Health Policy
The biggest cancer centers don't get to be biggest because they decided to be. They are accredited. Each of their accreditation regimes carries floor requirements. Some of those floors are clinical. Some of those floors include specialty palliative care.
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.
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
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.
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/NCP