From the room you can’t see, the voice you need to hear.

Most healthcare leadership writing comes from outside the rooms where decisions get made. This newsletter does not.

I am Dr. David Wild — a transplant anesthesiologist and a healthcare executive with more than two decades inside the system. Currently Chief Clinical Officer at Essential Anesthesia Management. Before that, more than a decade in large-system leadership across academic and integrated delivery systems, with operating room work alongside the executive role.

This newsletter writes from the rooms most readers do not enter. The boardroom where executive compensation is approved without much resistance. The exec office where workforce planning meets denial. The credentialing committee where the gap between what we need and what we can produce gets quieter every quarter. The contracting room where reimbursement decisions cascade into the bedside hours that follow.

What you can expect: a weekly free post on healthcare leadership and systems, a biweekly paid post that goes deeper, and the occasional argument I would not be able to make if I had not been in those rooms myself. Plain-spoken. Sharp on specifics. Constructive over corrosive. No rage bait.

If healthcare leadership thinking from inside the system is useful to your work, subscribe. If you want to support the deeper writing, the paid tier funds the time it takes to do it well.

Hero photography by Craig Lovelidge on Unsplash.