Communication Skills
Beyond Mandatory Autonomy: Truth Without Abandonment
Honesty and hope aren’t opposing forces. They are a matched set: hope for the best and prepare for the worst—paired with an explicit promise of nonabandonment.
Kyle P. Edmonds
Kyle: Palliative doc, educator, and professional overthinker. Known for turning rounds into rants and rants into teaching points. Writes about medicine, communication, and the evidence-base for the meaning of life.
Hows & Whys
AI Won't De-Skill Palliative Care
The de-skilling threat is real and asymmetric across specialties. Palliative care sits on the protected side of that asymmetry—because the highest-value things we do are the things machines are worst at.
Hospice
The Rise and Fall of San Diego Hospice — Part 2
This is what happened at San Diego Hospice between November 2012 and February 2013. Leadership made a series of irreversible operational decisions — public disclosure, inpatient closure, live discharges, admission restrictions — while sailing entirely on estimated position.
Health Policy
The Sectarian Temptation
We work in the places where evidence gets thin, emotions run hot, and the mysteries are real. It is the exact territory where sectarian certainty rushes in with confident answers, unfalsifiable frameworks, and the seductive promise that someone, somewhere, has figured it all out.
Hospice Was Never Built for Kids
💡No, gentle readers, you're not hallucinating. Those of you subscribed to the newsletter email got a preview of this one last week due to a publication scheduling error. Probably won't be the last time that happens! Maybe I'll call it a "subscriber perk.
Communication Skills
Teams, Not Saviors: Protecting Each Other from Compassion’s Edge States
Every team thinks they’re compassionate. Fewer can name the cliffs embedded in compassion—and fewer still can stop one another from going over the edge in the middle of a messy consult.
Hospice
The Rise and Fall of San Diego Hospice — Part 1
How a “Mother Ship” Was Built: Ethos, Scale, and Blind Spots I trained at San Diego Hospice. In fact I was part of the last class of fellows. That sentence carries weight I've been unpacking ever since. SDH shaped how I think about dying, how I talk to
Beyond Mandatory Autonomy: Clinician‑Guided Care Without Guilt
💡This is Part 2 of an ongoing series on the concepts and innovations that are challenging decision-making in serious illness. Part 1 laid out why "mandatory autonomy" is failing patients and families, and introduced Kon's shared decision-making continuum as a practical alternative. The Word We Don&
Hospice ROI Lives in Relationships, Not Throughput & Widgets
If you want real returns, invest in earlier hospice enrollment, stable teams, and time to do the relational work—then use tech to buy clinicians that time. I read the Hospice News piece celebrating AI’s promise in hospice—faster admissions, smarter documentation, and “efficiency” to stretch scarce clinicians. The
A Near‑future Worth Building For Community Specialty Palliative Care
A pediatrics team in Queensland just did something our field talks about but rarely executes. Gold Coast Health launched DevPaed Connect—a shared-care model that lets PCPs (we'll use the US lingo here, but "GP" if you're Down Under) submit a clinical question to
Beyond Mandatory Autonomy: Rethinking Decision-Making in Serious Illness
💡This is the first in a four (?) part series on the concepts and innovations that are challenging decision-making. The Autonomy Myth and Why It’s Failing Us Truth bomb: “Do you want us to shock his heart if it stops?” is not a neutral question. It’s a transfer of
Palliative Care
What Physicians Are (Actually) For On Specialist Palliative Care Teams
If you think the physician on a Specialist Palliative Care team is the captain, you’ve already missed the plot. Our role is counter‑cultural: we make space, translate, and selectively intervene—then get out of the way. That’s how teams deliver the outcomes the literature promises. Why teams,