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Saravanan Kasthuri, medical director at Northwest Endovascular Surgery, and Jason McKitrick, executive director at the Office Based Facility Association, discuss their article “Medicare payment is failing rural health.” Saravanan and Jason analyze …
Medicare cuts are destroying independent rural medical practices [PODCAST]
President Trump recently made national headlines by calling a female reporter “Piggy,” an act widely decried as outrageous, even for a man who doesn’t shy away from misogyny. It’s one thing to intentionally refer to someone with a derogatory, dismissive label. This kind of behavior should appropriately be met with indignation and moral outrage. But what happens when we carelessly (and repeatedly) call someone a name that belongs to …
Racial mistaken identity in medicine: a pervasive issue in health care
At some point in their careers, health practitioners find themselves preoccupied with issues that go beyond the confines of the clinical room. Beyond diagnoses and prescriptions lies a larger health care landscape, one shaped by policy, economics, culture, technology, and power. Health professionals then begin to ask how this broader system affects not only their individual patients, but also communities and society at large. It is often at this intersection …
Why health advocacy needs foresight and backcasting tools
As a nurse, I have been with patients during their first breath and their last. While with grieving families, one statement that stays with me is, “At least now she/he can rest.”
This statement almost always comes from a grieving Black family who lost a family member to a premature death of a preventable or manageable disease. Why must we wait until we are six feet under to rest?
As a Black …
Black women’s health resilience: the hidden cost of “pushing through”
When a correlation between acetaminophen and autism was claimed on the national stage recently, it did more than produce a headline; it signaled a fracture in public trust. Oftentimes dismissed simply as fringe rhetoric, medical misinformation is anything but, having lasting impact on public health outcomes. The same way the U.S. health care system suffers from a paradox between high spending and substandard outcomes, our information ecosystem suffers from high …
Medical misinformation: a fracture in public trust and health outcomes
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Obstetrician-gynecologist Priya Panneerselvam discusses their article “How medicine reflects women’s silence.” Priya discusses how the quiet deference observed in their mother’s generation continues to manifest in patients who apologize for their pain …
Silence is a survival mechanism that costs women their joy [PODCAST]
United States (U.S.) health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the …
Why the U.S. health care system is failing patients and physicians
As major public health agencies such as the Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), and state health departments face reductions in scope and resources, a unique opportunity arises for health insurers to take a leading role in improving public health, while also enhancing their own reputations and financial sustainability.
Consider tobacco use, the leading cause of preventable death in the United States, …
Putting health back into insurance: the case for tobacco cessation
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Medical oncologist, geriatrician, and physician scientist GJ van Londen and Chief of Genetic and Genomic Medicine at the University of Pittsburgh School of Medicine Gerald Vockley discuss the article “FDA delays could …
Regulatory red tape threatens survival of rare disease patients [PODCAST]
Eight years ago, motivated by concern for my six grandchildren and future generations, I began a systematic study of climate change through the assessment reports of the Intergovernmental Panel on Climate Change (IPCC). That work led me to focus on a central omission in mainstream climate modeling: The failure to model global conversion to exclusively organic agriculture.
In 2024, the preprint journal SSRN published my scenario to reduce net projected greenhouse …
Ecovillages and organic agriculture: a scenario for global climate restoration
Environmental justice, health disparities, and climate change are deeply interconnected, with climate change acting as a threat multiplier that exacerbates existing health inequities, particularly among marginalized and underserved communities. Environmental justice refers to equitable and meaningful involvement in environmental policies, regardless of income, race, etc. Historically marginalized communities of color, the low-income population, and indigenous people are disproportionately exposed to ongoing as well as historical environmental policies. Health disparities arise …
How environmental justice and health disparities connect to climate change
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President and chief executive officer of the National Psoriasis Foundation (NPF) Leah M. Howard discusses her article “Pharmacy benefit manager reform vs. direct drug plans.” Leah analyzes the recent emergence of direct-purchase …
Sustainable legislative reform outweighs temporary discount programs [PODCAST]
Canada prides itself on having a strong public health system, yet we continue to treat oral health as optional. Dental disease occupies a peculiar niche in health care: scientifically essential, yet structurally marginalized. We know that chronic gum inflammation is linked to heart disease, stroke, diabetes complications, and even adverse pregnancy outcomes. Yet it remains largely detached from how we think about preventing chronic illness.
This disconnect isn’t caused by a …
Mobile dentistry: a structural redesign for public health
As of January 1, 2026, the American health care system is in crisis. People can no longer afford their health insurance premiums or even to afford to pay for any health insurance. Recently, a 62-year-old self-employed friend of mine saw his premiums increased tenfold in a single cycle. I am lucky that I am over 65 and have Medicare insurance as well as a pension from my employment. Millions of …
Accountable care cooperatives: a 2026 vision for U.S. health care
There is a general undercurrent of dissatisfaction with health care in America that is, shall we say, palpable. Many studies and statistical analyses support this notion but I think a broader view is both valuable and less abstract than a data set. We could go measure the angle of the Leaning Tower of Pisa and evaluate the foundational errors, but it doesn’t take that level of granularity to see that …
The real cost of U.S. health care dissatisfaction
I want to make something clear from the very beginning, because this point often gets lost when taking this perspective on this topic.
Nurses, physician assistants, occupational therapists, physical therapists, medical assistants, and every allied-health professional are indispensable to our health care system. They are professionals whose expertise saves lives, keeps clinics running, and provides the continuity of care that physicians alone cannot sustain. Their work is rigorous, their training is …
Student loan cuts for health professionals
A laboratory transport truck crashed in Mississippi last month resulting in eight monkeys escaping, seven of whom were shot and killed after surviving the initial crash. Tragedies like this happen too often. Over the past two decades, there have been more than 15 publicly reported lab monkey escapes, both during transportation and directly from labs, including from the California, Southwest, and Oregon National Primate Research …
Why lab monkey escapes demand transparency
My last patient of the day had been to four other doctors before coming to see me. She was coming in for abdominal pain that had been going on for about two years and had seen multiple specialists that resulted in multiple tests, in hopes to get an explanation for her symptoms. She came in wanting answers, but also skeptical of me. Skeptical of my ability to help her, skeptical …
Why patient trust in physicians is declining
U.S. health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the best in …
Physician shortage and private equity: the ruin of U.S. health care
I’ve been thinking about “choice” a lot lately, not the rich, ethically grounded version we teach in medical school, rooted in autonomy, informed consent, and shared decision-making, but a thinner, more selective version now circulating in political and legal discourse. The kind that sounds principled until you read the fine print.
The message goes like this: You may choose, just make sure you choose correctly.
It’s the literary equivalent of Animal Farm: …
The political selectivity of medical freedom: a double standard
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