Special topics

Longer pieces on a single question physicians keep asking, argued from the evidence, with what to do about it. Each one also goes out on Substack.

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  Sept 29, 2026What does the Rural Health Transformation Program pay for, and how does a rural hospital get some?

  The $10 billion a year goes to states, not hospitals. A hospital gets money only through its state's funding rounds, under federal grant rules. Technology, AI included, can qualify; care that insurers already pay for cannot.

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  Sept 28, 2026Equal pay for equal results

  Medicare now pays technology firms for results, and a smart-ring maker will promote one of them to its members. Primary care deserves the same deal, or Medicare will pay twice for fragmented care.

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  Sept 27, 2026Keep your hand in

  AI is taking over the everyday work that kept doctors' skills sharp. The skills it cannot replace will now have to be practiced on purpose.