Literature Review

Why physician strikes are a form of hospiceKevinMD; by Patrick Hudson; 8/24/25I have only recently started thinking about strikes. They seemed like something other people did: railway workers, bus drivers, teachers, dockworkers. People with contracts. People who clocked in and out. Not doctors. Not surgeons. Certainly not me. You and I were supposed to absorb and adapt. To advocate from within. And we did, for a long time. We bent ourselves into shapes that did not fit. Worked around all the broken processes. Made phone calls after hours. Took the extra shift. Rewrote the notes to satisfy a system that did not understand the work. Until, eventually, some of us stopped. Not because we wanted to burn it all down, but because we could not keep pretending. And that is what a strike is, sometimes. Not rebellion. Not rage. Just a line and a refusal. And an end to the performance. Is it not strange how long you can work inside a system that is eating itself? ... You do not strike because you have stopped caring. You strike because you remember when it mattered.Publisher's note: An interesting analogy for our fractured healthcare system...

Hospice was meant to offer dignity in death — but it fails the most marginalized. We need hospice programs that go to the streets, into shelters, behind barsSTAT; by Christopher M. Smith; 8/26/25I’ve spent more than a decade in hospice care, sitting at the bedsides of people facing the final days of their lives. I’ve held hands in hospital rooms, in tents, in prison cells, and in homes that barely qualify as such. And over time, I’ve come to see that dying in America is not just a medical event — it’s a mirror. It reflects everything we’ve failed to do for the living. Hospice was created to bring dignity to the dying — to manage pain, provide emotional and spiritual support, and ease the final passage for people with terminal illness. But the systems surrounding hospice care are riddled with inequity. The very people most in need of compassion — the unhoused, the incarcerated, people of color, LGBTQ+ individuals, and people with disabilities — are systematically excluded, underserved, or erased. Access to a good death is too often reserved for the privileged, while everyone else is left to navigate a system that wasn’t built for them — or worse, actively works against them... The truth is, hospice care cannot achieve its mission unless it actively addresses the inequities built into the structures around it. We need hospice programs that go to the streets, into shelters, behind bars. We need training rooted in cultural humility, in antiracism, in trauma-informed care. We need to reimagine what it means to offer dignity to someone whose life has been defined by abandonment... Because dying is universal. But justice, even at the end of life, is still not.Publisher's note: STAT also references Dr. Ira Byock's article "The hospice industry needs major reforms. It should start with apologies, 8/22/23".

How music therapy can help people with cancerAmerican Cancer Society; 8/22/25When life gets hard, music can be a balm. Maybe listening to a playlist or making your own music lifts you up. For people facing cancer, music therapy offers a way to ease stress and find connection. What is music therapy? Music therapy is a type of mind-body therapy that uses music to promote healing. “For many people with cancer, it can offer a nonverbal, emotionally resonant way to cope with challenges,” said Cristiane Decat Bergerot, PhD, an American Society of Clinical Oncology (ASCO) expert and head of the Department of Psycho-Oncology at Grupo Oncoclínicas in Brazil. Music therapists use different techniques to help patients process their emotions. One goal of music therapy can be to help manage side effects from illness. For example, many people experience pain from cancer or cancer treatment. Medications can help with physical pain, but emotional pain can be tricky to treat.

Nonprofit hospital CEO, employee pay gap widens: StudyBecker's Hospital Review; by Kelly Gooch; 8/20/25The wage gap between CEOs and average employees at U.S. nonprofit hospitals widened from 2009 to 2023, according to a study published this month in Health Affairs. Researchers from the University of Chicago, Brown University in Providence, R.I., and Rand Corp. used IRS Form 990 and Medicare cost reports to examine data from 1,424 nonprofit hospitals. They found hospital CEOs earned about 10.2 times the average wage of hospital employees in 2009. By 2023, that ratio had risen to 12 times the average wage — a 17.6% increase. Between 2009 and 2023, average CEO pay rose by 27.5% and top executive pay by 23.1%, while the average wage for all hospital employees (executives included) rose just 9.8%. Inflation-adjusted average annual CEO pay rose from about $814,000 in 2009 to $1.04 million in 2023.Publisher's note: What is the CEO / Employee pay gap in your organization?

Hospice AI - Compare Medicare Advantage to Traditional MedicareHospice & Palliative Care Today staff; 8/24/25Today we asked ChatGPT two questions. It created a 3-page detailed summary that included:

Cambia, BCBS North Dakota announce strategic affiliationBecker's Payer Issues, by Jakob Emerson; 8/21/25Cambia Health Solutions and Blue Cross Blue Shield of North Dakota plan to enter a strategic affiliation that would bring the Fargo-based insurer under Cambia’s management while maintaining its local governance and mutual status. The agreement would integrate BCBSND into Portland, Ore.-based Cambia, alongside its Regence Blues plans in Idaho, Oregon, Utah and Washington, according to an Aug. 21 news release. Cambia will assume responsibility for operations, including claims, IT, financial reporting and plan performance. BCBSND employees will become Cambia employees, though the health plan will keep its local name, board of directors and foundation. Its reserves and philanthropic resources will also remain in North Dakota.

Charlie Brown: Some day, we will all die, Snoopy.Snoopy: True, but on all the other days, we will not.

UnitedHealth, Elevance scaling back ACA offerings in Colorado Becker's Payer Issues; by Andrew Cass; 8/21/25UnitedHealth’s Rocky Mountain HMO and Elevance’s Anthem HMO Colorado have filed plans to end coverage for multiple health plans in the individual market for the state. The decisions are projected to affect 96,000 Coloradans, the Colorado Division of Insurance said in an Aug. 20 news release. All counties will continue to have plans available in the individual market despite the discontinuation notices.

NPHI applauds California’s statewide campaign to combat hospice fraud ehospice; 8/21/25Momentum grows nationally to protect patients and preserve high-quality hospice care – The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for nonprofit hospice and palliative care providers, applauds California Attorney General Rob Bonta for launching a comprehensive statewide campaign to combat hospice fraud. This campaign includes public service announcements, community outreach events, and a new reporting hotline designed to educate consumers about hospice fraud. It comes amid a broader national effort by the Centers for Medicare & Medicaid Services (CMS) to strengthen hospice program integrity and crack down on fraudulent providers across the country, with heightened focus on fraud-prone states such as California, Nevada, Arizona, and Texas.Notable mentions: Statement from Tom Koutsoumpas.

Make every dollar count: Budget strategies you can implementCHAP blog; by Daniel Stephens, Jan Sweat; 8/22/25Every leader knows the feeling. Budget season rolls around, and suddenly you’re staring at spreadsheets, deadlines, and targets that don’t always add up to reality. Too often, the process becomes about filling in boxes instead of creating a plan that actually drives growth. But a budget isn’t just numbers, it’s your strategy in action. When approached the right way, it forces you to step back and ask: Where have we been? Where are we today? And where do we want to go? That’s where budgeting shifts from wishful thinking to purposeful planning.

Why more doctors can't make ends meetAxios; by Tina Reed; 8/12/25America's doctors are working harder and getting paid less. And that could soon translate into less access for some patients. The big picture: A new report from consultancy Kaufman Hall shows primary care physicians and specialists are delivering more services since the pandemic. But they're not making more money because of stagnant reimbursements from public and private insurers and inflation. The data helps explain why medical practice bankruptcies hit a six-year high last year — and why some providers are shifting to pricey procedures for cash-paying customers to boost their bottom lines.

Sick doctors: Don’t be the kind of patient you hateMedscape; by Eric Spitznagel; 8/18/25On a frigid November night in 2018, Michelle Sullivan came home from dinner with friends, took the dog out, and suddenly felt something off. “I walked outside, and I could feel my heart go into an odd rhythm,” says Sullivan, an osteopath from southern Illinois whose husband, Bill, is an emergency physician... “I said, ‘I don’t think I have time for an EKG. Something’s really wrong.’” When they hit the ER doors, her heart rate was 180. “I said, ‘I don’t know if I’m going to make it. I feel like I’m going to die right here,’” Sullivan recalls. “They hooked me up, and I said, ‘It’s AFib [atrial fibrillation], isn’t it?’ Yeah. It was AFib.” And then…nothing. No one came in. No crash cart, no orders - and this was her hospital. “Finally, Bill runs out into the hallway and says, ‘I’m sorry, can somebody please get in here?’”Publisher's note: This is part of a Medscape series titled "Dr. Patient" describing what it's like when healthcare professionals become patients. From a hospice perspective, does your hospice provide the quality of care you would want for yourself or a loved one?