I spent 3 days at a conference for women in Health IT despite lacking the professional credentials and approximately half the necessary chromosomes. I came home thinking differently about healthcare insiders, patient communities, and one surprisingly consequential pronoun.

Doctors and patients were never opposing teams. They’re the 2 people healthcare was built around. So how did we create a system where both can sit in the same exam room feeling powerless while everyone else apparently has a login?

American healthcare has spent decades teaching patients to become better mechanics instead of fixing the machine. We learn deductibles, networks, prior authorization, appeals and PBMs because something went wrong. When did surviving the healthcare system become the patient’s responsibility?

A lawsuit involving UnitedHealth Group alleges more than 90% of certain claim denials were reversed when appealed. The bigger story isn’t just AI. It’s a healthcare system that makes sick people fight decisions that may not survive scrutiny.

In 1996, I graduated from Binghamton University at 21 while going through brain cancer treatment, with no idea what came next. 30 years later, I’m going home. A reflection on cancer, music, survival, and the extraordinary amount of ordinary life that happened in between.

Fitness expert Fitz Koehler did everything “right” and still got breast cancer. She joins Out of Patients to talk exercise oncology, survivorship, wellness snake oil, and why fitness cannot prevent every diagnosis but can help prepare the body for what comes next.

Bryan Bishop and I bonded over brain cancer, bald heads, microphones, dark humor, and being two Jews who refused to let cancer become our personalities. Fourteen years after one unforgettable conversation, I went back to hear his voice again. This is for my bald brother.

American healthcare has insurers, hospitals, pharma, PBMs, employers, lobbyists and trade groups organized to protect their interests. The patient has a portal password. After 30 years inside the system, I think patients need something we’ve never had: a constituency.

In 2019, I wondered whether American healthcare had turned “patient” into meaningless industry jargon. An unpublished essay from the archives about patient engagement, consumer power, and a healthcare system very good at talking about the people it serves.

I wrote We the Patients for people trying to survive American healthcare. I did not expect physicians, academics, and medical educators to start asking whether it belongs in the classroom. So, naturally, I have one question: How the hell did this happen?

We the Patients is in the front window of Barnes & Noble on Fifth Avenue. For Matthew Zachary, the surreal milestone is about more than seeing his book on display. It’s about seeing patients, and the idea of patients as a constituency, finally occupying some very public real estate.

What happens after you understand how American healthcare actually works? The We the Patients reader survey asks whether healthcare literacy creates agency, anger, preparedness, or something more powerful: the expectation that the system should change.

Patients have always had the numbers. What they have never had is a shared political identity. After 30 years in patient advocacy, Matthew Zachary argues that the next chapter may be transforming shared healthcare experiences into civic and political power.

Thirty years ago, I walked into Gilda’s Club and the Wellness Community as a 22-year-old brain cancer survivor looking for people who understood. I recently returned to its successor, Cancer Support Community, and finally understood what those rooms, and the people who kept them open, had given me.

During my cancer treatment, my father documented everything: doctors, appointments, weather, parking and even where I threw up. Thirty years later, I understood those notes differently. They were a record of what a terrified parent does when love cannot fix the problem.

Dr. Harold Freeman saw poor Black women dying of breast cancer in Harlem and asked why. His answer helped create patient navigation and permanently changed cancer care. A personal remembrance of a pioneer whose road millions still travel today.

At 21, I watched my father drive onto a Manhattan sidewalk to get me home from brain cancer treatment. Thirty years later, I realized that absurd New York moment was a perfect metaphor for American healthcare: when the road is blocked, patients are expected to find the sidewalk.

Doctors know how to treat their patients. Increasingly, they’re being blocked from doing it. After decades in patient advocacy, I’m realizing that patients and physicians may be fighting different sides of the same healthcare battle.

Sydney Towle didn’t fail to look sick enough. We failed to understand what living with cancer can actually look like. Her story exposes a culture that demands patients perform suffering before offering compassion, and what that says about all of us.

More than 80% of appealed Medicare Advantage prior authorization denials are overturned, yet fewer than 0.2% of ACA Marketplace denials are ever appealed. The problem is not only denial. It is a system that profits when patients run out of time, energy, and hope.