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At 25, Jace Yawnick was building a career in health and wellness sales, chasing growth, status, and the usual young adult fantasy of getting somewhere fast. Then his body stopped cooperating. Fatigue turned into chemotherapy. The diagnosis was primary mediastinal B cell non Hodgkin lymphoma, and the rest of his life split into before and after. Now in remission, he talks about cancer the way people actually live it, not the way nonprofits package it. He gets into survivorship, mental health, young adult isolation, and the deadening absurdity of prior authorization. One of the sharpest parts of the conversation lands on a simple American insult disguised as policy: treatment innovation means very little when insurance can still deny the scan, the drug, or the next step. Jace has seen that firsthand, including during routine monitoring after active treatment. This episode tracks what happens when a young cancer patient becomes a public voice and refuses to play mascot. It covers oncology, insurance, remission, advocacy, and the long mental hangover that follows survival. It also names the part too many institutions dodge: the system works great right up until it doesn't, and when it fails, patients get handed the bill, the panic, and a camera if they want anyone to care. RELATED LINKSJace Beats CancerJace Yawnick on LinkedImConquer Cancer ArticleCURE Today ArticlePyure BrandsFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What if educating your people so well that they could leave was exactly the point? At Your Health, that's not a risk to manage — it's the philosophy that built an entire learning ecosystem. In this episode, Jamie talks with Aubrey Wall, who came to Your Health from a background in education and now leads Your Health University, the organization's learning management system and continuous-development engine. Aubrey brings an educator's eye to a fast-evolving healthcare environment, where best practice changes by the day and meeting patients where they are demands that staff never stop learning. Here's what you'll hear: Why a healthcare company runs 12-month, Department of Labor–registered apprenticeships — including programs in management, value-based care, population health, and hospice aide preparation How gamification is being built into nurse instruction (straight from Aubrey's dissertation research) The difference between Your Health University (your classroom) and the Hub (your resource library) How LinkedIn Learning delivered roughly $4.2 million in CEUs to staff last year Meeting Leah — the new AI assistant that helps employees find exactly the right course If you've ever believed growing your people is a cost rather than the whole point, this conversation will change how you think. Press play, then go ask Leah a question. www.YourHealth.Org
Guest Dr. Daliah, host "The Dr. Daliah Show", joins to discuss latest push for healthcare reform in the nation. Discussion of power in the industry with big pharma, big insurance, and big government. Is there a way to make food healthier, and rely on personal choices for a better health? Tulsi Gabbard prepares to leave the Trump administration, with some major bombshells. Discussion of new information on biolabs controlled and funded by the United States, lies from Fauci and government officials for years, and the industry of gain of function and harming humanity with bioweapons.
At 20 years old, newly arrived from Puerto Rico and trying to build a future in science, Benjamin Suarez Jimenez found himself sitting in front of two senior faculty members accused of plagiarism. He knew the material. He had done the work. His mistake came from failing to cite class notes during an exam because nobody had told him that was expected. In a matter of minutes, he watched what felt like his entire career flash before him.On this episode of Standard Deviation, host Oliver Bogler examines the hidden architecture of academic science through the experiences of Dr. Benjamin Suarez Jimenez, Assistant Professor at the University of Rochester and a neuroscientist studying PTSD, anxiety, trauma, and spatial cognition through virtual reality and video game environments.Benjamin traces his path from Puerto Rico to the mainland United States, through the NIH, Columbia University, and eventually to leading his own laboratory. Along the way, he encountered a series of barriers that had little to do with scientific ability and everything to do with access to unwritten rules. From academic gatekeeping to grant writing expectations, he learned that success in biomedical research often depends on knowledge that never appears in a textbook.Oliver explores how those invisible obstacles shape careers, influence research funding, and determine who gains access to opportunity. The conversation also examines the Justice, Equity, Diversity, and Inclusion Program at the Life Science Editors Foundation, which pairs scientists from underrepresented backgrounds with experienced scientific editors. Through that mentorship, Benjamin transformed a critical grant proposal into a successful pilot award that helped launch an NIH R01 application.The discussion extends beyond one scientist's experience. Benjamin describes helping a former mentee navigate dissertation roadblocks that threatened her graduation, illustrating how institutional bureaucracy can delay careers and discourage talented researchers. Together, they explore the hidden administrative burden, cultural barriers, and bias that many scientists carry alongside their research, and what happens when someone who receives support turns around and opens the door for others.RELATED LINKSLife Science Editors FoundationBenjamin Suarez Jimenez LabDr. Benjamin Suarez JimenezBenjamin Suarez JimenezFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
"Do nothing for us without us." According to today's guest Robyn Bussey, that operating principle is the basis for effective community health work. "You don't go into a community and dictate. You go and listen and trust and be a partner," she adds. As you'll learn in this enlightening conversation, Bussey is following that approach in her current work as Just Health Director at the Partnership for Southern Equity, an Atlanta-based nonprofit advancing racial equity and shared prosperity across the South. On this episode of Raise the Line from Elsevier, Bussey provides illuminating examples of community-rooted work in South Fulton County and rural Georgia, and explains why community health workers may be the most underutilized asset in addressing health disparities. This wide-ranging interview with host Michael Carrese also explores: Bussey's candid perspective on what happened to the surge of interest in health equity that occurred during COVID; Why life expectancy gains in many Southern states have lagged behind the rest of the country; Her advice to students and early-career clinicians about where they're needed most. Mentioned in this episode: Partnership for Southern Equity If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Dr. Sarah Matt trained as a burn surgeon, working in a field where patients arrive with catastrophic injuries and survival depends on speed, skill, and resources. She left the bedside after confronting a limit that medicine does not like to admit. One physician can only see so many people in a day. The system surrounding those patients decides the rest. She moved into health technology, held leadership roles in startups, and built global infrastructure at Oracle to scale care across populations. Then she watched billions of dollars in digital health and AI initiatives stall out when they hit real clinical environments.This episode follows that pivot from surgeon to strategist and back into direct patient care in rural New York, where she now treats uninsured patients, migrant workers, and communities pushed to the margins. The conversation centers on a persistent failure across healthcare systems. Products get built for regulators, executives, and investors instead of the people who use them. The result shows up in failed adoption, broken workflows, prior authorization delays, and rising physician burnout.The discussion cuts through health policy language and lands on lived consequence. The system rewards speed over usability, scale over trust, and compliance over care. Patients absorb the fallout. Physicians carry the liability. The incentives remain intact.RELATED LINKSDr. Sarah MattThe Borderless Healthcare RevolutionThe Clinical RealistJessica FedererSovatoFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What if your healthcare team already knew what happened during your hospital stay — before you even explained it? What if someone on your care team noticed you were struggling on a Saturday and simply showed up? In this episode, Jamie sits down with Christopher Laffey, Nurse Practitioner at Your Health, to break down what a truly connected, proactive model of care actually looks like when it's working. Christopher practices in North Charleston, SC, where his team — nurses, therapists, social workers, community health workers, and more — functions less like a traditional office practice and more like a living, breathing safety net woven around each patient's real life. What you'll hear in this episode: Why most patients are failing not because nobody cares, but because the system itself is fragmented — and what doing it differently actually looks like on a Tuesday morning The real difference between "patient-centered" as a marketing phrase and patient-centered as a daily practice (hint: it involves seeing the medication bottles on the kitchen table) A powerful real-life story of a bedbound patient whose caregiver suddenly disappeared — and how the team mobilized over a weekend, on their own time, to prevent a hospitalization The single mindset shift every clinician needs to make the transition from visit-based thinking to longitudinal care Why "value-based care" doesn't mean discounted care — it means the organization is accountable for your outcomes, not just your appointments If you've ever left a doctor's appointment feeling more confused than when you walked in, this episode will show you what healthcare can feel like when it's actually designed around you. www.YourHealth.Org
As concerns escalate about the deadly Ebola virus outbreak in Africa, we bring you the unique insights of Dr. Peter Piot, a renowned microbiologist who co-discovered the virus 50 years ago during the first recorded outbreak of the disease. His on-the-ground account of that crisis was provided to us in April before the current outbreak was declared, but it contains valuable historical perspective and shares lessons learned that he carried forward in his consequential career. “What I saw from the beginning is the most important thing is to listen to people and that you need to act fast to save lives, before you have the evidence you would like to have.” He followed his contributions on Ebola by diving into the fight against HIV/AIDS, eventually reshaping global response in leadership roles at the World Health Organization and United Nations. As he shares with host Lindsey Smith, the learnings in that case were more pragmatic than scientific. “We had to redefine HIV/AIDS not as a medical problem but as an economic and security problem in order to get it on the political agenda.” Tune in for a fascinating episode that takes you from the gritty frontlines of public health crises to the battles for funding and attention in the halls of power as Dr. Piot shares what it actually takes to move the world to respond effectively to health threats. Mentioned in this episode: London School of Hygiene & Tropical Medicine If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Derrick Morgan, Executive Vice President at the Heritage Foundation, joins Marc Cox and Dan Buck to discuss Republican priorities in Washington, including border security, spending reductions, healthcare reform, Medicaid and ACA oversight, welfare verification, and efforts to advance the Save America Act. Morgan also weighs in on government waste, alleged fraud in federal programs, and what Republicans should do while maintaining control of Congress.
Send us Fan MailAmerican hospitals now spend nearly $2 on administrative overhead for every dollar that touches direct patient care. Insurers earn billions in float by sitting on claims for weeks, providers borrow money just to stay liquid, and patients open bills for visits they barely remember.Don Peterson, Founder and CEO of PIM Health, joins host David E. Williams to discuss why healthcare's payment system is working exactly as it was designed to work, and how real-time claims adjudication at the point of care could eliminate prior authorization as it currently exists, cut administrative overhead from 12 to 15 percent down to 2 to 3 percent, and return hundreds of billions of dollars in waste back to patients, providers, and plan sponsors.
Before 911, Before Organ Donation Laws, Before Physician AssistantsImagine calling for help during a medical emergency in the 1960s and discovering there was no coordinated EMS system.Imagine lifesaving organs being lost because there was no legal framework for donation.Imagine overworked doctors without trained Physician Assistants helping bridge the gap in care.That was American healthcare before identical twin brothers Fred Sadler, M.D., and Blair Sadler, J.D. started working together.In this fascinating episode of HarmonyTALK, host Lisa Champeau sits down with the pioneering physician-and-lawyer team behind some of the most transformative healthcare innovations of the last century.Their book, (P)Luck: Lessons We Learned for Improving Healthcare and the World, reads like a hidden history of modern medicine. One part policy thriller. One part leadership memoir. One part blueprint for how unlikely collaborations can reshape entire systems.Together, the Sadler brothers helped establish the legal foundations for organ donation, shaped the early Physician Assistant profession, contributed to the creation of Emergency Medical Services in the United States, and helped elevate bioethics into mainstream healthcare conversations.But this conversation is bigger than medicine.It is about what happens when expertise crosses disciplines. What happens when a doctor and a lawyer stop arguing across conference tables and start building solutions together.Lisa Champeau explores the brothers' remarkable journey through the chaos and reinvention of American healthcare during the 1960s and 1970s, the risks they took inside large institutions, and the leadership lessons they believe still matter today.For listeners who love hidden histories, systems thinking, public policy, innovation, and stories about people quietly shaping the world behind the scenes, this episode delivers a remarkable deep dive into how modern healthcare was built.
In the late 1980s, a child exposed to fallout from the Chernobyl disaster lay in a hospital bed while doctors told his family there were no clear answers and no reliable path forward. Decades later, that same child, Yan Leyfman, walks into exam rooms as a hematology oncology fellow, expected to deliver clarity inside a system that still runs on delay, uncertainty, and institutional self preservation.This episode traces the throughline from early life shaped by radiation exposure and hospice level uncertainty to a career inside academic medicine, translational research, and oncology media. Yan built his identity around survival and usefulness, moving from patient to physician while carrying the memory of what it feels like to sit on the other side of the table. He helped launch MedNews Week during the COVID crisis to push back on misinformation and expand access to medical knowledge, stepping into a public role while still in training.The conversation stays grounded in the friction between personal narrative and system reality. Clinical training demands efficiency, hierarchy, and emotional distance. Cancer care demands time, clarity, and human connection. Those forces collide in real patient encounters where prior authorization delays, insurance barriers, and fragmented care pathways shape outcomes as much as any treatment protocol.Yan speaks openly about mentorship, belonging, and the drive to make meaning out of survival. The discussion pushes further into what the healthcare system actually rewards, what it quietly strips away, and how quickly empathy can erode under institutional pressure. The episode also examines the role of medical media, where education, industry influence, and narrative control often blur together.This is a conversation about identity under construction, about what happens when someone who remembers powerlessness steps into a role that carries authority, and about whether that memory can survive long enough to change anything.RELATED LINKSYan Leyfman on LinkedInYan Leyfman on InstagramSurviving ChernobylFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Matthew Zachary is a brain cancer survivor, healthcare advocate, founder of Stupid Cancer and We the Patients, and host of Out of Patients. In April 2026, he returned to the stage at Merkin Hall near Lincoln Center for his first solo public piano concert in almost 22 years while launching his debut book, We the Patients: Understanding, Navigating, and Surviving America's Healthcare Nightmare.What unfolded became far larger than a concert.Over 2 hours, survivors, clinicians, advocates, nonprofit founders, journalists, pharmaceutical sponsors, and healthcare insiders gathered in one room to reflect on 30 years of survivorship, institutional failure, accidental advocacy, and the emotional afterlife of cancer. The evening moved through original piano performances, live chapter readings, and deeply personal conversations about infertility, disability, financial toxicity, insurance denials, grief, burnout, and what happens when patients spend decades navigating systems designed around transactions instead of continuity.Guests including Wendell Potter, Maimah Karmo, Craig Lustig, Shelly Fuld Nasso, Tamika Felder, and others reflected on how the modern cancer advocacy movement emerged largely because patients built parallel systems where healthcare infrastructure failed to meet human needs. The conversation explored how prior authorization, reimbursement incentives, administrative fragmentation, and institutional distrust continue shaping the patient experience across oncology and survivorship.The performance also marked a deeply personal milestone. After brain cancer compromised his left hand at age 21, Zachary spent 6 months rehabilitating both hands to return to public performance for the first time in over 2 decades. The result became part concert, part civic gathering, and part historical record of a generation of survivors who refused to disappear quietly.RELATED LINKSMZLIVE Official WebsiteMZLIVE YouTube VideoFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Send us Fan MailMore than 160 million Americans live in federally designated mental health provider shortage areas. Even those with insurance often spend months searching for a therapist who takes their plan and has availability.Mark Frank, Co-Founder and CEO of SonderMind, joins host John Driscoll to discuss why fixing the provider infrastructure had to come before solving patient access, and how a fully integrated platform combining measurement-based care with AI-powered tools between sessions is producing outcomes up to 275% better than traditional therapy alone.
Send us Fan MailFor most small businesses, health insurance is their second or third largest expense. And they usually find out what it's going to cost them two to three weeks before renewal.In this clip from our episode “Why Health Insurance Needs Transparency”, host John Driscoll and Ty Wang, Co-Founder and CEO of Angle Health, break down why unpredictable premium increases make it nearly impossible for small businesses to plan, and why the market has accepted this as normal for far too long.Listen to the full episode here
In December 1996, a 37 year old pharmaceutical executive sat in a Borders bookstore reading medical textbooks on the floor, trying to understand a disease she had never heard of. Multiple myeloma carried a three year prognosis. Her daughter was 18 months old. Her father had just died of cancer. Within weeks, she pushed her doctors to say the quiet part clearly. This would likely end her life before her child entered kindergarten.Kathy Giusti refused to accept passive survival. She built a plan while the system offered fragments. She interviewed oncologists and fertility specialists at the same time. She pursued IVF to have a second child while preparing for treatment. She stayed employed to keep insurance coverage. Every decision carried financial, medical, and emotional risk.That same urgency exposed a deeper failure. Cancer research moved slowly. Academic centers guarded data. Clinical trials lacked coordination. Patients entered a system that demanded compliance without providing clarity. Giusti responded by building the Multiple Myeloma Research Foundation, not as a support group, but as an operating engine to accelerate drug development, fund research, and force collaboration across institutions.This episode tracks the tension between individual agency and systemic failure. Giusti describes how patients navigate diagnosis, insurance barriers, and fragmented care in real time. She explains how data, genomics, and clinical trials reshape cancer treatment while still leaving patients responsible for decisions they are not trained to make. She addresses disparities in access, the limits of early detection, and the reality that progress in oncology often depends on speed, funding, and alignment of incentives.The conversation moves between lived experience and structural critique. It names the cost of delay, the burden placed on patients to act as their own advocate, and the tradeoffs required to push a system forward that still protects itself first.⸻RELATED LINKSKathy GiustiMultiple Myeloma Research FoundationFatal to FearlessAmerican Society of Hematology⸻FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
The ongoing outbreak of hantavirus infections that originated with passengers on the Dutch cruise ship MV Hondius in April has generated concerns across the globe. This very rare occurrence has led to a number of deaths, required quarantining of passengers and prompted emergency responses from public health authorities in multiple countries. On this episode of Raise the Line from Elsevier, we're tapping the expertise of a leading authority on the subject, Dr. Jamie Childs of Yale University, to provide you with a scientific understanding of hantaviruses and what level of threat is posed by this situation. In short, Dr. Childs believes this is not the start of a pandemic. “The Andes variant involved here is one of the most dangerous hantaviruses, but it is totally controllable with contact tracing.” This timely conversation with host Lindsey Smith is informed by Dr. Childs' decades of hantavirus research as well as learnings from his role leading the CDC's environmental investigation during the landmark 1993 hantavirus outbreak in the Four Corners region of the American Southwest. And be sure to stay tuned to hear his concerns about the factors complicating containment of the current Ebola outbreak in East Africa. Note: this conversation was recorded on May 19th, 2026. Mentioned in this episode: Yale School of Public Health Yale Institute for Global Health If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
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Marketing Prioritizes Inferior Drugs; Underreporting of Harm in Trials; Key Differences in Independent Trials; Why Pharma Avoids Lifestyle Comparisons; Final Recommendations for System Reform; Empowering Individuals Through Lifestyle and Skepticism; Resources and Ways to Stay Informed #PharmaTruth #EvidenceBased #MedicalEthics #HealthTalks
Heads up — this is Part 2 of Jamie's conversation with Jaclyn Taylor If you haven't heard Part 1 yet, go back and start there. It sets up everything we unpack today. Most healthcare teams are working hard. They're just not working together. And the patient is the one absorbing the cost. In this second half of the conversation, Jamie and Jaclyn move from the why into the how. What does it actually look like when a provider stops responding to today's schedule and starts managing an entire patient panel? How do you turn a community health worker, a pharmacist, a PT, and a social worker into one coordinated team instead of four parallel ones? And what's the difference between data that produces reports and data that produces decisions? You'll hear: Why "frequent touches" only work when they're connected — and how fragmented touches still land patients back in the hospital The quarterback model — what it actually means for a provider to own a patient's trajectory, not just their visit The shift from seeing patients to managing a population — and why most providers were never taught how Why we don't have a resource problem in healthcare — we have an orchestration opportunity How to use technology and data without drowning in either What "showing up" really means inside a system that isn't perfect yet This is the episode for anyone trying to lead change from inside a system that's still catching up. Press play. www.YourHealth.Org
Send us Fan MailNearly half of all Americans get their health insurance through a small business. Most of those businesses have no idea why their premiums go up every year and no real power to do anything about it.Ty Wang, Co-Founder and CEO of Angle Health, joins host John Driscoll to discuss why legacy insurers benefit from keeping small businesses in the dark on costs, and how rebuilding the health plan stack from the ground up on modern, AI-native infrastructure is finally making transparency and customization possible for the employers who have always needed it most.
We mark National Mental Health Awareness Month on this episode by tapping the expertise of Dr. Steve Strakowski, an internationally recognized expert in bipolar disorder, who has spent decades studying the neurobiology and treatment of mood conditions while pushing just as hard on the structural barriers that keep effective treatments out of reach for more than half the people who need them. In this conversation with Raise the Line from Elsevier host Michael Carrese, Dr. Strakowski explains why access, not science, is now the biggest obstacle to improving mental health outcomes. He also addresses the heavy toll society pays for underfunding mental health prevention and treatment programs. “The money is spent eventually, but in the most expensive places like emergency rooms and prisons, and there is the human cost of suffering and suicides." This important discussion also covers: The persistent problem of Black patients presenting with mania being misdiagnosed with schizophrenia; Why he describes bipolar disorder as a reward-processing illness; The emerging therapies he finds encouraging. Mentioned in this episode:Indiana University School of Medicine If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Medical Mistakes Are America's 3rd Biggest Killer | My Partner Died 25 Years Ago Today 26-83 A quarter century ago, a preventable medical mistake took the life of my partner, Andrew Lee Howard. Today, medical errors are considered the third leading cause of death in America — behind only heart disease and cancer. How did we get here? Why are so many families still suffering because of mistakes that should never happen? In this deeply personal episode of The Karel Show, I open up about grief, survival, loss, forgiveness, and what it really takes to move forward after tragedy. Twenty-five years later, I'm still learning the lessons Andrew taught me: life is too short for meaningless meetings, everyone should grow something, cooking should come from passion, and even in the face of illness, you still have to get up and live. We also talk about HIV/AIDS, caregiving, resilience, and why love sometimes means accepting people exactly as they are. If you've ever lost someone, struggled with grief, or questioned the healthcare system, this episode will hit home. The Karel Show is one of the top independent podcasts covering current events, culture, politics, entertainment, and real life — streaming everywhere from Spotify and Apple Podcasts to iHeartRadio and Spreaker.
Hosted by Michael Tetreault | Editor-in-Chief, Concierge Medicine Today Episode Overview In one of the most comprehensive episodes in DocPreneur Leadership Podcast history, host Michael Tetreault takes an honest, evidence-based, and encouraging look at the cash-pay and subscription-based primary care landscape — who it serves, how it works, where it's heading, and what every physician and advanced practice clinician needs to understand before making a career-defining decision. This episode doesn't take sides. It takes a clear-eyed look at the full picture — including the parts that don't always make it into the conference keynote. What's Covered in This Episode The Foundation Not all subscription-based primary care models are the same. Two models operating in this space share surface-level similarities but are structurally distinct businesses with different economic logic, different patient populations, and different long-term trajectories. Understanding which one you're considering — and why — changes everything about how you plan. A Lesson From Healthcare History Before committing to any practice model, it helps to understand what happened to the movements that came before it. This episode traces three instructive parallels: the micropractice and ideal medical practice movement of the early 2000s; the decades-long fight for healthcare price transparency and what happened when physicians finally got it; and the rise and reality check of retail health — what scaled, what didn't, and why. The common thread in every model that has achieved durable scale in American healthcare is the same: structural fit with the economic environment, not ideological purity. Two Pathways, One Brand Name The episode walks through both economic models in the cash-pay primary care space — the purist, cash-only, no-insurance model and the employer-integrated model — explaining how each works, who each serves, and what the financial picture actually looks like for physicians considering either path. The revenue math is done out loud. The sustainability data from peer-reviewed research is cited. The patient demographic fit for each model is examined honestly and specifically. Who Each Model Serves — and Where Other Models Fit Better A detailed breakdown of the patient populations each model genuinely serves well — and an honest, evidence-based look at the patient populations where other models may be a better structural fit. Including Medicare-eligible patients, patients with complex chronic disease, lower-income households, and employees of small and mid-sized businesses. The Overlooked Opportunity — NPs, PAs, and Advanced Practice Clinicians One of the most significant and underexplored opportunities in subscription-based healthcare delivery today is the direct-care model as a pathway for nurse practitioners, physician assistants, and other advanced practice clinicians. The evidence on NP and PA-led primary care outcomes is strong and peer-reviewed. The physician shortage projections make the need urgent. And the organizational infrastructure for advanced practice clinician-led direct-care practices is largely unbuilt — which means the opportunity belongs to whoever moves first. The Organizational Landscape An honest look at what the multiplicity of organizations, coalitions, and alliances in the cash-pay primary care space tells us — and what research on professional association dynamics says about the long-term implications of organizational fragmentation for legislative effectiveness and individual practice planning. One Brand, Two Directions Drawing on four documented historical parallels from the history of American medicine — the AMA and managed care, osteopathic medicine's identity divide, family medicine's emergence as a separate specialty, and the micropractice movement — the episode makes the case that two communities with genuinely different economic interests and regulatory priorities currently sharing a brand name may, consistent with historical precedent, find their own distinct professional homes over time. This is presented as pattern recognition grounded in verified historical evidence — and as practical planning context for physicians building practices today. The Tax and Structuring Update A clear, practical summary of the 2025 "One Big Beautiful Bill" Act changes — effective January 2026 — and what they mean for HSA eligibility of cash-pay membership fees. What qualifies, what doesn't, and why legal counsel is essential before making any representations to patients about tax-advantaged payment options. Eight Questions Before You Commit A practical pre-decision checklist — eight specific questions every physician or advanced practice clinician should be able to answer clearly before committing to any cash-pay practice pathway. Key Takeaways Cash-pay primary care and concierge medicine are not the same model, do not serve the same patient populations, and should not be evaluated as interchangeable alternatives. The purist cash-pay model has grown from approximately 100 practices in 2009 to over 2,100 by 2023 — real and meaningful growth. The financial sustainability data, however, reflects consistent challenges that peer-reviewed research has documented specifically in lower-income markets and solo practice settings. The employer-integrated pathway has stronger structural sustainability — multiple revenue streams, embedded benefit relationships, and documented employer cost reductions of 12 to 20 percent over three to five years. A December 2025 Johns Hopkins study found concierge and cash-pay primary care practices combined grew 83.1 percent between 2018 and 2023. The employer-integrated model is the primary driver of that growth trajectory. Concierge medicine — particularly the PCM model — is not retreating. The global concierge medicine market is projected to surpass $34 billion by 2032 and is growing at a compound annual rate that outpaces most healthcare market segments. The National Academy of Medicine's 2021 Future of Nursing report, AAMC physician shortage projections, and peer-reviewed NP/PA outcomes research collectively point to advanced practice clinician-led direct-care models as one of the most significant underexplored opportunities in subscription-based healthcare delivery. Pattern recognition from healthcare history — price transparency, retail health, the micropractice movement — consistently shows that the distance between a compelling healthcare idea and durable scaled impact is longer and more complicated than early advocacy suggests. Models that have achieved durable scale in American primary care share one characteristic: structural fit with the economic environment, not independence from it. Sources and Citations All claims in this episode are supported by published, verifiable sources. Full citations below. Micropractice and Practice Model History Moore, G. (2002). "Accountability and Improvement in Physician Practice." Family Medicine. Moore, G. & Showstack, J. (2003). "Primary Care Medicine in Crisis." Health Affairs. healthaffairs.org AAFP TransforMED Initiative. (2006). aafp.org Nutting, P.A. et al. (2010). "Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home." Annals of Family Medicine. Rittenhouse, D.R. et al. (2009). "Primary Care and Accountable Care." New England Journal of Medicine. Rittenhouse, D.R. & Shortell, S.M. (2009). "The Patient-Centered Medical Home." JAMA. Price Transparency Research Pathak, Y. & Muhlestein, D. (2024). "Public Awareness and Use of Price Transparency: Report From a National Survey." West Health Institute / Gallup. pmc.ncbi.nlm.nih.gov Parente, S.T. (2023). "Estimating the Impact of New Health Price Transparency Policies." Inquiry.pmc.ncbi.nlm.nih.gov ScienceDirect. (2025). "Outcomes of Price Transparency Policies for Healthcare Services in the United States: A Systematic Review." sciencedirect.com Retail Health Fein, A.J. (2017). "Retail Clinic Check Up: CVS Retrenches, Walgreens Outsources, Kroger Expands." Drug Channels. drugchannels.net CNBC. (2024). "Why Walmart, Walgreens, CVS Retail Health Clinic Experiment Is Struggling." cnbc.com Healthcare Finance News. (2023). "Retail Clinics Seeing Utilization Soar, Popularity Grow." healthcarefinancenews.com MedCity News. (2023). "Retail Clinics Are Gaining Momentum." medcitynews.com Cash-Pay and Subscription Primary Care Market Data MedCity News. (March 2026). "DPC Is Scaling — The Financing Architecture Isn't Ready." medcitynews.com Johns Hopkins. (December 2025). Study on concierge and cash-pay practice growth 2018–2023. As cited in MedCity News, March 2026. Liaw, W. et al. (2024). "Direct Primary Care: Financial Analysis and Potential to Reshape the U.S. Healthcare Landscape." Journal of General Internal Medicine. springer.com Lujan, D.Y. (2025). "Why Direct Primary Care Models Fail." KevinMD. kevinmd.com Doan, L. et al. (2019). "Physician Perspectives on Direct Primary Care." Family Medicine. Eskew, P.M. & Klink, K. (2015). "Direct Primary Care: Practice Distribution and Cost Across the Nation." Health Affairs. healthaffairs.org Tseng, P. et al. (2018). "Administrative Costs Associated With Physician Billing and Insurance-Related Activities." JAMA Internal Medicine. Medscape Physician Compensation Report. (2023). medscape.com Employer-Integrated Model Spann, S.J. et al. (2020). "Employer-Sponsored Direct Primary Care." Journal of Occupational and Environmental Medicine. National Alliance of Healthcare Purchaser Coalitions. (2021). purchaseralliance.org Kaiser Family Foundation. (2023). Employer Health Benefits Annual Survey. kff.org National Business Group on Health. (2022). businessgrouphealth.org Employers Health Coalition. (2022). employershealthcoalition.org Patient Demographics and Population Health Anderson, G.F. (2010). "Chronic Conditions: Making the Case for Ongoing Care." Johns Hopkins Bloomberg School of Public Health. Tikkanen, R. & Abrams, M.K. (2020). "U.S. Health Care from a Global Perspective." Commonwealth Fund.commonwealthfund.org Collins, S.R. et al. (2022). "Paying for It: How Health Insurance and Healthcare Costs Are Shaping the Lives of American Adults." Commonwealth Fund. commonwealthfund.org Bureau of Labor Statistics. (2023). "Contingent and Alternative Employment Arrangements." bls.gov Petterson, S. et al. (2012). "Unequal Distribution of the U.S. Primary Care Workforce." Annals of Family Medicine. Advanced Practice Clinicians and Nursing Laurant, M. et al. (2019). "Revision of Professional Roles and Quality Improvement in Primary Care." New England Journal of Medicine. Naylor, M.D. & Kurtzman, E.T. (2010). "The Role of Nurse Practitioners in Reinventing Primary Care." Health Affairs. healthaffairs.org National Academy of Medicine. (2021). "The Future of Nursing 2020–2030." nationalacademies.org AAMC. (2021). "The Complexities of Physician Supply and Demand: Projections from 2019–2034." aamc.org Legal, Tax, and Compliance Eischen, J. (2025). Legal Commentary on Cash Practice Structuring. eischenlawoffice.com DLA Piper. (2025). "Paying for Direct Primary Care Arrangements With HSAs." dlapiper.com IRS Notice 26-05. irs.gov CMS. "Opt-Out Affidavits and Private Contracts." cms.gov Organizational and Professional Identity Research Hoff, T.J. (2010). Practice Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century. Rutgers University Press. Scott, W.R. (2008). Institutions and Organizations: Ideas and Interests. SAGE Publications. Freidson, E. (2001). Professionalism: The Third Logic. University of Chicago Press. Wolinsky, H. & Brune, T. (1994). The Serpent on the Staff: The Unhealthy Politics of the American Medical Association. Putnam. Gevitz, N. (2004). The DOs: Osteopathic Medicine in America. Johns Hopkins University Press. Stephens, G.G. (1989). "Family Medicine as Counterculture." Journal of Family Practice. Colwill, J.M. (1992). "Where Have All the Primary Care Applicants Gone?" New England Journal of Medicine. Meltzer, D.O. & Chung, J.W. (2014). "The Population-Based Physician Workforce." Health Affairs.healthaffairs.org Bodenheimer, T. & Pham, H.H. (2010). "Primary Care: Current Problems and Proposed Solutions." Health Affairs. healthaffairs.org Grumbach, K. & Grundy, P. (2010). "Outcomes of Implementing Patient Centered Medical Home Interventions." JAMA. Concierge Medicine Market Data Grand View Research. (2022). Concierge Medicine Market Size & Growth Report. grandviewresearch.com Precedence Research. (2023). U.S. Concierge Medicine Market Size and Forecast. globenewswire.com MDVIP. (2020). Personalized Primary Care Reduces ER Visits, Hospitalizations, and Outpatient Expenditures.mdvip.com AAPP / Software Advice. (2023). "Concierge Medicine Salary and Definition." softwareadvice.com Disclaimer The DocPreneur Leadership Podcast is produced by Concierge Medicine Today, LLC, an independent healthcare leadership publication. This episode and its accompanying summary are intended for educational and informational purposes only. Nothing in this episode or summary constitutes medical, legal, financial, or accounting advice. The information presented reflects publicly available research, published data, and editorial observation, and is not intended to replace the guidance of qualified medical, legal, financial, or business professionals. All factual claims are supported by named, verifiable third-party sources, which are cited in full above. Concierge Medicine Today makes no guarantee regarding the completeness or currency of external sources cited and encourages listeners to verify information independently. References to specific organizations, publications, legal decisions, or market data are provided for educational context only. Mention of any organization, publication, or individual does not constitute endorsement, and no commercial relationship exists between Concierge Medicine Today and any source cited in this episode unless otherwise disclosed. 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At 19, Shlomit woke up unable to speak. The right side of her body went numb. An emergency room sent her home and called it stress. That moment did not end in a diagnosis that changed policy or triggered reform. It sent her into a decade long pursuit of understanding how the brain fails language and how the healthcare system fails patients who cannot advocate for themselves.Shlomit trained as a speech language pathologist and spent years inside acute care hospitals and ICUs, performing endoscopies and treating patients with brain injury, stroke, and dysphagia. She watched medical teams rotate in and out, deliver dense updates, and leave families nodding without comprehension. She stayed behind and translated. Every day, patients told her she was the only one who explained what was happening. That gap is not an accident. Hospital systems optimize for throughput, not understanding. Patients move through beds based on cost, not readiness. Discharge planning becomes a financial decision wrapped in clinical language. A stay under 48 hours can shift the insurance burden dramatically, leaving patients exposed to higher out of pocket costs. Shlomit left the system and built Patient Path NYC, a private patient advocacy service. She now spends 15 to 20 hours a week per client reading charts, coordinating care teams, and translating medical decisions into plain language. Her work sits in the uncomfortable space between healthcare policy and lived experience. Families pay out of pocket to understand their own care. Hospitals benefit from the clarity she provides while maintaining the same structural incentives that created the confusion.This conversation tracks the human cost of fragmented care, the economics behind discharge decisions, and the quiet reality that patients who cannot communicate clearly often lose control of their own outcomes.RELATED LINKSShlomit LibertyShlomit Liberty on LinkedInPatient Path NYCBoard Certified Patient AdvocateFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What if every "non-compliant" patient was actually a signal that the system isn't working for them? In this episode, Jamie sits down with Jaclyn Taylor, Clinical Strategy Director at Your Health and a nurse practitioner who started her career as a home-based provider in 2020 — thrown straight into the fire of COVID, isolated patients, and a healthcare world rewriting itself in real time. What she saw inside patients' homes — medications scattered on tables, food insecurity, missing transportation — changed how she thinks about every chart she's ever read. You'll hear: Why a nurse-first pathway gives nurse practitioners a fundamentally different lens than a medical school pathway — and why patients feel it What working across home care, telehealth, trauma, and wellness teaches you about treating the whole human, not just the diagnosis Why trauma surgery turned Jacqueline into a believer in proactive, longitudinal care — and what gets missed when we only meet patients after something has already gone wrong The two words she uses to describe what's most broken in traditional healthcare: fragmentation and misalignment How empathy stops being a poster and starts being operational — built into the design of care itself If you've ever felt invisible inside the healthcare system, or if you're the one trying to fix it, this conversation reframes the whole game. Press play. www.YourHealth.Org
In 2020, developmental biologist Dr. Crystal Rogers drove the country roads outside Davis, California crying between grant rejections, wondering whether she was about to lose her lab, her career, and the scientific future she had spent years building. She had already done what academia tells young scientists to do. She earned the credentials. She landed a faculty position at UC Davis. She built a lab. Then the real test began.On this episode of Standard Deviation, Dr. Oliver Bogler examines the unspoken rules that determine which scientists survive academic research and which quietly disappear from it. The conversation follows Crystal Rogers and cancer biologist Dr. Michelle Mendoza as they collide with the “Hidden Curriculum” of biomedical science: the unwritten rhetoric, institutional signaling, and grant writing strategies that often decide who receives funding, tenure, and long term stability.Michelle Mendoza entered a tenure track position at the Huntsman Cancer Institute while raising 3 children, navigating a divorce, and trying to secure major NIH funding during COVID. What looked like objective scientific review turned out to depend heavily on persuasion, presentation, and insider fluency. Established researchers could promise massive research agendas based on reputation alone. Junior investigators faced a completely different standard.Oliver traces how the Life Science Editors Foundation and its JEDI program intervened by pairing scientists with former editors from journals including Cell and Nature. The work had little to do with commas or grammar. Editors challenged logic, structure, and scientific framing before grant reviewers could destroy an application in public.Both researchers eventually secured career defining grants. One realized she would keep her job and not have to move her family. The other celebrated by ordering a personalized “DEV BIO” license plate and driving through Davis blasting nineties hip hop and Beyoncé.The episode exposes how biomedical research funding rewards institutional fluency as much as scientific talent, and how hidden systems inside academic medicine continue shaping who gets to stay in science long enough to make discoveries.RELATED LINKSDr. Crystal Rogers LinkedInDr. Crystal Rogers Faculty PageDr. Crystal Rogers LabDr. Michelle Mendoza LinkedInDr. Michelle Mendoza Faculty PageHuntsman Cancer Institute Mendoza LabLife Science Editors FoundationFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
"When the workforce does not align with the population, your system is misaligned by design." That candid observation comes from Tina Loarte-Rodríguez, DP, RN who has spent much of her two decade career in patient safety, risk management, and systems leadership as the only Latina in the room, which she sees as a signal of a systemic failure that demands structural solutions. As we mark National Nurses Month, Dr. Loarte-Rodríguez joins Raise the Line from Elsevier host Lindsey Smith to explain why a culturally congruent workforce has important implications for access, trust and quality of care. This wide-ranging discussion also covers: What Dr. Loarte-Rodriguez means by "narrative infrastructure" and how a book series born during COVID is now shaping workforce conversations nationwide; The case for making mentorship a core institutional system; Why nursing burnout is not about a lack of resiliency. Mentioned in this episode: Latinas in NursingThe Connecticut Center for Nursing Workforce If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Send us Fan MailIs it easier to change the medical establishment from the inside or the outside?In this clip from our episode "MAHA Split Over New Surgeon General," hosts David E. Williams and John Driscoll break down what separated Casey Means from Nicole Saphier, and why the switch from outsider advocate to credentialed insider may say everything about how health reform actually gets done.Listen to the full episode here
In 2008, Katy Talento walked away from Capitol Hill and into a Catholic convent. Within a year, she walked out. Within another decade, she sat inside the White House shaping health policy. Somewhere in between, she got labeled “infertile” after a single cycle of testing and spent years believing it.That label stuck. The pain that came before it never got investigated. Doctors offered birth control and moved on. No one asked why her body was struggling. No one followed the thread.Talento built her career inside the very systems she now critiques. She worked on federal health policy, global disease programs, and later advised the Trump administration on healthcare reform. She helped advance price transparency rules in a system where hospitals can still list 457 different prices for the same service.Then she left.Now she builds employer health plans that bypass insurers, PBMs, and traditional networks. Her approach replaces insurance contracts with direct payment, nurse navigators, and cost sharing models that promise simplicity but raise hard questions about risk and protection.This conversation sits in that tension.Talento describes a healthcare system shaped by layered incentives, where insurers, hospitals, and intermediaries profit from complexity. She argues that employers hold the leverage to disrupt it. The host pushes on what happens when patients fall outside those structures, when contracts disappear, and when community based models fail.The episode moves through infertility, misdiagnosis, insurance design, and the mechanics of employer sponsored care. It tracks how policy decisions made in Washington ripple into exam rooms, billing departments, and family lives.It also confronts a harder truth.Even insiders who understand the system can still get caught in it.RELATED LINKSAllBetter HealthKaty TalentoThem Before UsAn Arm and a LegRelentless Health ValueFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What happens when big business runs healthcare and clinicians are pushed out of decision-making? In this powerful conversation, Dr. Harry Severance shares decades of clinical and educational experience to diagnose the root causes of our workforce crisis: moral injury, profit-over-patient priorities, and the exodus of burned-out physicians and nurses. Dr. Severance and Dr. Austin explore multi-tiered healthcare solutions, the unsustainability of the current U.S. system, barriers like the Stark Law, the growing unionization movement, and practical paths for clinicians to reclaim agency, both top-down (seats at the C-suite table) and bottom-up (advocacy and collective action). You'll hear how they: Examine the shift from patient-centered care to corporate metrics and its devastating impact on clinician wellbeing and patient outcomes Discuss alarming statistics: more physicians leaving than entering the U.S., projected shortages, and unpayable medical bills driving bankruptcies Challenge the status quo on single-payer vs. hybrid systems and the need for baseline healthcare access for all citizens Address apathy vs. agency and the power of persistence, political involvement, and community action Emphasize the timeless wisdom of “never give up” even when the system feels overwhelmingly broken If you're feeling the weight of a corporate-dominated healthcare system or searching for ways to drive meaningful change, this episode delivers both hard truths and hopeful calls to action. About the Guest: “You can't always get what you want. But if you try, sometimes you just might find you get what you need.” - Dr. Harry Severance Dr. Harry Severance is an Assistant Adjunct Professor at Duke University with decades of clinical experience in emergency and acute care medicine. A passionate change-maker and workforce advocate, he has counseled countless physicians and clinicians navigating burnout and disillusionment. Dr. Severance writes and speaks on healthcare system reform, clinician wellbeing, and the urgent need to return clinical voices to healthcare leadership.
What if the most important thing you did today wasn't on your task list? In the final episode of Your Health University's Values Series, host Jamie Preston brings back the full Patient Experience Team — Jennifer Kistler, Kim Metz, Whitney Myers, Carlos Heyward, and Rebecca Dillard — to explore the value that brings every other one to life: Service. Not the idea of it. The real, daily, roll-up-your-sleeves version that shows up in 60 extra seconds, one extra phone call, and the moments when you decide not to leave someone when they need you most. What you'll hear in this episode: Whitney's story of refusing to leave a patient on his worst day — and what true service looks like when the moments count most Carlos's creative solution for a patient in Charleston who keeps falling — and the phone call she made just to say thank you Rebecca's respiratory therapists who change cat litter boxes and wheel trash cans to the curb — because they noticed, and they could Kim's ICU story: braiding the hair of ventilated patients who couldn't do it themselves, because I would want someone to do that for me Jamie's deeply personal account of his wife's breast cancer diagnosis — and the profound difference between a healthcare team that says "this is what you need to do" and one that asks "what do you think?" Carlos's challenge to every listener: don't just adopt these values at work — make them yours Service is the reason you got into this. It's the thing that makes the hard days worth it and wakes you up the next morning ready to go again. Press play — and let this episode remind you exactly why what you do matters. www.YourHealth.Org
Send us Fan MailThe collapse of Dr. Casey Means' nomination this week has sent shockwaves through the “Make America Healthy Again” (MAHA) movement. While the tech world debates AI, healthcare is debating the “Saphier Pivot,” the Trump administration's sudden shift from a radical MAHA outsider to a credentialed Fox News regular. With the Surgeon General's office at a crossroads, we have to ask: is the role still a beacon of public health, or has it become the ultimate prize in the culture war?John Driscoll, Chairman of UConn Health and David E. Williams, President of Health Business Group, diagnose the state of the Surgeon General's office, examining what the rapid pivot to Dr. Nicole Saphier reveals about the limits of MAHA's political power, and whether the nation's most visible public health platform can still move the needle in an era of historic distrust in federal health agencies.
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Despite sky-high drug use and spending, U.S. life expectancy lags. Dr. Campbell explains how a meat-heavy diet and poor public policy are to blame. #HealthcareCrisis #NutritionNeglect #PlantBasedCure
The doctor is in....the box. That's one way to describe how patients are now encountering their physicians in what's being described as the future of telehealth. Imagine that instead of a cancer patient in a rural area driving hours for an appointment to see their specialist at an academic health center, they can go to their local clinic and see a life-size, real-time, 3-D projection of them in a seven foot tall light box. The doctor can see the patient through two-way video, and is assisted by a clinician in the exam room. The technology behind this remarkable scene is provided by a Los Angeles based start-up called Proto Hologram, whose founder and chairman, David Nussbaum, joins us on this episode of Raise the Line from Elsevier. "Our holograms start where Zoom ends and where physically being there begins," says Nussbaum, a TIME Healthcare100 honoree who has spent the last decade developing commercial and educational applications for holograms. In addition to clinical settings, Proto units are being used at medical schools and senior living facilities and are playing a role in public health campaigns about breast cancer and vaccines. Join host Lindsey Smith for a fascinating conversation that covers: The role of holograms in extending access to specialty care; How the technology could be used to combat loneliness among seniors; Nussbaum's philosophy of "commercializing the impossible". Mentioned in this episode: Proto Hologram If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
The healthcare system is flatlining, and it's time for a professional resuscitation. This Nursing Week, join Dr. Danielle McCamey and Gloria E. Barrera for a heavy-hitting breakdown of the HESS framework—Humanity, Ethics, Social Justice, and Science—as the ultimate toolkit for systemic reform. From the grassroots power of Nurses Shift Change to the national Report for Duty call to action, we explore how to move beyond the bedside to fight for environmental justice, primary care, and safe working conditions. We are done paying the price for a profit-first system; it is time to stop working the shift and start being the change. Inside This Episode: The HESS Framework: Why merging social justice with clinical science is the future of nursing. Nurses Shift Change: How grassroots movements are mobilizing the workforce to demand better working conditions. Political Power: Why nurses must engage in policy and advocacy to fix a broken healthcare system. The Retention Crisis: Addressing the unique challenges facing young nurses and how to prevent "ethical injuries" in the workplace. Collective Action: The roadmap for nurses to unite and demand better outcomes for both patients and practitioners. Nurses are the backbone of healthcare, but systemic barriers often stifle their voices. This episode is a call to action for every nurse, student, and healthcare advocate to pivot from "coping" to "changing." "It's not just about surviving the shift; it's about changing the shift." Keywords: Nursing Week, Nursing Advocacy, HESS Framework, Healthcare Reform, Nurses Shift Change, Nursing Ethics, Social Justice in Nursing, Nurse Retention, Health Policy. Don't forget to like, share and subscribe and leave a review if you're ready to see the nursing profession lead the charge in healthcare transformation! Chapters 00:00 Introduction to Nursing Advocacy and Community Building 02:25 The HESS Framework: Humanity, Ethics, Social Justice, and Science 05:14 Public Health and Nursing: Bridging the Gap 07:45 The Power of Collective Voice in Nursing 10:45 Mobilizing for Change: The Report for Duty Rally 13:48 Strategic Nursing Leadership and Systemic Change 23:03 Awakening the Nursing Profession 24:45 The Political Nature of Nursing 26:57 Understanding Nursing as a Political Force 33:08 Addressing Racism in Nursing 39:13 The Leaky Bucket: Retaining Nurses 42:15 Ethical Injuries in Nursing More about Nurses Shift Change: https://nurseshiftchange.org Gloria E. Barrera, MSN, RN, PEL-CSN, PLNC Gloria E. Barrera (she/her/ella) is a public health and school nurse leader, recognized expert, and dedicated nursing faculty member with over 16 years of experience. She serves as Director of an RN to BSN Program and has been recognized nationally for her leadership, including being named Nurse Influencer of the Year by ANA-Illinois, and a 40 Under Forty in Public Health honoree by the de Beaumont Foundation. Gloria is the Co-Founder of Nurse Heroes for Zero and the Society of Latinx Nurses, a Fellow of the Center for Health Equity Education and Advocacy (CHEEA) and the Alliance of Nurses for Healthy Environments, and alumni of Healing Politics '25. She is dedicated to advancing health equity, climate justice, and the next generation of nurse leaders. Danielle McCamey, DNP, APRN, ACNP-BC, FCCP Danielle McCamey is a dedicated nurse leader, educator, and advocate for diversity in healthcare. With over 16 years of critical care experience and nearly a decade as an Acute Care Nurse Practitioner, she currently serves as the Chief Advanced Practice Provider of the Pre-anesthesia Testing Department and Senior Advanced Practice Provider in the Surgical Intensive Care Unit. She also chairs the MedStar Doctoral Nurses Collaborative and is a Fellow of the American College of Chest Physicians. As the founder, CEO, and president of DNPs of Color, Inc., Dr. McCamey is committed to advancing diversity, equity, and inclusion in nursing through mentorship, leadership development, and community empowerment. Listen on Apple Podcasts – : The Gritty Nurse Podcast on Apple Apple Podcasts https://podcasts.apple.com/ca/podcast/the-gritty-nurse/id1493290782 * Watch on YouTube – https://www.youtube.com/@thegrittynursepodcast Stay Connected: Website: grittynurse.com Instagram: @grittynursepod TikTok: @thegrittynursepodcast Facebook: https://www.facebook.com/profile.php?id=100064212216482 X (Twitter): @GrittyNurse Collaborations & Inquiries: For sponsorship opportunities or to book Amie for speaking engagements, visit: grittynurse.com/contact Thank you to Hospital News for being a collaborative partner with the Gritty Nurse! www.hospitalnews.com
In a wooded campground cabin in the early 2000s, 19 year old Ben Unger stood in the doorway and watched 20 naked men form a circle around a crying teenager. A counselor held up two tangerines and shouted, “These are your balls.” The exercise claimed to cure same sex attraction by forcing young men to “reclaim” their masculinity from overbearing mothers. Phones had been confiscated. Parents had paid thousands of dollars. Religion supplied the script. Pseudoscience supplied the props.Ben had grown up in an Orthodox Jewish community in Brooklyn and later studied in Israel to become a rabbi. When he admitted he felt attracted to men, rabbis told him to eat 7 figs a day, immerse in a ritual bath 5 times daily, or marry a woman and trust that “if there's friction, it works.” At 19, he entered conversion therapy through an organization called Jews Offering New Alternatives to Homosexuality, known as JONAH. He left with depression, religious trauma, and 6 months of silence toward the mother he had been taught to blame.Years later, represented by the Southern Poverty Law Center, Ben helped sue JONAH for consumer fraud in a landmark New Jersey case. The argument centered on evidence, not theology. Sexual orientation cannot be changed. The jury deliberated for 3 hours and ruled against the organization. The verdict helped reshape how states regulate conversion therapy and protect minors from psychological harm disguised as treatment.Today, Ben runs Buff Personal Training in New York City, a gym built on autonomy, mental health, and self respect. His story traces the arc from institutional control to self authorship. The conversation examines religion, LGBTQ rights, conversion therapy, consumer protection law, and the lasting cost of being told your identity is a disorder.RELATED LINKSBen Unger on LinkedInBen Unger on InstagramBUF Personal TrainingSouthern Poverty Law CenterJONAHFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
As part of the Future of Texas series in partnership with Texas 2036, this episode tackles one of the most urgent and personal challenges facing Texans today: the rising cost of healthcare. Through the Future of Texas podcast series, Texas 2036 brings together diverse perspectives as we explore the opportunities and challenges facing our state over the next ten years. The views expressed in this program are those of the individual speakers and do not necessarily reflect the views of Texas 2036, its staff or its Board of Directors. Host Brad Swail is joined by Avik Roy, Co-Founder and Chairman of FREOPP, and Charles Miller, Director of Health and Economic Mobility Policy at Texas 2036, for a deep dive into why healthcare costs keep rising — and what Texas can actually do about it. The conversation begins with a stark reality: healthcare affordability has become a top concern for voters, even surpassing issues like property taxes. With employer-sponsored family coverage approaching $27,000 per year and out-of-pocket costs averaging around $10,000 annually for Texas families, the financial strain is reshaping both household budgets and business decisions. A major theme is how the current system distorts incentives. Rather than functioning as a true free market, U.S. healthcare operates as a heavily subsidized system where consumers often lack visibility into prices — and have little control over spending decisions. The discussion covers: • Why healthcare costs are rising faster than wages and inflation • How employer-based insurance distorts consumer incentives • The role of federal tax policy in shaping today's system • Why “free market vs government” is a false choice • The importance of competition, transparency, and aligned incentives • How monopoly power among hospitals and providers drives prices higher • Why past reforms — like surprise billing laws — sometimes backfire • The impact of vertical and horizontal consolidation in healthcare • How anti-competitive contracting limits consumer choice • Why Texas has made progress on transparency — but more is needed The episode also explores solutions that could reshape the Texas healthcare landscape. These include expanding price transparency, tackling provider monopolies, enabling more consumer-driven insurance models, and supporting innovative alternatives like direct payment systems and healthcare sharing models. Roy and Miller highlight promising developments already underway in Texas, including efforts to improve data transparency through all-payer claims databases and reforms targeting anti-competitive practices in provider contracts. Looking ahead, the goal isn't perfection — it's progress. Both guests emphasize that simply slowing the growth of healthcare costs to match inflation would represent a major win for Texas families and businesses. The takeaway is clear: the tools to fix healthcare affordability exist — but meaningful reform will require aligning incentives, increasing competition, and taking on entrenched interests within the system. 00:00 — Intro + Future of Texas series overview 00:30 — Why healthcare affordability matters now 01:13 — Cost of employer-sponsored coverage explained 02:00 — National vs Texas-specific cost challenges 03:12 — Texas vs California healthcare cost comparison 04:21 — Why affordability is now a top voter issue 05:21 — 53% cost increase over the past decade 06:41 — Why Texas policy drives higher costs 07:28 — Surprise billing reform and unintended consequences 08:24 — Incentives that drive price inflation 09:53 — Free market vs government: a false debate 10:14 — Why U.S. healthcare isn't truly a free market 11:17 — Employer-based insurance and tax distortions 12:23 — Why consumers don't behave like shoppers 13:23 — What a “healthy market” actually requires 14:17 — Transparency, competition, and incentives explained 15:25 — How subsidies can increase costs 16:09 — Insurance incentives and rising premiums 17:19 — Lack of price transparency in real-world care 17:58 — Switzerland as a model system 19:10 — Competition vs monopoly power in healthcare 20:29 — Real-world example: pricing distortions 21:42 — Hospital consolidation and market power 23:04 — Hospital Competition Act explained 25:02 — Why regulators struggle to fix consolidation 27:08 — Federal vs local enforcement gaps 29:33 — What Texas has done right so far 30:13 — Transparency reforms and data systems 31:05 — Anti-competitive contracting reforms 32:33 — Vertical integration and its risks 34:07 — What Texas still needs to fix 35:14 — Consumer-driven insurance models (ICHRA) 36:01 — Alternatives to traditional insurance 37:26 — Cash pricing and cost savings 38:04 — State employee health plans as a reform lever 40:31 — What success looks like by 2036 42:10 — Slowing cost growth as the first win 43:18 — Final thoughts + closing Watch Full-Length Interviews: https://www.youtube.com/@TexasTalks
Mutual respect is easy when everyone agrees. The real test comes when the pressure is on, the roles clash, and the person across from you sees things completely differently — and you have to choose, in that moment, what kind of teammate you're going to be. In this episode of Your Health University, host Jamie Preston is joined by the Your Health Patient Experience Team — Jennifer Kistler, Kim Metz, Whitney Myers, Carlos Heyward, and Rebecca Dillard — to explore one of the most demanding values in healthcare: Mutual Respect. Not as a concept, but as a daily practice that shows up in how we listen, how we disagree, how we treat the people we serve, and how much we're willing to learn from someone who doesn't look, think, or live like we do. What you'll hear in this episode: Why active listening is the foundation of all mutual respect — and what it looks like when someone has already "checked out" of a conversation Rebecca's moving story of a nurse who protected a patient's dignity in a single, graceful moment — without missing a beat How reverse mentoring flips the hierarchy and why Rebecca learned one of her most valuable lessons from Whitney Carlos's quiet act of mutual respect that resolved a conflict the room couldn't — just by listening Why conflict isn't the enemy of respect — and how Disney's creative process models what happens when mutual respect stays in the room Every patient is valued. Every voice belongs. That's not a slogan at Your Health — it's a practice. Press play and find out what it takes to really live it. www.YourHealth.Org
Send us Fan MailAmerican employers now spend over $25,000 a year to cover a single family, and chronic disease is driving the system toward collapse. Yet medicine is still built around a doctor's office visit every three to four months.Dr. Robert Pearl, former CEO of the Permanente Medical Group, Stanford professor, and author of ChatGPT MD, joins host David E. Williams to make the case that generative AI is the only tool that can shift medicine from episodic to continuous care, and why without it, the chronic disease crisis will break American healthcare entirely.
“One of the reasons The Pitt has been so successful is because it's showing real expertise in a time when everybody thinks they're an expert,” says Dr. Mel Herbert, who brings decades of experience as an emergency medicine specialist to his work as a writer and consultant on the hit HBO Max show. Dr. Herbert, who was also a consultant on the groundbreaking TV drama ER, is one of seven physicians on The Pitt's writing and production team, which explains the high degree of medical accuracy that is a hallmark of the show. But Dr. Herbert is also proud of the emotional accuracy captured on screen. “It's about the emotions. It's about the stress. It's about how it really affects the doctors and the nurses that I've found the most interesting to write about.” In this candid conversation with host Lindsey Smith, Dr. Herbert talks about his own struggles coping with the demands of life in the emergency room and the importance of letting clinicians know that help is available. “You don't have to suffer. We can help you now in ways we couldn't even do ten years ago. That's the story I want to tell.” In addition to his work using TV as an educational vehicle, Lindsey and Dr. Herbert discuss his real world efforts to provide emergency medicine education across the globe through his companies EM:RAP and EM:RAP GO. Stay tuned to this very special episode of Raise the Line with Elsevier in which you will also: Learn how writers tackle misinformation and hot button health topics; Get a behind the scenes look at how actors learn complex medical terminology; Discover who Dr. Herbert's favorite characters are. Mentioned in this episode: The PittMental Health Resources from American College of Emergency PhysiciansEM:RAPThe Extraordinary Power of Being Average If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Drew Flugstad-Clarke never planned to work in brain cancer. She planned to play Division I soccer at Georgetown. She planned to paint. She even tried investment banking, answering emails at 4am in a cubicle that never slept. Then in June 2022 her father, Jim, was diagnosed with glioblastoma at 57. He died 1 day shy of 7 months later, just before his 58th birthday. His symptoms began with emotion, not seizures. A steady HR executive suddenly cried. His golf game slipped. By the time he entered the hospital for a scan, he did not leave without surgery. A subway poster for a 5K became a lifeline. Drew showed up. She found a community. She later joined the American Brain Tumor Association as Community Manager for the Eastern Region. This conversation walks through anticipatory grief, caregiving in real time, strategic numbness, and what it costs to curate hope when the median survival clock is already ticking.RELATED LINKSDrew Clark Flukestad on LinkedInTopor StudiosAmerican Brain Tumor AssociationGeorgetown University Women's SoccerFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What if the most powerful thing you could do for your patients, your teammates, and your own career is simply to say: I made a mistake? In this episode of Your Health University, host Jamie Preston is joined by the Your Health Patient Experience Team — Jennifer Kistler, Kim Metz, Whitney Myers, Carlos Heyward, and Rebecca Dillard — for one of the most honest conversations in this Values Series yet: a deep dive into integrity. Not the word on the wall, but the daily practice of accountability, consistency, and courage that defines who we really are. What you'll hear in this episode: Why fear is the single biggest barrier to integrity in healthcare — and what leadership must do about it The real-time story of Rebecca owning a patient complaint oversight at 5:45 AM, and why it made all the difference Whitney's powerful reframe: integrity isn't just doing the right thing when no one's watching — it's consistency, whether it's easy or hard Jennifer's insight on how strong patient-provider relationships reduce malpractice suits — and why that starts with honesty The unforgettable story of a million-dollar mistake, a resignation letter, and a CEO who said: "Why would I let you go? I just spent a million dollars training you." Integrity matters here. At Your Health, it's not a policy — it's a promise. Press play and find out what it looks and feels like when an entire team commits to living it every single day. www.YourHealth.Org
"Headache is just a teeny piece of the puzzle," says Dr. Regina Krel, an insight that's at the heart of why migraine syndrome, one of the leading causes of disability worldwide, remains so persistently misunderstood. In this informative conversation with Raise the Line from Elsevier host Michael Carrese, Dr. Krel, the director of Headache Medicine at Hackensack University Medical Center, explains migraine as a storm that sensitizes the entire brain, not just the site of the headache, which explains the long list of symptoms people experience including sensitivity to light and sound, brain fog, fatigue and problems with balance. “The headaches can be severe, but it's the other symptoms that really kind of take over your whole body that make patients dysfunctional.” Dr. Krel also explains why migraine disproportionately impacts women in the prime of their working and caregiving years, and offers guidance for treating migraines in women, whose symptoms are commonly dismissed by non-specialists. Stay tuned to also learn about: The "migraine triangle"; Why stigma around migraine persists even in doctors' offices; New treatment options including neuromodulation devices. Mentioned in this episode: Headache Center at Hackensack University Medical Center If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Janine Durso spent 30 years inside pharmaceutical advertising shaping healthcare narratives before becoming a belief strategist and founder of The Believist. In November 2024, during a routine Zoom coaching session, she felt what she called a sharp, terrible pain in the right side of her head. Within hours she was in surgery for a ruptured brain aneurysm. She does not remember the ambulance, the ICU, or the first weeks that followed. She spent 5 weeks in intensive care, then 10 days relearning how to walk, calculate simple change, and manage basic cognition. Doctors later placed a stent and continue monitoring a second unruptured aneurysm.This episode traces the moment she told her husband something broke in my brain, the 14 days doctors called touch and go, and the slow mental rebuild that followed. It also examines insurance barriers that require 2 direct relatives with aneurysms before screening coverage, and why she now lobbies in Washington for change.RELATED LINKSJanine DursoThe BelievistBrain Aneurysm FoundationWhite Plains HospitalDr. Jared CooperFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
To mark the sixth anniversary of Raise the Line from Elsevier we're revisiting one of the most remarkable stories we've had the privilege of sharing over the last 575 episodes. To do that, we're delighted to welcome back Dr. David Fajgenbaum, a physician-scientist who repurposed an existing medication that saved his own life from Castleman disease, an ultra-rare condition that nearly killed him on five occasions. Because there was no treatment specifically for Castleman, Dr. Fajgenbaum set out to find a previously approved medication that might work. “I eventually found a drug that was made for another disease 50 years ago. It's been over 12 years that I've been doing great on this medicine.” When he first joined us in 2022, Dr. Fajgenbaum was just launching a non-profit organization called Every Cure with the hope of replicating the success he achieved in his own case, and as you'll learn in this inspiring interview with host Lindsey Smith, its work has already saved thousands of lives. “It's a tragedy if someone dies while there's already a drug in their local hospital that could help them.” In the latest installment of our Year of the Zebra series on rare conditions, you'll hear an inspiring example of a life saved by this approach and also learn about: The role of artificial intelligence in scanning thousands of medications and diseases to find possible matches; How Every Cure decides which drugs merit the costly research needed to confirm a match; Dr. Fajgenbaum's philosophy of “living in overtime.” Mentioned in this episode:Every Cure Osmosis Video on Castleman Disease Dr. Fajgenbaum's Bestselling Memoir, Chasing My Cure If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Rebecca Benghiat holds a JD, passed the bar, and skipped corporate law to build mental health systems instead. She now serves as Chief of Staff and Head of Impact at Inner Foundation, where she helps direct capital toward emerging adults ages 18 to 30 and asks a hard question every day: Is this actually working?In this conversation, she dismantles the myth of easy fixes. She explains why mental health measurement resists clean metrics, why a PHQ 9 score starts a conversation but never finishes one, and why “scale” often flatters institutions more than it helps people. She breaks down how impact investing shapes care delivery, why schools need networked systems not slogans, and why friction might be developmentally necessary.The stakes are real. Vulnerable families navigate snake oil, glossy apps, and pay to play algorithms while carrying the burden of choice in crisis. Benghiat lives inside that complexity and refuses to simplify it.RELATED LINKSRebecca BenghiatInner FoundationAspen Ideas HealthThe Jed FoundationFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Bioethicist and psychiatrist Dr. Aaron Kheriaty, author of “Making the Cut: How to Heal Modern Medicine,” discusses declining public trust in healthcare. Kheriaty describes his medical training and argues medicine has become an industrial, bureaucratic “turnstile” system that dehumanizes care, turns physicians into data-entry clerks, and relies on reimbursement-driven “guidelines” and narrow evidence-based medicine that favors costly pharmaceuticals. He proposes creating “parallel” grassroots medical institutions—such as direct primary care—analogous to homeschooling and Eastern European dissidents' “parallel polis,” since systemic reform from within is difficult. Kheriaty recounts opposing COVID vaccine mandates at UC Irvine, being fired after suing, and participating in Missouri v. Biden and Ho v. Newsom, which challenged government-influenced social-media censorship and California's physician “misinformation” law. He also discusses informed consent, assisted suicide opposition, and advocating opt-in organ donation.
Dr. Hoffman continues his conversation with bioethicist and psychiatrist Dr. Aaron Kheriaty, author of “Making the Cut: How to Heal Modern Medicine.”
At age 12, Dr. Chrystal Starbird stood by a pond after turning her mother in to the police. She watched tadpoles and fish move beneath the surface and found a strange kind of order. Science became her refuge long before it became her career. Years later, she built that refuge into a profession. She now serves as an Assistant Professor at the University of North Carolina, studies structural biology tied to cancer and Alzheimer's disease, and won Cell's first Rising Black Scientist Award in 2020. On paper, she fits the model of success. In practice, she had to fight for basic access at every stage.Conference travel required upfront cash she did not have. Networking favored pedigree over merit. Mentorship often depended on who knew your name in the room. Chrystal learned those rules, then chose to break them open for others.Oliver Bogler examines what Chrystal calls the advocacy tax. She has delivered over 70 invited talks. Nearly 40 percent focus on equity, mentorship, and policy. Academic reward systems do not count that labor toward tenure. She still does it.Through her leadership at the Life Science Editors Foundation, Chrystal helped build the JEDI program, which pairs underrepresented scientists with editors from journals like Cell and Nature. The program has supported over 100 awardees with more than 1,000 hours of mentorship. This episode exposes how biomedical science rewards output while ignoring the work required to make the system accessible. It also shows what happens when the people most affected refuse to step back.RELATED LINKSDr. Chrystal StarbirdStarbird LabLife Science Editors FoundationJEDI ProgramFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
At 19, Jansher Naim went from sharp stomach pain to a Stage 4 fibrolamellar diagnosis that few doctors see and even fewer young adults survive. He pushed through 41 rounds of chemotherapy, a Whipple surgery, and months of isolation while his friends kept moving through normal college life. In the studio, Jansher sits beside his mother Sadia Siddiqui, who refused early defeat and helped overhaul his care team when the first plan offered little optimism. Now a Computer Science student at Columbia, Jansher lives in the uneasy space between remission and risk, managing fertility decisions, travel for ongoing care, and the strange pressure to look fine at 22. Together they describe what it takes to grow up fast inside a system that rarely knows what to do with young adults who refuse to disappear.RELATED LINKSJansher NaimSadia SiddiquiFibroFighters FoundationColumbia UniversityFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.