American Healthcare Has Been Treated for the Wrong Disease.

American healthcare is ill, and the symptoms are everywhere — spending, burnout, quality, safety, outcomes, data, and technology. The technology that promised relief is, in too many places, a treatment with side effects of its own.

For three decades, the response has been treatment after treatment: payment reform, electronic health records, value-based purchasing, quality measurement, clinical AI, ambient documentation, telehealth, digital health at scale. Each was prescribed before the diagnosis was ever made. The patient has been treated for the wrong disease.

In The Diagnostician, Thomas Powell applies the clinical method to American healthcare itself — taking the chief complaint, running the workup, ruling out five candidate diagnoses, and arriving at the working diagnosis: the structural absence of an executive-physician capable of synthesizing the whole. The CMIO is that lead physician. This book makes the case — and shows the cure.