance
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      Tim Brocklehurst, MBA | Conditions and Diseases
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      Arthur Lazarus, MD, MBA | Health Technology
  • Past 6 Months

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      Ronald L. Lindsay, MD | Physician
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      The Podcast by KevinMD | Podcast
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      Payam Zamani, MD | Health Technology
    • The residency personal statement is an identity problem

      Kathleen Muldoon, PhD | Medical Education
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      Amanda Whitehouse, PhD | Conditions and Diseases
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      Tarpan Patel | Health Technology
    • How AI is reshaping applied behavior analysis care

      Brad Smith, PhD | Conditions and Diseases
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      Sathya Narayanan, PharmD | Conditions and Diseases
    • Loneliness in successful men hides behind abundance

      J.H. Lynn | Conditions and Diseases
    • Dark money is writing your health care laws [PODCAST]

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