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.
💡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
Palliative Care
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,
Health Policy
Hospice isn’t failing because clinicians forgot how to care. It’s failing because we built a structure that funds poorly, measures the wrong things, and aims enforcement in ways that often miss the mark.
While this topic is important and topical (and I'm really trying to keep my commentary on current events elsewhere), I couldn't in good conscience not take a moment to acknowledge what's going on around us. These past days have been heavy. The slaying of
Health Policy
💡Start with Rachel Cohen Booth's excellent article in Vox, What happens when a city takes women’s unpaid work seriously? It catalyzed my thoughts below. Hospice prides itself on dignity at the end of life. But what about dignity for those doing the hardest work—unpaid caregivers? If
Opinion
I think this might be true, but I invite your commentary and reactions: The move toward “everyone with serious illness needs specialist palliative care” consumed a decade of oxygen and money while the harder, more consequential work—how to pay for specialist, team-based palliative care as defined by NQF/
Teaching Pearl
Welcome back to Rounds & Rants, where we tackle the myths, misunderstandings, and maddening habits that make living harder than it needs to be. For today’s topic I thought I'd bring us back from the clouds where I lived for the first few points and talk about
Changing the World
In specialist palliative care, we talk about “compassion training” as if it’s a discrete skill you can add to a checklist. Joan Halifax’s enactive model challenges that notion: compassion isn’t a module; it emerges when attentional clarity, affective balance, ethical intention, and embodied engagement cohere in context.
Changing the World
Dr. Whyte's right—and in palliative care, the stakes are even higher.
Changing the World
If you’ve ever wondered why working in healthcare, especially in Specialist Palliative Care, feels like its being pulverized by grinding gears, this essay is for you.
Changing the World
Let’s stop pretending that our health system is anything other than a Frankenstein’s monster stitched together from billing codes, productivity metrics, and cultural myths about heroism in medicine.
Communication Skills
From time-to-time, I will publish articles that have recently crossed my path with my analysis of what they tell us. This will be the first in that series.