Literature Review

How physician CEOs are reenergizing later-career cliniciansBecker's Hospital Review; by Kristin Kuchno; 4/9/25 While much attention has been paid to recruiting top talent amid workforce shortages, retaining physicians later in their careers is also a key focus for health systems. Mentorship, flexible scheduling and leadership development opportunities can help energize experienced physicians and reduce burnout in the years leading up to their retirement, health system CEOs told Becker’s. Physician CEOs are uniquely positioned to understand the challenges around burnout and retention. Sunny Eappen, MD, president and CEO of The University of Vermont Health Network in Burlington [described], “Having experience being in front of a patient and having to either have difficult conversations or make difficult decisions is at the core of what we do,” Dr. Eappen said. “People understand that I can really speak from the heart and truly be in their shoes.”

Transforming communities through leadership with Quint StuderTeleios Anatomy of Leadership podcast; by Chris Comeaux, Quint Studer; 4/9/25In this episode, Chris sits down with Quint Studer, Founder of Healthcare Plus Solutions Group and one of his most trusted mentors, to dive deep into the transformation of Pensacola, Florida. Quint reveals his powerful framework for community change, sharing essential leadership insights and the challenges of driving real transformation.

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, Benjamin E. Canter; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.

Hospitalists in a bind when cancer prognosis hasn’t sunk inMedscape; by Jake Remaly; 4/15/25 When a patient with cancer is admitted to the hospital, the reason might not be related to the malignancy. But the hospitalist in charge sometimes becomes aware of a major disconnect: The patient, who they just met, does not grasp the severity of their cancer prognosis. On the one hand, the hospital medicine team and patient have advance directives and goals of care to consider, which may steer the course of the hospitalization and any use of hospice. The cancer prognosis — the patient might only have months to live, for example — could be a key component of those conversations. On the other hand, explaining the cancer situation should fall to the oncologist, right? ...Editor's notes: Pair this with today's posts, 

Today is National Healthcare Decisions Day - Make your advance care plans Institute for Healthcare Improvement - The Conversation Project; retrieved from the internet 4/14/25The links and resources [provided in this article] explore a variety of resources to help make, discuss and document future healthcare wishes and decisions in your advance care planning. ... The Conversation Project offers free tools, guidance, and resources to begin talking with those who matter most about your and their wishes.

Community Catalyst leads national response against new rule that threatens health care access Community Catalyst, Boston, MA; by Jack Cardinal; 4/11/25 Today, Community Catalyst organized hundreds of local, state and national partners to submit comments to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) opposing a new proposed rule from the Trump administration that would make it harder and more expensive for people to buy their own insurance on Affordable Care Act (ACA) Marketplaces and increase their medical debt. ... The administration’s own estimates suggest that as many as 2 million people will lose their coverage under this proposal, ...

Proposed FY26 Hospice Wage Index and Payment RateCMS press release; 4/11/25On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for hospices under the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Updated Proposed Rule (CMS-1835-P). [Major provisions include:]

Faith is the strength by which a shattered world shall emerge into the light. ~ Helen Keller

Never allow a person to tell you no who doesn’t have the power to say yes. ~Eleanor Roosevelt

TIEC, trauma capacity, and the moral priority of surrogate decision makers in futility disputesThe Journal of Clinical Ethics; Autumn Fiester; Spring 2025In the past 15 years, trauma-informed care (TIC) has evolved as a new paradigm in healthcare that recognizes the impact of past traumas on patients' and families' healthcare experience while seeking to avoid inducing new trauma during clinical care. A recent paper by Lanphier and Anani extends TIC principles to healthcare ethics consultation (HEC) in what they label "trauma-informed ethics consultation" (TIEC), which calls for the "addition of trauma informed awareness, training, and skill in clinical ethics consultation." While Lanphier and Anani claim that TIEC is "novel, but not radical" because it builds on the approach to HEC endorsed by the American Society for Bioethics and Humanities, I believe that TIEC has radical implications, particularly regarding ethical obligations to surrogate decision makers (SDMs). Given what I call the SDM's "trauma capacity," I argue that TIEC accords moral priority to SDMs over patients in certain types of end-of-life cases, particularly futility disputes, which is a radical departure from the conventional HEC approach to SDMs.

PEMF therapy: A non-invasive approach to enhance cancer treatmentHope 4 Cancer Treatment Centers; by Antonio Jimenez, Subrata Chakravarty; 2/25The Earth’s magnetic field, a constant presence in our environment, has a subtle yet profound impact on human health. Operating at extremely low frequencies and low intensities, it is generated by electric currents in the Earth’s conductive iron-rich core. This magnetic field serves as a protective shield, deflecting solar wind—charged particles from the sun— that could devastate life on Earth. Beyond its protective role, It also helps regulate circadian rhythms and supports cellular function. Our cells exist within this dynamic electromagnetic environment, and by harnessing its properties, we can actively enhance cellular health, physiological balance, and overall well-being.Publisher's note: Hope 4 Cancer is a naturalistic / neuropathic healing center in Mexico exploring innovative cancer treatments. Additional articles readers might be interested in include Treating cancer with sound waves: An overview of sonodynamic therapy and Modulated TRPC1 expression predicts sensitivity of breast cancer to doxorubicin and magnetic field therapy: Segue towards a precision medicine approach.

Appropriate deprescribing and payment in hospice dementia careJAMA Internal Medicine; Nathan M. Stall, MD, PhD; Sharon K. Inouye, MD, MPH; Lona Mody, MD, MSc; 3/25People living with dementia are one of the largest growing users of hospice care in the US, with approximately 20% of enrollees having a terminal diagnosis of dementia. In the setting of advanced dementia specifically, guidelines recommend deprescribing cholinesterase inhibitors and memantine as there is insufficient evidence for benefit, and there are risks of adverse events including bradycardia, falls, and gastrointestinal adverse effects. The Centers for Medicare & Medicaid Services specifies that hospices are responsible for covering all medications under the Medicare Part A hospice benefit, but audits have revealed that millions of dollars of prescription drug costs are being inappropriately shifted to Medicare Part D. The study by Hunt et al occurs within a context of growing concerns about shifts in US hospice care where more than 70% of hospice agencies serving patients with terminal illness across all settings now operate on a for-profit basis, with increasing acquisition of hospices by private equity firms and publicly traded corporations. Compared with nonprofit hospices, for-profit hospices have more acute care utilization, provide less direct care, and have poorer caregiver-reported care experiences. For-profit hospices also enroll a higher proportion of persons living with dementia, which may relate to their lower acuity and longer stays, as well as more profitable margins under the per-beneficiary daily payment.

[Australia] Effectiveness of grief camps in supporting bereaved individuals: A systematic reviewOmega-Journal of Death and Dying; Jingyi Chi, Karolina Krysinska, Karl Andriessen; 3/25Experiencing the death of a loved one is a stressful and disruptive event that can have short-term and long-term detrimental effects on the grief, mental health, and social functioning of the bereaved individuals. Grief camps represent a relatively novel form of support. Narrative synthesis of the study findings indicated a positive impact of grief camps on the grief and psychosocial functioning of bereaved individuals, and participants’ feedback indicated that grief camps are an acceptable intervention. Further research in various locations and across different age groups may broaden our understanding of the effects of grief camps.