10-Year Retrospective: My PM360 Column

Ten years ago, at the height of Stupid Cancer's rising influence, right before the Internet became evil, I was given the prestigious opportunity to collaborate with Mark and Ana Stashower at PM360. They offered me what became my very first column with carte blanche to speak truth to power with unbridled authenticity and amplify the sentiments of not only the young adult cancer community but the collective frustrations of the greater AYA nonprofit community.

RELIVE THE MAGIC ➡️ https://www.pm360online.com/author/matthew_zachary/

While the names of each article end in "Stupid," it was not meant to be reductive; instead, it was an on-brand telling of real-world frustration.

• It’s Your Lawyers, Stupid

• It’s Your Budget, Stupid!

• It’s Customer Service, Stupid!

• It’s Customer Service, Stupid!

• It’s Customer Service, Stupid!

• It’s The Young Adult Caregiver, Stupid!

• It’s The Patient, Stupid!

• Regulatory Killed the Radio Star (My personal favorite)

I recently revisited all of them (so others don't have to), and it's both surprising and unsurprising how little has changed. And what a treasure trove of insight these articles provide, with each title a pithy, almost ironic directive — from "It's the Patient, Stupid!" to "It's Your Lawyers, Stupid!" — all of them pointed and unapologetically candid.

Ten years back, each of these “Stupid” articles offered an unapologetic look at the good, the bad, and the truly baffling in our healthcare ecosystem. Now, a decade later, it’s both surprising and exhausting to realize how little has actually changed.

Yes, we’ve seen some progress—but the same old issues are still lurking, just dressed up in new, buzzword-heavy outfits.

Pharma: Big Goals, But the System’s Still Slow

Let’s be real: people in Pharma are working hard to make a difference. But the system they work in? It’s like trying to steer a cruise ship with a paper straw. “Patient-centricity” was supposed to be the North Star—a promise that Pharma would finally listen, engage, and empower. And they tried. Kind of. But take a closer look, and you’ll see that “patient-centricity” has morphed into yet another bullet point on a corporate brochure rather than a lived reality.

Don’t get me wrong—there have been some strides. We’re talking about real people who genuinely want to help. But that vision gets diluted by the bureaucratic sludge, the rigid hierarchies, and the endless parade of “legal’s not cool with that.” The result? Patients are still falling through the cracks, still struggling to get access, and still wondering if “patient-centricity” is just code for “We’ll look like we care.”

Access to Care: Is it Actually Any Better?

Access has been a rallying cry for as long as I can remember, and yet, here we are. The good news is that we’ve got more technology than ever, with apps and patient portals out the wazoo. The bad news? Access is still like a game of “Where’s Waldo” but with your life on the line. Young adults facing cancer are still navigating a system that demands way too much patience and grit, just to get the treatments they need.

While Pharma and the healthcare industry love to tout “better access” on paper, the reality is more convoluted. Tech has given us new ways to get information, but it’s also added layers of red tape that many patients are too burned out to cut through. Access should mean straightforward, but in practice, it often means “hope you like paperwork.”

Nonprofits: Essential, but Still Underfunded and Overstretched

Nonprofits are still doing the heavy lifting when it comes to real advocacy. They’re the ones banging the drum for better access, better care, and better everything else. But they’re also strapped for cash and stretched thin, trying to make an impact in a system where the big players have far more resources to throw around. Nonprofits are fighting the good fight, but with one hand tied behind their backs.

These organizations matter, and they do push the needle—but only so far. Until the system starts giving them a little more respect (and funding), their impact will be limited by constraints that they shouldn’t have to carry alone. They’re here for patients, but there’s only so more they can do without serious systemic support.

Privacy: Now a Double-Edged Sword

Remember when privacy was just a matter of not sharing your social security number? Those were the days. Today, privacy has become the wild west of healthcare, especially as patient data is collected, analyzed, and sold in ways most of us can barely comprehend. Patients have access to their data, sure, but how much control do they really have? With every click, swipe, and login, they’re handing over data that could help or hurt them, depending on how it’s used.

Regulations like HIPAA were meant to protect patient information, but the digital age has blown the doors wide open, and privacy is no longer as simple as a locked filing cabinet. Patients now find themselves in an era where privacy and transparency are competing interests, and they’re often left wondering who’s really looking out for them.

Lawyers, Regulations, and the Never-Ending Tango of Red Tape

Lawyers and regulations—necessary, yes. But also, exhausting. “It’s Your Lawyers, Stupid” wasn’t just a catchy title; it was a jab at the mountain of legalese that patients and advocates wade through daily. The tension between innovation and regulation is as strong as ever, and while rules are meant to protect, they can also stifle meaningful change.

The healthcare industry still leans on legal constraints as a reason for not making certain strides, and sometimes that’s justified. But other times, it feels like an excuse to avoid taking risks that could actually benefit patients. Patients are asking for progress, and they’re met with a wall of “Well, the lawyers said no.” Necessary? Sometimes. Frustrating? Always.

Let's Review

These articles were written TEN YEARS AGO.

It’s clear that while we’ve added new layers of complexity, the core issues remain. The people working in Pharma, biotech, nonprofits, and advocacy are doing their best, often with limited support and bound by a system that doesn’t make it easy to truly innovate.

We’re seeing incremental progress, but the bigger shifts patients need are still somewhere in the foggy distance while we still sit around and claim to innovate for the sake of a cap table and not a human being.

Until the system takes a hard look at how it really operates, we’re going to be stuck in this frustrating loop—talking a big game but making tiny steps.

If we want real change, it’s going to take more than a new tagline.