Health Policy
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.
đź’ˇNo, 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
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
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
💡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
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 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
💡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