When people talk to me about healthcare in the U.S., it’s usually a conversation filled with frustration. Costs are out of control, inequities are real, and outcomes are often better in other developed nations. But as Dr. Carroll suggested, when we do a deep dive, we find incredible accomplishments that deserve attention, too. The challenge we face as a nation and the opportunities presented by that challenge lie in keeping what works and fixing what doesn’t.

For example, over the last half-century, vaccines and better treatments have helped drive childhood mortality rates down by more than 75%. Diseases like polio and smallpox are gone, and before the Hib vaccine, meningitis, epiglottitis, pneumonia, and sepsis were killing and disabling hundreds of kids every year.

Leukemia, a near-certain death sentence for a child, can now be treated with real hope. Despite this progress, we still trail behind many countries in infant and child mortality. Black infants die at twice the rate of white infants. What’s missing? Equal access to care and the social support for healthy beginnings.

The United States’ research is the envy of the world. The NIH spends more on medical science than any other nation, and its discoveries have represented the future of medicine. HIV is a manageable condition. We can cure Hepatitis C. So, what is the problem? A hepatitis C cure costs tens of thousands of dollars. Taxpayers fund the science, but patients can’t afford the drugs. If we used government purchasing power to lower costs, the drugs could reach more people.

How about regulation? The Food and Drug Administration reviews and approves new medicines faster than several of its peers. Cancer drugs often become available here months or years before they do in Europe. Unfortunately, some drugs end up offering slim benefits at exorbitant costs. It would be great to have quick access with stronger evidence at a fair price, but can we ever have quick, good, and cheap? It’s like the iron triangle of challenge.

How about medical education? The U.S. dominates the world with many of the best medical schools that draw students from across the globe. But we still don’t train enough doctors, especially in primary care and rural areas. We end up relying on immigrant physicians. High tuition costs are a major problem. If we expanded medical school slots, reduced debt burdens, and provided stronger incentives for service in underserved areas, we could match our educational excellence with workforce adequacy. Hence the pending IUP College of Osteopathic Medicine journey.

Recent safety and prevention initiatives have saved tens of thousands of lives and billions of dollars. But preventable errors still are one of the leading causes of death in this country. More coordination, transparency, and accountability could help to improve our healthcare institutions.

Since the introduction of the Affordable Care Act, millions of Americans have gained access to screenings like mammograms and colonoscopies. Early detection can make an enormous difference. But the recent Medicaid cuts will mean that millions will be uninsured or underinsured. By making prevention and wellness the key to healthcare, expanding coverage, and making healthcare affordable, prevention can become a reality rather than a privilege.

Dr. Carroll is right to celebrate the good news. But we can’t ignore that, despite spending nearly 17 percent of GDP on healthcare, Americans live shorter, less healthy lives than people in other successful nations. We’re not missing the science. We are missing the policy.

The answer? Expand coverage, enforce fair drug pricing, provide equity, train more physicians, and hold institutions accountable for safety. Then we have a system that is both world-class and fair. But that would mean deciding between social capitalism and savage capitalism. That’s the real challenge.

? This column draws on Aaron E. Carroll’s essay, “The Bright Spots of American Healthcare: A Beacon of Innovation and Progress,” published in The New York Times on September 5, 2025.

Coretta Scott King said, “The greatness of a community is most accurately measured by the compassionate actions of its members.”

Some disturbing facts came to my attention at a recent meeting. Only you can help lessen the challenge presented by these facts. There is an entire generation of Baby Boomers who are leaving without having completed the most important task there is for communities. They have not put a successful succession plan in place.

Every business, organization, association, and community establishment will only remain successful if they have a roadmap in place to continue. What am I talking about? It is not unusual to hear various organizers and fundraisers lamenting, “Once the current leaders retire, no one is coming up to take their place in major leadership or philanthropy roles.’

What are the ramifications of this quandary? Let us look at not just the critical infrastructure but also those organizations that make a town more exciting, attractive, interesting, and livable. These include public spaces, parks, transportation, walkability, and community engagement.

One of the most important assets of any area can be the Cultural and Recreational Opportunities.

During the years that I was “in the business” of trying to convince physicians and their families to come to a town to work at our hospital, those elements were all on their checklist. If, you could add the fact that there were entertainment centers or a symphony orchestra, that became a game changer. Just knowing they were available without having to drive an hour or two to enjoy the arts sometimes made all the difference in the world.

Each year when I speak to leadership groups, my subject matter always has a sincere pitch to get involved in the community at multiple levels. Service clubs, fire departments, and ambulance organizations need volunteers and employees, but communities also need culture and the arts. So, volunteering and support can and must happen on all levels or a community suffers. This involvement can take many forms: volunteering, attending local meetings, supporting local businesses, or simply engaging with our neighbors.

Why is this important? Because it fosters a sense of belonging. When we engage with one another, we build relationships based on trust, understanding, and collaboration. It enhances our mental well-being. Volunteers report higher levels of happiness and lower levels of stress. Plus, it gives us purpose and helps combat feelings of isolation. We meet diverse individuals, gain new perspectives, and develop relationships that can open doors—both personally and professionally. Lastly, it fosters personal growth.

Active community involvement and local initiatives foster a sense of belonging and Inclusivity. Community involvement evokes kindness which is essential for shaping the future. Your decisions to volunteer, and to give freely at whatever level you can afford will impact lives for decades to come.

Recently, Jeff Goldblum, the actor, was asked what he thought was the essence of life. He paused and quoted George Bernard Shaw. “This is the true joy in life, being used for a purpose recognized by yourself as a mighty one. Being a force of nature instead of a feverish, selfish little clod of ailments and grievances, complaining that the world will not devote itself to making you happy. I believe that my life belongs to the whole community and as long as I live, it is my privilege to do for it what I can. I want to be thoroughly used up when I die, for the harder I work, the more I live. I rejoice in life for its own sake. Life is no brief candle to me. It is a sort of splendid torch which I have got hold of for the moment and I want to make it burn as brightly as possible before handing it on to future generations.

During a recent keynote speech for the United Way, my topic was finding the hidden gems among our co-workers.

During my decades in not-for-profit organizations, I have depended upon volunteers. Max DePree, former CEO of Herman Miller Furniture, beautifully articulated in his book Leadership Jazz, a technique for interacting with people that resonated with me.

You might wonder what jazz or business furniture has to do with leadership. Well, as a former professional trumpet player, I can tell you that, just like jazz music, leadership is about improvisation, collaboration, and, most importantly, finding the unique contributions that each volunteer can bring to the table.

De Pree’s philosophy is simple yet profound: leadership is not about being the loudest voice in the room or the one who has all the answers. It is about discovering and nurturing the hidden gems within your team—the talents, skills, and qualities that often go unnoticed but can make a world of difference when brought to light.

Each of us has these hidden gems. Sometimes, like unique gifts that we receive nestled in bubble wrap, these hidden gems are special hidden talents, passions, and interests, and we must remove the bubble wrap to find them. To do that often means getting to know the people we work with more closely.

Sometimes, these talents are under layers of routine, doubt, or simply under the demands of everyday work. As leaders, we must dig deep and uncover these treasures. Then the organization benefits, and the individuals grow and find personal fulfillment.

The beauty of jazz is that much of it is not on the written page. There is room for improvisation, for each musician to shine in their way while contributing to the group’s harmony.

In the same way, effective leadership allows for flexibility and creativity. It is about setting the stage for your team members to improvise, to bring their flair and ability to the challenges at hand. It is about recognizing that leadership is not a solo act but a collective effort where everyone has a role to play.

So, how do we, as leaders, uncover these hidden gems? Here are three practical steps:

Create a culture of trust. People need to feel safe and valued before revealing their true talents.

Listen Actively. Often, we are so busy directing and instructing that we forget to listen. Take the time to hear what your team members are saying. Listen for their words, their ideas, concerns, and aspirations. That is where you will find those hidden gems.

Encourage experimentation. Give your team the freedom to try new things, take risks, and explore their potential. Allow people to experiment without fear of failure. Then, they will be more likely to discover and develop their unique talents.

When you start to uncover these hidden gems, the impact is profound. Not only do you empower individuals to reach their full potential, but you also help to create a more dynamic, innovative, and resilient team. You will find that the solutions to your toughest challenges often come from the most unexpected places.

United Way’s vision and mission are extremely important. It is an organization where people of diverse backgrounds and opinions can come together to volunteer and support projects that help families, particularly growing children, to have success early in life.

It is about finding those compassionate, empathetic, inspirational givers who will ignite your folks to help ease the pain suffering, and challenges that we all either have or may experience in our lives. We live in a world of givers and takers where it feels like the takers are winning more and more frequently. Let’s inspire our people to unfold the bubble wrap and find the givers amongst us.

As National Women’s Month drew to a close and faded into the other 11 months that are not dedicated exclusively to Women, I received a solicitation from an Email friend regarding a new book written by author, Phyllis E. Greenberger, titled “Sex Cells.”  The author had a list of credentials regarding advocacy for women’s health that was as long as my forearm, and the fact that her latest book was published by Mayo Clinic Press was all I needed to respond positively to read and comment on her work.

The core of her book is that, despite all the work that has been done during the past thirty or so years, women are often still treated medically like men. She maintains that “Every woman can point to a time her pain wasn’t taken seriously or a medical professional didn’t seem knowledgeable about women’s health.” With her focus on biological sex differences, Ms. Greenberger, “continues to be struck by the lack of understanding of the topic, even among medical professionals.”

Consequently, the book provides the readers access to “the wide-world of sex-specific medical issues . . .how women pay the price, with a close look at the impact that it has on minority populations. “Told with humor, ferocity, and passion, ‘Sex Cells’ appeals to anyone interested in health, women’s rights, and public health policy.”

Having personally been involved on the administrative side of healthcare for nearly four decades with a focus on research directed primarily toward women, this topic captivated my interest. During my time at our research institute, the work was focused on breast, cervical, endometrial, and ovarian cancers plus heart disease, diseases that the author referred to as “bikini medicine” because it was limited to breast and genital health.  Interestingly, however, our research not only looked at the genomic differences, we also studied the impact of behavioral modification on these various maladies.

It was during this time that we began asking female patients suffering from these diseases to visit the researchers and explain what they were going through. This was intended to personalize their challenges and encourage the scientists to look at individual women instead of just numbered test tubes and aliquots. In other words, we attempted to personalize, humanize, and feminize their work.

We found genetic differences associated with race, ethnicity, and sex that would alter not only the severity of the disease but also the detection and eventual prevention and cure of certain diseases that were very different than those formerly acknowledged in the field.

During this time, as the author so skillfully pointed out, it was clear to us that generally, research on an international level was challenging in its history due to its lack of inclusion of women and minorities in clinical trials. Ms. Greenberger also addressed how women can begin to advocate for themselves in the doctor’s office.

She elaborated on the disparities women face in medical treatment that continue to this day. These disparities are even more prevalent among female minorities. Equal but not the same as the primary thesis of “Sex Cells.”

Her chapter titles ranging from “The History of the Mystery, The Heart of the Matter, Neurological Stew, to a Brighter Tomorrow,” address topics and content that display the gravity of the challenges which are all carefully explored and amplified.

Phyllis Greenberger has been at the forefront of advocacy for women’s health for decades, and this book is a strong example of her dedication to enlightening her readers about the challenges of women’s health.

As Louse Otto-Peters, a German suffragist and women’s rights activist said, “The history of all times, and today especially, teaches that . . . Women will be forgotten if they forget to think about themselves.”

This book “. . . is a comprehensive tale of scientific stonewalling, intrepid advocacy, and the still-pitched battle to get the scientific and medical world to recognize that women are not small men.”

Dan Buettner, a New York Times bestselling author, has spent two decades studying places in the world where longevity seems to be a given, and people simply forget to die. They live into their late 90’s and early 100’s as healthy, productive participants in their communities. The other thing he discovered was that the vast majority of them were happy people leading happy lives.  

In his first book, Dan found that only 10 percent of longevity is dictated by genes, and the centenarians did not live longer because of workout gyms, fad diets, supplements, or whatever. “Long life was not something they pursued. It was something that ensued” because of their environment, their support systems, and several other naturally connected things.   

They had a great sense of purpose to their lives, were nudged into physical movement about every 20 minutes because of where they lived, and were completely energized by being in what he described as “Like-tribes” in the right communities that helped keep them on the right track. They lived in interconnected, mutually supportive clusters of people allowing them to do the right thing long enough not to get disease            .

He also attempted to determine where the happiest places were in the world. What he found might throw some of you for a loop, but for many of us, it’s that not so common, “common sense” that our grandparents, parents, and friends have shared with us throughout our lives.

            Buettner worked with Google, Gallup, and the University of Pennsylvania and found some fun examples from about 50 billion Google searches regarding happiness. Generally, people who own dogs are happier than cat owners. (Sorry, Taylor) People who liked action movies or comedies seemed to be happier than those looking for romance movies.  

From his world observations, he found that gender equality is important. It makes men happier when women are treated equally. Education for both men and women was an important key to happiness because educated girls become educated mothers and produce better everything. Plus, countries where there is complete equality are where the happiest people live.  

They found that healthcare . . . not America’s sick care, but genuine health care which includes prevention and wellness is a great predictor of happiness. 

Mike Norton, a professor of business administration from Harvard asked these two questions on three continents: Do you think life is short and hard or long and easy? The people who selected long and easy were always happier, but they were also more civic-minded and generous. They were 40% happier, 30% more likely to vote, and 60% more likely to donate money. That’s a good psychographic profile to seek out for your next fundraising event. It will save you time if you ask those two questions and then only invite the generous, civic-minded, happy people.  

Happy people place their values on family, some type of belief system, face-to-face conversations, walking to the church, market, and friend’s homes, laughter, and seven hours of sleep a day. They also take all their vacation days and try new things.  

So, own a dog, socialize, stay married if you can, pick a job you love over money, give something back, and most importantly, choose where you live because that is the single most important happiness indicator. If you live in an unhappy place and move, you will be exponentially happier within a year. 

They also recommend meditation, financial security over consumption, big windows for lots of light, a front porch, and having a best friend at work. 

Dr. Carl Jung said, “Eat without gluttony, drink without drunkenness, love without jealousy, argue but don’t go to bed mad, and occasionally, with great discretion, misbehave.” 

Check off your happiness boxes and make some changes because it’s never too late, and they can make a tremendous difference. You can choose to be happy every day.  

Why are things the way they are? The University of Eastern Finland recently released a paper by Sipra Manninen, Samli Koponen, Timko Sinervo, and Sanna Laulainen in the Journal of Advanced Nursing on the impact of ostracism in the workplace. We all have experienced this phenomenon in several ways, but my personal experiences pale when compared to those individuals who had a different skin tone, religious belief, any type of physical anomaly, or were just less self-assured people.

Ostracism is, as defined by Oxford, exclusion from society or a group, and it comes from the Greek ostrakismos which has the same meaning.  Although it typically causes no visible physical damage, the emotional and psychological impact can be intense and often heartbreaking. It most certainly can harm the individual’s mental health, self-esteem, and personal well-being in ways that are long-lasting and deep.

Many of our adult behaviors can be traced back to experiences relating to these exclusions or outright rejections from our peers.  Ostracism can occur in personal situations, the workplace, or on societal levels. It can be both unintentional and intentional and can influence the individual’s perception of the world around them for a lifetime.

Because we are inherently social human beings, finding one’s tribe and being comfortable in that scenario can provide a sense of emotional and mental well-being. Conversely, when someone is ostracized, it often triggers feelings of sadness, despair, and loneliness that can have a significant impact on feelings such as anxiety and depression.

The Finnish article was directed toward ostracism in the healthcare workplace, and it described examples like the impact of exclusion from social activities, lack of communication or the withholding of information, being overlooked in meetings, and how these slights can negatively impact the workplace. All of these actions can create what can only be described as a toxic work environment. This can result in decreased job satisfaction, underperformance in the form of less productivity, and even higher turnover rates.

Because our coping skills are less developed as children and young adults, that same behavior in school or social settings can result in academic underachievement, withdrawal, behavioral problems, and more prevalent actions recently due to the addictive and anonymous nature of social media, such as self-harm and even suicide that can be both intentional and unintentional.

If you’re the kid who is not invited to the party or gathering where all of your friends are. If you’re excluded from a club about which you were passionate. If you’re not part of the in-crowd at a dance or a meeting where you were previously a key player, you are being socially ostracized. The worst part of this is there may be no real concrete reason for being cut-out, and if there is a reason, it may be even more hurtful.

As we look at the numerous scenarios that have brought our country to this point in terms of philosophical separation, we can reflect on what contributed to the two political camps, and within those camps, we will find people who were ostracized at various times in their lives. There are reasons why certain groups feel more of an affiliation with others and this is often based more on the previously felt pain caused by being eliminated from situations that were meaningful to them.

If we could take a deep look at the personalities of the leaders that are controlling life and death decisions in our world, they are dealing with deep issues that have roots in their past. The desire to dominate, eradicate, decimate, and eliminate entire countries, groups of people, or societies is not normal.

Only through encouraging inclusivity, open communication, and the promotion of empathy can we help mitigate the negative impact of ostracism. By working to create a more compassionate and inclusive society through fostering understanding and empathy, we can create a world where everyone feels valued, accepted, and capable of reaching their full potential.