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Kyle Edmonds, MD

@kpedmonds.com
1.3K followers 3.8K following 45 posts

Partner to @LaseAjayi.com Academic Palliative MD Follow me at rounds-and-rants.ghost.io Frequently purges my posts & activity

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Kyle Edmonds, MD @kpedmonds.com · 17/09/2026
"Our healthcare system is already consumed by efficiency. [...] Yet patients need something fundamentally inefficient from healthcare providers: time, attentiveness, emotional honesty, & the willingness to remain present even when no solution exists." Perfectly said, Daliya Rizvi. #HAPC #Palliative
thehastingscenter.org
Artificial Empathy: What AI Is Teaching Future Physicians About Caring   : The Hastings Center for Bioethics
I worry that future healthcare professionals are increasingly being socialized into forms of communication that privilege emotional performance over genuine human presence.
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Reposted by Kyle Edmonds, MD
Bob Herman @bobjherman.bsky.social · 16/09/2026
MedPAC has consistently reported overpayments in Medicare Advantage. Health insurance companies want to kneecap how MedPAC reports these overpayments. Now, insurers have allies in Congress: Republicans, John Wilkerson reports. www.statnews.com/2026/09/16/m...
statnews.com
GOP aims to change Medicare adviser’s math so it's more favorable to health insurers
The GOP bill directs MedPAC to study the topic of overpayments to Medicare Advantage plans in a manner that’s more favorable to insurers.
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Kyle Edmonds, MD @kpedmonds.com · 15/09/2026
Pay for the forecast. Pay for the interpretation. And require someone to answer for the recommendation. Otherwise AI will arrive just in time to take the blame for hollowing medicine did to itself. rounds-and-rants.ghost.io/why-did-they... #HealthPolicy
rounds-and-rants.ghost.io
Why Did They Keep Letting Us Into the House?
Our predecessors arrived with lancets, basins, and calomel, and families opened the door anyway. Two documents published this August argue about what physicians are for without ever asking why.
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Kyle Edmonds, MD @kpedmonds.com · 15/09/2026
Palliative Care already knows the danger. Relational work does not need to be automated to be hollowed out. A billing code, template, or quality measure can do the job. What we decline to measure, we decline to pay for. #PalliativeMedicine #Hospice
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Kyle Edmonds, MD @kpedmonds.com · 15/09/2026
AI may someday outperform physicians at diagnosis, test selection, and guideline-concordant treatment. But task accuracy cannot decide whose goals govern when two reasonable paths lead to different futures. #SeriousIllness #GoalsOfCare
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Kyle Edmonds, MD @kpedmonds.com · 15/09/2026
🧵 Our predecessors entered the house with lancets, basins, and calomel. Families let them in anyway. Why? Because medicine offered more than treatment: interpretation, prognosis, presence, and someone answerable for the recommendation. #PalliativeCare
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Kyle Edmonds, MD @kpedmonds.com · 08/09/2026
The patient always gets the fix. Then comes the neglected step: tell someone who can fix the cause. Every silent workaround tells the system the arrangement works. Fix the case. Report the generator. rounds-and-rants.ghost.io/the-work-ben... #HPM #PalliativeCare
rounds-and-rants.ghost.io
The Work Beneath the Conversation: The Workaround
Operations research has a name for what a palliative care consult does to a system failure. The name explains why the failure keeps happening.
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Kyle Edmonds, MD @kpedmonds.com · 08/09/2026
Researchers watched nurses encounter 194 system failures. They patched 93% and rarely reported the cause. Palliative Care is often that reflex, staffed and scheduled. Our competence makes recurring failures disappear. #PatientSafety #HealthPolicy #QualityImprovement
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Kyle Edmonds, MD @kpedmonds.com · 08/09/2026
🧵 Some of the best days in Palliative Care are evidence that the hospital is failing. We catch the broken discharge, reconcile conflicting plans, and repair the family’s trust. The patient benefits. We drive home satisfied. The institution learns nothing. #PalliativeCare #HPM #MedSky
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Reposted by Kyle Edmonds, MD
Max Kozlov @maxkozlov.bsky.social · 04/09/2026
Under pressure, the DOD just released the text of its secret 10-year agreement with the NIH. Here are the biggest revelations from the document 🧵
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Kyle Edmonds, MD @kpedmonds.com · 01/09/2026
Programs serving patients with fragmented coverage and scarce resources do more of this work, then look worse on encounter-based productivity metrics. The work has had a name for 40 years. Medicine mostly missed it. rounds-and-rants.ghost.io/the-work-ben... #PalliativeCare #MedSky
rounds-and-rants.ghost.io
The Work Beneath the Conversation: Articulation Work
There's a word for the part of our job nobody can see. Sociologists have had it since the 1980s. We were never trained in the discipline that keeps it.
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Kyle Edmonds, MD @kpedmonds.com · 01/09/2026
Sociologists call it articulation work: reconciling plans, tracing failures, getting clinicians to give the same prognosis, and finding out why the discharge plan was doomed. It happens between encounters, so it produces almost no billable trace. #HealthPolicy #HealthEquity #HPM
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Kyle Edmonds, MD @kpedmonds.com · 01/09/2026
🧵 “You’re so good with families.” That compliment captures the only part of Palliative Care the system can see. The meeting lasts 40 minutes. The work that made it possible took 4 days. #PalliativeCare #HPM #MedSky
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Reposted by Kyle Edmonds, MD
Brittlestar @brittlestar.com · 01/09/2026
It’s Nice To Be Disliked By One Of Those
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Reposted by Kyle Edmonds, MD
Scott Edelman @scottedelman.bsky.social · 01/09/2026
Farewell to the great Wendell Berry. Remember — though you have done nothing shameful, they will want you to be ashamed.
DO NOT BE ASHAMED
You will be walking some night in the comfortable dark of your yard and suddenly a great light will shine round about you, and behind you will be a wall you never saw before.
It will be clear to you suddenly that you were about to escape, and that you are guilty: you misread the complex instructions, you are not a member, you lost your card or never had one. And you will know that they have been there all along, their eyes on your letters and books, their hands in your pockets, their ears wired to your bed.
Though you have done nothing shameful, they will want you to be ashamed.
They will want you to kneel and weep and say you should have been like them.
And once you say you are ashamed, reading the page they hold out to you, then such light as you have made in your history will leave you.
They will no longer need to pursue you.
You will pursue them, begging forgiveness, and they will not forgive you.
There is no power against them.
It is only candor that is aloof from them, only an inward clarity, unashamed, that they cannot reach. Be ready.
When their light has picked you out and their questions are asked, say to them:
"I am not ashamed." A sure horizon will come around you. The heron will rise in his evening flight from the hilltop.
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Kyle Edmonds, MD @kpedmonds.com · 30/08/2026
“We have reached the apotheosis of the colonial age, a time when extractive institutions and administrative reach have been so perfected that they now span the globe.” - @henrywismayer.bsky.social
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Kyle Edmonds, MD @kpedmonds.com · 29/08/2026
Side note: hospice is not for those who will die in “three months,” it’s a benefit for those who are predicted to die within 6 months if the disease runs its typical course.
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Kyle Edmonds, MD @kpedmonds.com · 29/08/2026
Hospice fraud will not be eliminated by gleefully taking a bazooka to hospice agencies. It will take dedicated, _good-faith_, difficult, collaborative work. oag.ca.gov/dmfea/hospic...
oag.ca.gov
Hospice Fraud
Hospice fraud occurs when hospice providers take advantage of the hospice system for financial gain. Hospice fraud has become an epidemic in California, specifically in the greater Los Angeles area. T...
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Kyle Edmonds, MD @kpedmonds.com · 29/08/2026
Hospice fraud is real. It’s a problem. It degrades trust in the hospice benefit and puts patients at risk.
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Kyle Edmonds, MD @kpedmonds.com · 29/08/2026
Contribution to the discourse: while all hospice is palliative care, palliative care is much more than hospice. Its specialist, team-based care focused on quality of life and wellbeing for patients at any stage of illness and any age and their families.
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Reposted by Kyle Edmonds, MD
Tressie McMillan Cottom @tressiemcphd.bsky.social · 27/08/2026
I wrote about Dolly Parton in my latest @nytopinion.nytimes.com column. Thank you. www.nytimes.com/2026/08/27/o...
nytimes.com
Opinion | The Greatest Story Dolly Parton Ever Wrote Was Herself (Gift Article)
She didn’t see herself as a saint; she identified as something we needed even more: a writer.
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Reposted by Kyle Edmonds, MD
Jes Steele ✌️ @piratito.com · 25/08/2026
Dolly Parton, Linda Ronstadt, and Emmylou Harris performing “Bury Me Under the Weeping Willow” on The Dolly Parton Show (1976)
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Kyle Edmonds, MD @kpedmonds.com · 25/08/2026
Join me in giving: imaginationlibrary.com
imaginationlibrary.com
Dolly Parton's Imagination Library | USA, UK, IE, CA, AU
Dolly Parton’s Imagination Library is a book gifting program that mails free books to children from birth until they begin school in participating areas.
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Kyle Edmonds, MD @kpedmonds.com · 25/08/2026
In our best trials, what we are finding works is a relationship over time that includes symptom management and cognitive support, with the right "dosing" of interprofessional specialists and enough continuity for benefits to compound. rounds-and-rants.ghost.io/the-work-ben... #HAPC #PalliativeCare
rounds-and-rants.ghost.io
The Work Beneath the Conversation: I Could Do That If I Had Time
Three trials tested whether the conversation is the intervention. Two came back null and one looked inside the machine. None of them supports the sentence — or our answer to it.
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Kyle Edmonds, MD @kpedmonds.com · 25/08/2026
Today begins a three week arc on exactly what makes complex communication work. Today tills the ground in response to a hospitalist's belief that "I could do what you do if I had the time."
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Kyle Edmonds, MD @kpedmonds.com · 25/08/2026
In reality, if a family meeting ever hits the 40 minute mark, I look for ways to bring it to a close and continue it later when attentionality and executive functioning has returned to the room.
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Kyle Edmonds, MD @kpedmonds.com · 25/08/2026
...I sometimes let my colleagues think that the conversations our team has with patients take enormous amounts of time.
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Kyle Edmonds, MD @kpedmonds.com · 25/08/2026
I'm going to tell you a secret... 🧵
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Kyle Edmonds, MD @kpedmonds.com · 19/08/2026
More from me here: rounds-and-rants.ghost.io/why-palliati...
rounds-and-rants.ghost.io
Why Palliative Care Works Best When the House Is on Fire
What Specialist Palliative Care has is concentration and repetition—we are in these rooms constantly, so we have gotten fast at reading which belief has seized and where the opening is. Scarcity does ...
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Kyle Edmonds, MD @kpedmonds.com · 19/08/2026
We should build a system that can notice.
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Kyle Edmonds, MD @kpedmonds.com · 19/08/2026
It will not happen because the calendar day advanced. It will happen in a hallway after a scan result, or at 4 a.m. during a third admission in two months, or in the pause after an oncologist says the word "options" in a tone that has changed.
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Kyle Edmonds, MD @kpedmonds.com · 19/08/2026
🧵Somewhere in your health system this week, a person's understanding of their own life is going to stop working. #HAPC #Palliative #PalliativeCare #HealthPolicy
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Reposted by Kyle Edmonds, MD
Adam Bonica @adambonica.bsky.social · 16/08/2026
The fundraising texts you delete are working on someone. It’s infuriating and heartbreaking. An 85yo in Ohio gave more than double the value of his home. A 91yo in an Indianapolis senior facility gave 25K times. The DCCC/DSCC don’t just tolerate the spammers who exploit seniors. They take part.
data4democracy.substack.com
Hook and Squeeze
How Democratic consultants, committees, and party leaders built a fundraising spam pipeline that funnels money from a captive pool of elderly donors into their own operations.
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Kyle Edmonds, MD @kpedmonds.com · 11/08/2026
The hard part is becoming someone whose recommendation is safe to refuse. My latest on informed non-dissent, CPR, race, trust, and the 90 seconds after the sentence: rounds-and-rants.ghost.io/beyond-manda... #PalliativeCare #HPM #Bioethics #MedEd #HealthPolicy
rounds-and-rants.ghost.io
Beyond Mandatory Autonomy: When to Stop Asking
The asking is the easy part. It's the move that lets you leave the room with clean hands, a documented preference, and a man who will get chest compressions he never wanted.
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Kyle Edmonds, MD @kpedmonds.com · 11/08/2026
Silence can mean agreement. It can also mean uncertainty, disagreement, or no understanding at all. Before writing the DNR order, find out which silence you’re standing in. Then document how you know.
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Kyle Edmonds, MD @kpedmonds.com · 11/08/2026
A recommendation can spare a family from authorizing the death of someone they love. It can also smuggle clinician power into the room. The ethical line is whether “no” is a real word there, with no penalty attached.
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Kyle Edmonds, MD @kpedmonds.com · 11/08/2026
🧵 We teach clinicians to ask beautiful questions. We don’t teach them when to stop asking. Then we hand a sleepless surrogate a CPR decision they may get wrong 1 time in 3 and call the transfer of burden “autonomy.”
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Reposted by Kyle Edmonds, MD
The American Academy of Pediatrics @ameracadpeds.bsky.social · 10/08/2026
A statement from AAP President Dr. Andrew Racine on today’s executive order on U.S. childhood vaccines: www.aap.org/en/news-room...
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Kyle Edmonds, MD @kpedmonds.com · 09/08/2026
It has been wonderful to not have to worry about insurance coverage for my patients in my post-training career. I cannot adequately express how much more difficult dealing with serious illness becomes for people when they’re also being dragged down by financial toxicity. #HAPC #OBBBA #Palliative
timesofsandiego.com
California nearly achieved universal healthcare. Now, millions are losing coverage
Facing budget shortfalls and new federal restrictions, state leaders have begun rolling back the coverage system they built.
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Kyle Edmonds, MD @kpedmonds.com · 08/08/2026
I’m fond of “plane falling on my head”
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Kyle Edmonds, MD @kpedmonds.com · 08/08/2026
Palliative doc says: yup, that's pretty much it.
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Kyle Edmonds, MD @kpedmonds.com · 07/08/2026
These stories continue to give me hope for us all. That we can do difficult, near impossible, things together.
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Kyle Edmonds, MD @kpedmonds.com · 07/08/2026
The pendulum swing to now an opiophobia epidemic is real and dangerous.
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Kyle Edmonds, MD @kpedmonds.com · 04/08/2026
The patient keeps the real choices: tonight or tomorrow, before or after family arrives. A small real choice beats a large fake one. The period closes the recommendation. It does not close the conversation. 3/3 rounds-and-rants.ghost.io/the-question... #PalliativeCare
rounds-and-rants.ghost.io
The Question That Ends With a Period
There are two options that are good for you. Both are disagreeable. My job is not to invent a third or to make you pronounce the medical conclusion so I don't have to be the one who said it. My job is...
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Kyle Edmonds, MD @kpedmonds.com · 04/08/2026
If the PCA needs to stop, I should say so, explain why, name what it costs the patient, and defend my reasoning out loud. Bias thrives in conclusions with the fingerprints wiped off. A claim spoken clearly can be challenged. I can be caught. 2/3 #HealthEquity #MedEd
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Kyle Edmonds, MD @kpedmonds.com · 04/08/2026
🧵 A patient can lose the PCA and feel they’re losing the only proof anyone believes their pain. Then we arrive with a question: “What would you like to do?” Except we’ve already decided. That question mark can lie. 1/3 #PalliativeCare #HPM
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Reposted by Kyle Edmonds, MD
250 to 250 @250to250.bsky.social · 29/06/2026
A'Lelia Bundles is an award-winning journalist, Emmy-winning producer, and author of acclaimed biographies telling the stories of the civic-minded business women in her family, including her great-great-grandmother Madam C. J. Walker. #WeAreAmerica250 @aleliabundles.bsky.social
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Kyle Edmonds, MD @kpedmonds.com · 28/07/2026
The patients were never in two boxes anyway. rounds-and-rants.ghost.io/a-decade-on-... #PalliativeCare #HealthPolicy #CancerCare #SeriousIllnessCare #MedTwitterMigrants #MedSky
rounds-and-rants.ghost.io
Time to Move On From The Buckets
The delivery models our best researchers are building don't use the binary. They use tiers, triggers, defaults, dose-response logic, and precision targeting.
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Kyle Edmonds, MD @kpedmonds.com · 28/07/2026
Maybe I'm wrong. The binary is politically useful. It helped build the field. But our most important job isn't preserving a framework. It's reducing suffering.
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Kyle Edmonds, MD @kpedmonds.com · 28/07/2026
The future looks a lot more like tiers, triggers, competencies, defaults, and dose-response specialist involvement. Closer to precision medicine. Closer to how patients actually experience illness. Farther from two boxes. #HAPC #HealthServicesResearch
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