06/03/2026
I appreciate so many of KevinMD.com posts. They highlight the broken system of health care in our nation. The cost savings of collapsing all medicine into huge hospital systems was an illusion. Costs are rising while the wait times are increasing and compassion is disincentivized. Providers who sell their practices to the system are beholden to serve the system.
Snippet from my own story: I once asked a group leader what was the best approach for patient care in a situation being discussed. I was told that didn't matter. I fell silent and knew that anything else I could say after that would be ignored.
Therefore, I set my eyes on creating something new, outside that system. It took years, sleepless nights, most of my savings, missed vacations, but now I can offer real care without having to answer to Big Insurance or Big Medicine directly.
IF patients want to have alternatives to Big Medicine, take your business to someone outside the system. Don't keep feeding the Beast that as a whole does NOT care about you. When those inside the system see that others are escaping, we will see more of those who want to escape willing to risk the jail break.
The broken system will continue to break us unless we break its hold on us.
A farm worker with gangrene in his foot was told by a big hospital system that the wait was three weeks, just for an ultrasound.
He went to a small independent practice down the road instead. On the morning of his procedure his car broke down at 8:15 a.m. The practice got the call, moved their later patients, started him at 11:30 a.m. instead of 9, and saved his leg in a week.
Saravanan Kasthuri is the interventional radiologist who runs that practice in rural Washington.
The patient was one of 67 employees on a family-owned farm verging on bankruptcy. He had been working there for 24 years. He needed his leg.
The same vertebroplasty he billed at $7,800 in 2016 now pays $4,800. His staff costs are up 70 percent. His Medicaid mix went from 1.2 percent to 27 percent. There are now more than 300 office-based procedures where Medicare pays less than the direct cost of the supplies. Private practice has collapsed from roughly 60 percent of physicians in 2012 to about 18 percent today.
If you need a cardiology consult for a family member right now, the wait through the dominant hospital system is seven months. This is what private practice collapse looks like in rural America.
Saravanan put it this way:
"We got him done, and his leg was saved with no amputation. It was all done within a week."
Listen to the full conversation on The Podcast by KevinMD. Link in the comments.
