Medically Lost: Inside Medicine's Systemic Dysfunction
A longform essay exploring why our medical system fails complex patients—not because of bad actors, but because of structural blind spots, misaligned incentives, and a culture that resists complexity.
By Robert Spearman. First published June 23, 2025.
Why I Wrote This
Why do so many patients fall through the cracks—misdiagnosed, dismissed, or left to navigate illness alone? This longform essay explores why our medical system fails complex patients—not because of bad actors, but because of structural blind spots, misaligned incentives, and a culture that resists complexity.
Drawing on systems thinking, economics, and personal experience, it maps out the deeper causes of diagnostic delay, mislabeling, and invisible suffering—and why even well-meaning care often goes wrong.
What You'll Find
- Why chronic, multisystem illness is so often misunderstood
- How diagnostic culture, insurance coding, and institutional norms derail care
- What gets missed when medicine focuses on symptoms instead of systems
- Why patients are forced into self-advocacy—and what we can learn from them
- Ideas for change—from policy to mindset to practice
Who It's For
Whether you're a patient, clinician, policymaker, or just trying to understand why modern medicine feels so broken, this piece is meant to help you see the system more clearly—and think differently about how it could change.
Read the Full Essay
Like What You Read?
This essay is part of the foundational thinking behind Sympa, a platform we're building to help patients with complex or chronic illness make sense of their symptoms, history, and genomics.
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