Sunday, October 4, 2026

Mitch Phillis Gave His Father Mike a Kidney. Then Came ESPN.

A father. A son. A kidney transplant. A basketball championship. And a healthcare story we keep losing.



“Commodifying such micro-interactions undermines the value of having a trusted personal doctor.” — Ishani Ganguli, MD, associate professor of medicine at Harvard Medical School, The Washington Post

 

A kidney saved a life. But healthcare still struggles to preserve the story behind it.


Mitch Phillis Gave His Father a Kidney.

Then he went to Orlando to shoot basketballs.

That sounds like the beginning of a joke.

It isn't.

It is the story of Mike Phillis, his son Mitch Phillis, Mitch's wife Susan Phillis, transplant surgeon Amit Tevar, MD, and a medical journey that began in Salem, Ohio, passed through UPMC Montefiore in Oakland, Pittsburgh, made a stop in Chicago, and somehow ended with a national championship in Orlando, Florida.

And it raises a question that has almost nothing to do with basketball.

Why is healthcare so good at recording what happened and still so bad at remembering why it mattered?

That question matters to physicians.

It matters to clinic owners.

It matters to billers.

It matters to patients.

And increasingly, it matters to anyone building artificial intelligence for healthcare.

Because Mitch and Mike Phillis did not experience their lives as a series of disconnected database fields.

Neither do your patients.


It Started With a Blood Donation

Mike Phillis wasn't looking for a kidney problem.

He was trying to donate blood.

He was turned away because his blood pressure was too high.

That ordinary moment led doctors to discover that his kidney function had fallen to about 34 percent.

For years, Mike's kidney function continued to decline.

There wasn't a neat explanation.

There wasn't one dramatic event that made everything obvious.

There was simply a slow deterioration that eventually became impossible to ignore.

By October 2025, his kidney function was around 20 percent.

By December, he was eligible to begin the transplant process.

And now the family had a problem that healthcare knows very well:

They needed the right answer.

Fast.

Several of Mike's siblings wanted to donate.

They couldn't.

Then Mitch stepped forward.

Mitch was 41.

He lived in North Canton, Ohio.

He had a wife, Susan.

He had a life.

He had his own plans.

And he had something his father desperately needed.

A kidney.

Mike didn't exactly celebrate the idea.

He worried about his son.

His response was essentially:

I don't want to take something from your future to extend mine.

Mitch apparently had a different definition of family.

If he could safely donate, he would.

Testing showed he was an excellent match.

So father and son headed to UPMC Montefiore in Pittsburgh.

That is where Amit Tevar, MD, surgical director of UPMC's Kidney and Pancreas Transplant Program, and the transplant team entered the story.

Mitch gave Mike one of his kidneys.

Mike received it.

The surgery worked.

And then something happened that healthcare documentation does not always capture very well.

Life continued.


The Kidney Was the Beginning, Not the Ending

Mike's kidney function improved dramatically after the transplant.

Mitch had to recover from donating an organ.

That alone would have been enough of a story.

But Mitch had another problem.

He apparently had too much time on his hands.

Enter:

Pop-A-Shot.

If you don't know what Pop-A-Shot is, imagine taking the least complicated part of basketball and becoming completely unreasonable about it.

No defense.

No coach.

No referees.

No trade rumors.

Just a basketball arcade machine and a clock.

Mitch had loved the game since childhood.

When he was about 10 or 11, he had used money from delivering newspapers to buy a small Pop-A-Shot machine for his bedroom.

That childhood obsession returned during his recovery.

He saw the national competition.

He entered.

He qualified.

He went to Chicago.

At the 2026 Chicago Super Qualifier, Mitch—competing as MAP21—beat THE-GLOVE, Gary Preston, 160-144 in the final and secured his place in the national championship. Pop-A-Shot describes him as a dark horse who upset JSCHWAB on his way to the championship.

Then came Orlando.

And ESPN.

And his father.

Four months after donating a kidney, Mitch Phillis was standing in front of a basketball arcade game in Orlando.

His father, Mike, was there.

Mitch won.

The kidney donor became a national champion.

There is something almost delightfully absurd about that sentence.

And something deeply human about it.


The Real Story Isn't the Kidney

It isn't even the basketball.

It is the connection between the two.

Mike's kidney disease was not an isolated laboratory value.

Mitch's donation was not an isolated procedure.

The transplant was not an isolated encounter.

The championship was not an isolated sporting event.

They were parts of one human story.

But healthcare systems tend to break stories into events.

Encounter.

Diagnosis.

Procedure.

Authorization.

Documentation.

Code.

Claim.

Payment.

Denial.

Each one can be perfectly documented.

And the whole story can still disappear.

That is the contradiction.


Healthcare Has a Memory Problem

We talk constantly about healthcare's data problem.

I think that description is incomplete.

We don't have a shortage of data.

We have an enormous amount of it.

We have laboratory results.

Clinical notes.

Imaging.

Medications.

Diagnoses.

Procedure codes.

Eligibility information.

Authorization records.

Referral records.

Claims.

Remittance advice.

Messages.

Phone calls.

Scanned documents.

Portals.

Faxes.

And, somewhere in there, the patient.

The problem is not that healthcare has no memory.

The problem is that healthcare has fragmented memory.

Everyone remembers something.

Nobody necessarily remembers everything together.

The physician knows why the decision was made.

The authorization team knows what the payer required.

The biller knows what the claim said.

The patient knows what actually happened.

The payer knows what its system received.

And then everyone wonders why the story doesn't line up.


The Patient Is Not the Chart

Here is where I would challenge conventional healthcare technology thinking.

The patient is not the chart.

The chart is a representation.

A useful one.

An imperfect one.

Sometimes a very good one.

But still a representation.

The diagnosis is not the patient.

The code is not the encounter.

The authorization is not the clinical reasoning.

The claim is not the care.

And the denial is not necessarily the explanation.

A claim can be perfectly formatted and still fail to carry the context that made the care make sense.

That is why I don't think the future of healthcare billing is simply about building better downstream tools.

We need to ask a more uncomfortable question:

Why are we waiting until the claim fails to discover that the information was incomplete?


The Industry Loves the Rearview Mirror

Healthcare has become remarkably sophisticated at fixing problems after they happen.

Denial management.

Claims scrubbing.

Appeals.

Coding audits.

Payment reconciliation.

Revenue-cycle analytics.

Artificial intelligence that reviews charts after the encounter.

Artificial intelligence that finds missing documentation after the claim.

Artificial intelligence that writes the appeal after the payer says no.

All of that has value.

But there is a strange assumption underneath it:

The problem has already happened.

Then we optimize the cleanup.

Imagine doing that in an airport.

The plane takes off.

Then someone asks:

“Did we actually put fuel in it?”

That is not an automation problem.

That is a timing problem.

And healthcare has plenty of those.


What If the Denial Is Actually a Clue?

I have become increasingly skeptical of the idea that the denial is the enemy.

A denial can be useful.

It can tell us something.

Maybe eligibility wasn't captured correctly.

Maybe authorization information didn't travel with the encounter.

Maybe the referral wasn't connected.

Maybe documentation was technically present but operationally inaccessible.

Maybe the physician's reasoning never became structured information.

Maybe the information existed in one system but never reached the next.

The denial is what we see.

The information failure may have happened much earlier.

So instead of asking:

“How do we fight this denial?”

I'd also ask:

“Where did the story first become ambiguous?”

That question moves the conversation upstream.

And upstream is where the leverage may be.


Mitch and Mike Give Us a Better Definition of an Outcome

Suppose we reduced the Phillis story to a medical dashboard.

Mike:

Kidney disease.

Mitch:

Living donor.

Procedure:

Kidney transplant.

Outcome:

Improved kidney function.

Done.

Case closed.

Except it isn't.

Because months later:

Mike is alive.

Mitch is competing.

They are traveling together.

They are watching basketball.

They are standing in Orlando.

Mitch wins.

Mike gets to watch his son win.

That is an outcome too.

It just doesn't fit neatly into a claim field.

This is one of the great weaknesses of modern healthcare measurement.

We are extremely good at measuring events.

We are less consistent at preserving meaning.


Medicine Can Move an Organ.

Why Can't It Move Context?

This may be the most provocative question in the entire story.

Modern medicine can do something extraordinary.

A kidney can be removed from one living human being.

Transported into another.

Connected to the recipient's circulation.

And, if everything goes well, it begins doing its job.

Think about that.

Healthcare can move an actual organ from one human being to another.

Yet we still struggle to move a piece of information from one department to another.

The kidney travels better than the context.

That should bother us.

A lot.


The Fax Machine Would Like a Word

This is where healthcare gets unintentionally funny.

We can transplant kidneys.

We can operate robots.

We can sequence DNA.

We can train artificial intelligence models on enormous amounts of information.

And then someone says:

“Can you fax that?”

Apparently the future arrived.

It just forgot the fax number.

The humor is useful because the problem isn't really the fax.

The fax is a symptom.

The deeper problem is that healthcare has accumulated layers of technology without necessarily redesigning the information architecture underneath them.

We keep adding tools.

We rarely ask whether the story is becoming easier to follow.


This Is Where AI Could Actually Matter

I'm not particularly interested in AI because it can write another note.

Healthcare already has plenty of notes.

I'm interested in AI that can help preserve context.

That's different.

Could an AI system recognize that an authorization decision today matters to a claim weeks later?

Could it understand that a referral is connected to a specific clinical pathway?

Could it recognize that the same diagnosis can mean different things in different encounters?

Could it identify missing context before the claim reaches the payer?

Could it explain where a piece of information came from?

Could it tell a biller:

“This claim appears incomplete because the authorization context captured earlier has not propagated to the current encounter.”

That is more interesting than:

“Would you like me to summarize the chart?”

We have enough summaries.

We need better continuity.


Human-Supervised AI Is More Interesting Than AI Alone

There is another reason I'm cautious about the industry's obsession with autonomous AI.

Healthcare isn't a clean data environment.

It is messy.

Patients are messy.

Documentation is messy.

Workflows are messy.

Exceptions are everywhere.

That makes human judgment important.

The goal shouldn't necessarily be:

Remove the human.

It should be:

Remove the unnecessary reconstruction so the human can focus on judgment.

Let AI find patterns.

Let AI surface missing context.

Let AI connect related information.

Let AI flag inconsistencies.

Let AI explain why something may fail.

But let qualified humans decide when the stakes require judgment.

That's not anti-AI.

It is a more mature view of AI.


What Dr. Ishani Ganguli's Argument Gets Right

Dr. Ishani Ganguli recently wrote about the growing practice of charging patients for messages to their physicians.

Her concern wasn't that physician time has no value.

Quite the opposite.

The work matters.

The problem is what happens when every interaction is reduced to a transaction.

Her broader point is that primary care works partly because physicians develop continuity and knowledge of the patient.

That matters here.

Because continuity is not just a clinical luxury.

It is an information advantage.

A physician who knows the patient doesn't merely know more facts.

They understand relationships between facts.

That is context.

And context is incredibly difficult to recreate after it has been lost.


The Hidden Enemy Isn't Data.

It's Disconnection.

Think about what happens in a typical practice.

The patient tells the receptionist something.

The receptionist records part of it.

The nurse sees something else.

The physician documents something else.

The authorization team needs another piece.

The biller interprets the documentation.

The payer evaluates the claim.

Then the denial comes back.

Someone says:

“What happened?”

That may be the most expensive sentence in healthcare.

Because it means the organization has lost continuity.

Someone now has to reconstruct the story.

And reconstruction is expensive.

It consumes time.

It consumes attention.

It creates errors.

It creates frustration.

And sometimes it creates a denial.


The Real Cost of Lost Context

We usually calculate healthcare waste in dollars.

We should.

But there are other currencies.

Time.

Attention.

Trust.

Physician energy.

Staff morale.

Patient patience.

Every time a physician has to explain something twice, the system spends attention.

Every time a biller searches through multiple systems, the system spends attention.

Every time a patient repeats their history, the system spends trust.

The invoice doesn't always show those costs.

The practice still pays them.


What Clinic Owners Should Ask Instead

If I were sitting with a physician-owned practice, I wouldn't start by asking:

“Which AI platform do you use?”

I'd ask:

“Where does your staff spend time reconstructing what happened?”

That's a better question.

Then I'd ask:

Where does information first get lost?

Not where the denial happens.

Earlier.

What information gets entered more than once?

Duplicate entry is often a clue that systems aren't communicating.

What does the physician know that billing doesn't?

That gap matters.

What does billing know that the physician doesn't?

That gap matters too.

What does the patient have to explain repeatedly?

Listen carefully to that answer.

Which workflows depend on someone's memory?

Memory is wonderful.

It is also a terrible database.

Where does an authorization become disconnected from the encounter?

That is where money and time can disappear.

How long does it take to reconstruct a patient's story?

Start measuring that.

Call it context recovery time.

You may discover that it is one of the most expensive invisible metrics in the practice.


The Upstream Test

Here's a simple test for any healthcare workflow.

Take one patient.

Follow the journey.

Capture.

What was known at the beginning?

Structure.

Was the important information organized?

Preserve.

Did it survive the next handoff?

Propagate.

Did the relevant context move where it needed to go?

Act.

Did someone make the right decision using it?

Learn.

Did the system become better because of what happened?

If the answer breaks at any point, you have found a potential failure point.

That is upstream intelligence.

Not more information.

Better information at the right time.


Pain → Solution → Proof

The Pain

The physician remembers the patient.

The system remembers fragments.

The biller sees the claim.

The payer sees the submitted data.

The patient remembers the entire experience.

Those are five different perspectives on one event.

The Solution

Build a canonical context record that preserves the information that matters across the workflow.

Not another giant repository.

Not another dashboard.

Not another place for people to click.

A structured layer of context that can move with the encounter.

The Proof

The Phillis story is an unusually beautiful example.

Mike's kidney disease had a history.

Mitch's decision had a reason.

The transplant had a purpose.

The recovery had a consequence.

The championship had a meaning.

None of those things existed independently.

The story was the connection.


Five Myths Healthcare Should Retire

Myth 1: More data means more intelligence.

No.

Sometimes more data simply gives everyone more places to search.

Myth 2: A complete chart means a complete story.

No.

A chart can be comprehensive and still fail to communicate the relationships between events.

Myth 3: A clean claim means clean upstream data.

Absolutely not.

The claim is the output.

It isn't necessarily evidence that the process was healthy.

Myth 4: AI will solve bad workflows.

AI can make bad workflows faster.

That isn't the same thing.

Myth 5: The answer to fragmentation is another application.

Sometimes the answer is better architecture.


The Most Dangerous Phrase in Healthcare

It may be:

“That's in another system.”

Because those five words are an architectural confession.

The information exists.

But it isn't where the next person needs it.

Healthcare has become very good at creating islands of information.

The future should be about bridges.


What I Would Change First

If a clinic asked me where to begin, I would not tell them to buy an expensive AI system tomorrow.

I'd start smaller.

Step 1: Choose one high-friction workflow.

Eligibility.

Authorization.

Referral.

Coding.

Claims.

Pick one.

Step 2: Follow the information.

Not the patient.

The information.

Where does it start?

Where does it go?

Who touches it?

Who changes it?

Where does it disappear?

Step 3: Find the first manual reconstruction.

That's your clue.

Step 4: Identify the missing context.

What did the next person need but not have?

Step 5: Structure that information earlier.

Capture it before it becomes a scavenger hunt.

Step 6: Preserve it.

Don't let critical context live only in an email, fax, phone call or someone's memory.

Step 7: Propagate it.

Make relevant context available at the next decision point.

Step 8: Automate carefully.

Use AI after the information architecture makes sense.

Step 9: Keep humans accountable.

Especially where clinical, financial or ethical judgment matters.

Step 10: Measure what changed.

Track:

First-pass acceptance.

Preventable denials.

Authorization turnaround.

Eligibility errors.

Staff touches.

Duplicate entry.

Rework.

Patient callbacks.

Time spent searching.

And again:

Context recovery time.


The OnnX Thesis

This thinking is part of why I am building OnnX.

The premise is intentionally contrarian:

Healthcare billing is a data-quality problem before it becomes a billing problem.

Most systems attack the visible problem.

The denial.

The rejected claim.

The missing code.

The appeal.

The unpaid balance.

But those are often downstream symptoms.

The more interesting question is:

What happened upstream?

Was the information captured correctly?

Was it structured?

Was it preserved?

Did it propagate?

Was the right person able to act on it?

Did the system learn?

That is the difference between reactive revenue cycle management and upstream intelligence.

The goal isn't to eliminate humans.

It is to stop using highly trained humans as middleware.


Humans Should Not Be the API

This may be the most important operational point.

In too many healthcare workflows, the human becomes the integration layer.

The physician explains something to the nurse.

The nurse explains it to authorization.

Authorization explains it to billing.

Billing explains it to the payer.

The payer sends something back.

Someone calls the physician.

The physician says:

“I already documented that.”

And everyone starts searching.

That's not intelligence.

That's a human-powered API.

Humans are extraordinarily expensive middleware.

We should stop designing systems that require them to perform data integration manually.


What Mike and Mitch Teach Us About Outcomes

There is a temptation to turn every healthcare story into a statistic.

This story resists that.

Mike was not merely a 67-year-old kidney recipient.

Mitch was not merely a 41-year-old living donor.

Susan was not merely a spouse.

Dr. Tevar was not merely a surgeon.

UPMC Montefiore was not merely a facility.

Salem was not merely a location.

North Canton was not merely an address.

Chicago was not merely a qualifier.

Orlando was not merely a championship venue.

Those details matter because humans live in context.

Take away all the context and you still have data.

But you don't have the story.


The Strange Beauty of Healthcare

Medicine is at its best when it remembers that the point isn't the procedure.

The point is what the procedure allows someone to do afterward.

A transplant is successful because someone gets another chance at life.

A hip replacement matters because someone can walk.

Cancer treatment matters because someone gets another birthday.

Primary care matters because someone can stay healthier before the crisis.

Billing matters because the practice has the resources to keep providing care.

These things are connected.

We've just built systems that often make them look separate.


The Future May Not Be More AI.

It May Be Better Context.

This is where I think healthcare technology needs a reset.

We have spent years asking:

How can AI do more?

Perhaps we should ask:

How can healthcare forget less?

That's a different question.

And potentially a much more important one.

AI should not simply generate.

It should understand provenance.

It should preserve relationships.

It should surface missing context.

It should identify contradictions.

It should know what it knows.

It should know what it doesn't know.

And when the stakes are high, it should know when to hand the decision back to a human.

That's not artificial intelligence replacing healthcare.

That's intelligence helping healthcare become more coherent.


The Phillis Family Accidentally Gave Healthcare a Metaphor

Mike needed a kidney.

Mitch gave him one.

The transplant changed Mike's future.

Then Mitch went to Chicago.

Then Orlando.

Then ESPN.

Then he won.

A system looking only at the medical record might see the transplant.

A system looking only at the sports coverage might see the championship.

A human being sees the connection.

The son who gave his father a kidney was the same son his father later watched become a national champion.

That's the story.

And that's what healthcare systems often struggle to preserve.

Not facts.

Relationships between facts.


A Final Challenge to Physicians and Clinic Owners

Tonight, pick one patient.

Not your easiest patient.

Pick an ordinary complicated one.

Ask your team to reconstruct the patient's journey from the first contact through the claim.

Don't tell them where to look.

Just ask:

“Tell me what happened.”

Then watch.

Watch how many systems they open.

Watch how many times they say:

“I'm not sure.”

Watch how often someone says:

“That's in another system.”

Watch how many times someone has to call somebody else.

Watch how much information is reconstructed from memory.

Then ask the question that matters:

Why did we make humans reconstruct a story that our system already experienced?

That is where your next improvement opportunity may be hiding.

Not in another dashboard.

Not in another chatbot.

Not in another denial-management queue.

Upstream.


The Question I Can't Stop Thinking About

Mitch Phillis gave his father Mike a kidney.

Four months later, Mike was in Orlando watching his son compete for a national championship.

Think about what had to remain connected for that moment to happen.

A diagnosis.

A declining kidney.

A donor.

A father.

A son.

A wife.

A transplant team.

A surgery.

A recovery.

A trip.

A basketball machine.

A championship.

Life doesn't care which department owns each piece.

Life is one story.

Healthcare shouldn't require patients to become the integration layer between its departments.

And it shouldn't require physicians and billers to become detectives every time information crosses a boundary.

The kidney made it from Mitch to Mike.

Maybe healthcare should learn to move context that well.


Final Question

Where does your patient's story first disappear inside your practice?

Is it at eligibility?

Authorization?

Documentation?

Coding?

Claims?

Denials?

Or somewhere even earlier?

Don't tell me where the denial happened.

Tell me where the story broke.

That's probably where the real problem started.

If this perspective resonates, consider reposting it to help other physicians and clinic owners rethink how information moves through their practices.


Frequently Asked Questions

Is this really a medical billing problem?

Not always.

Billing may simply be where an upstream information problem becomes visible.

Why call it a context problem?

Because healthcare can possess all the relevant facts while losing the relationships between those facts.

Does artificial intelligence solve that?

Only if the underlying information is structured well enough for AI to work with it responsibly.

Should humans be removed from the process?

No.

Humans should spend less time reconstructing information and more time applying judgment.

What is upstream intelligence?

It is the practice of capturing, structuring, preserving and propagating relevant context before downstream problems occur.

What is context recovery time?

The amount of human time required to reconstruct what happened, why it happened and what should happen next.

Why does this matter financially?

Because lost context can create rework, delays, preventable denials, staff burden and patient frustration.

Why does this matter clinically?

Because fragmented information can interfere with continuity, coordination and decision-making.


Myth Buster: The Biggest One

“The information is somewhere in the chart.”

That may be technically true.

It may also be completely useless.

Information that cannot be found, interpreted or propagated at the moment of decision is functionally unavailable.

Healthcare needs to stop confusing storage with accessibility.

And stop confusing accessibility with understanding.


Practical Metrics for the Next Generation Practice

A modern clinic should consider measuring more than revenue.

Measure:

Context recovery time

Number of systems accessed per claim

Duplicate data-entry events

Authorization rework

Preventable denials

Eligibility-related denials

Staff touches per claim

Patient callbacks

Documentation clarification requests

Time from clinical decision to complete administrative context

These metrics reveal something conventional revenue-cycle reports often miss:

how much friction exists between what the physician knows and what the system knows.


Ethical Considerations

The more healthcare depends on AI, the more important provenance becomes.

If an AI system recommends an action, people should be able to ask:

Where did that information come from?

Was it current?

Who verified it?

What context was missing?

What assumptions did the system make?

Who made the final decision?

Healthcare should not trade human judgment for algorithmic opacity.

The goal should be traceable intelligence.


The Future

I don't think healthcare needs another decade of simply adding technology to broken workflows.

We need to become more selective.

Less:

“What else can we automate?”

More:

“What should never have required manual reconstruction?”

Less:

“How do we fix this denial?”

More:

“Why did this become deniable?”

Less:

“Where is the data?”

More:

“Does the right person have the right context at the right moment?”

That is the shift from automation to intelligence.

And it is a shift worth making.


About the Author

Dr. Daniel Cham is a physician, medical consultant and healthcare entrepreneur focused on the intersection of clinical medicine, healthcare operations, medical technology and medical billing.

His work examines how better information architecture, upstream intelligence and human-supervised artificial intelligence can help physicians and clinic owners navigate increasingly complex healthcare workflows.

Connect with Dr. Cham on LinkedIn to learn more.

He is the founder of OnnX, an AI-powered healthcare billing concept built around a simple premise:

Healthcare billing problems often begin as information-quality problems upstream.

His perspective draws on experience in clinical medicine, healthcare management, medical consulting and medical billing.


Continue the Conversation

Healthcare technology will continue to evolve.

Artificial intelligence will become more capable.

Automation will become more sophisticated.

But the fundamental question will remain remarkably human:

Can the system remember the person while it processes the data?

That may be one of the defining questions of the next generation of healthcare.

Knowledge drives progress. Start your journey here.

Check the Featured section of my LinkedIn profile for a free resource. No signup required there.

Visit Dr. Cham's website

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If this perspective resonates, consider reposting it to help other physicians and clinic owners rethink how information moves through their practices.


Disclaimer

This article is for general educational and informational purposes only. It is not medical, legal, financial or professional advice. Healthcare organizations and professionals should evaluate their own clinical, operational, compliance and technology requirements with appropriate qualified advisers.


The line I would leave readers with

The patient went home.

The story should have gone with them.

And if it didn't, perhaps the problem wasn't that healthcare needed more data.

Perhaps it needed a better memory.


References

  1. Pittsburgh Post-Gazette — Roberta Burkhart
    “From kidney transplant to ESPN, father and son score remarkable victories.” October 4, 2026. The primary source for the Mitch and Mike Phillis story, transplant, recovery, and Pop-A-Shot journey.
    Pittsburgh Post-Gazette article
  2. Pop-A-Shot — 2026 National Championship
    Official tournament information documenting Mitch Phillis as the 2026 National Champion and his path from the Chicago Super Qualifier to the national championship.
    Pop-A-Shot 2026 National Championship
  3. Pop-A-Shot — Official Championship Recap
    Details the August 2026 championship in Orlando, including Mitch's 3–1 victory over James Isham and his 95.3% shooting accuracy.
    Pop-A-Shot Championship Recap
  4. The Washington Post — Ishani Ganguli, MD
    “Bill patients for emailing? This could backfire.” October 1, 2026. Ganguli, an associate professor of medicine at Harvard Medical School, discusses how fragmented interactions can undermine the continuity and relationship at the heart of primary care.
    The Washington Post article

 

#Healthcare #MedicalBilling #HealthcareAI #HealthTech #PhysicianFounder #MedicalPractice #HealthcareInnovation #RevenueCycleManagement #HealthcareOperations #ClinicalWorkflow #PriorAuthorization #HealthcareData #UpstreamIntelligence #IndependentPhysicians #ClinicOwners #PatientExperience #MedicalTechnology #DigitalHealth #OnnX

Saturday, October 3, 2026

Luca George Is Four. His Story Raises an Uncomfortable Question About Healthcare

Luca George's story is a reminder that healthcare should create more room for life—not more administrative work for the people delivering it.


“Technology, if done right, is one of the very few deflationary forces we can apply to health care costs right now.”
— Dr. Toyin Ajayi, CEO, Cityblock Health

 

A four-year-old living with an ultra-rare genetic disorder is teaching us something surprisingly relevant to physician-owned practices: the goal of better healthcare isn't to make people better at navigating the system. It's to make the system require less navigation in the first place.

Luca George is four years old.

He has an ultra-rare genetic disorder.

His parents, Mariah and Nicholas “Nick” George, know hospitals, specialists, medications, therapies and medical equipment far better than most parents ever should.

But that is not the life they want for their son.

They want Luca to go to the beach.

They want him to ride an adaptive bike.

They want him to experience adaptive surfing.

They want him to laugh, joke, play with his family and dogs, watch television and simply be a kid.

Luca cannot walk independently or use his hands independently. He lives with drug-resistant epilepsy and hearing loss and communicates with an eye-gaze device. His condition, SPATA5L1-related disorder, is so rare that fewer than 100 children have been identified worldwide.

And yet his mother, Mariah, says something that should stop healthcare professionals in their tracks:

“I just want people to see Luca as a little boy first.”

That sentence is bigger than rare disease.

It is bigger than pediatrics.

It is bigger than disability.

It may even be one of the most important questions we can ask about healthcare.

What if the goal of healthcare isn't to make people better at navigating the healthcare system?

What if the goal is to make the system require less navigation in the first place?

Because somewhere along the way, healthcare developed a strange habit.

We started measuring how much work the system performs.

Then we started confusing that work with care.

And now we have an industry where a task can be completed, documented, timestamped, assigned, escalated, routed, closed and billed—

while the underlying problem remains completely unsolved.

That is not efficiency.

That is administrative theater.

And Luca's story gives us a very human reason to ask whether we can do better.


The Healthcare System Has a Weird Definition of “Done”

Healthcare loves the word done.

The referral was sent.

Done.

The authorization was submitted.

Done.

The claim was submitted.

Done.

The fax was sent.

Done.

The task was assigned.

Done.

The patient was contacted.

Done.

The note was signed.

Done.

Except…

The referral never arrived.

The authorization was denied.

The claim rejected.

The fax went into a black hole.

The patient never received the message.

The note contained incomplete information.

And somebody has to do the work again.

Welcome to healthcare.

Where “done” sometimes means:

We have successfully created the next problem.

We have become extraordinarily sophisticated at moving information from one place to another while occasionally forgetting to ask whether the information was correct in the first place.

That sounds funny until you are the patient.

Then it is not funny at all.


Luca's Parents Are Not Asking Healthcare for a Miracle

Mariah and Nick George are not asking the healthcare system to make Luca's condition disappear.

They are asking for something much more ordinary.

A childhood.

That distinction matters.

Healthcare often defines success through clinical outcomes:

  • Was the treatment delivered?
  • Was the test completed?
  • Was the medication prescribed?
  • Was the appointment attended?
  • Was the claim paid?

Patients experience success differently.

Can I go home?

Can I get back to work?

Can my child play?

Can I sleep tonight?

Can I spend an afternoon at the beach without organizing my entire life around healthcare?

Can I stop being a patient for five minutes?

Those questions rarely appear neatly inside a workflow dashboard.

But they are often the reason the healthcare system exists.

Mariah described their reality with brutal simplicity: their life isn't defined only by hospitals and medical appointments, although some weeks it feels like it is.

That should make us uncomfortable.

Because healthcare is supposed to serve life.

It should not quietly consume it.


The Contrarian Idea: Healthcare Doesn't Have a Workflow Problem

I think we have diagnosed the problem incorrectly.

We keep saying healthcare needs:

More automation.

More workflows.

More dashboards.

More alerts.

More AI.

More integrations.

More rules engines.

More portals.

More notifications.

More task queues.

More analytics.

More “visibility.”

Maybe.

But there is another possibility.

Maybe healthcare doesn't have a shortage of workflow.

Maybe healthcare has a surplus of workflow.

We have built entire industries around helping people manage the consequences of information being incomplete, late, inconsistent or trapped in the wrong place.

Then we celebrate when technology makes the process faster.

That's like inventing a faster way to clean up a spill while refusing to ask why the pipe keeps leaking.

The technology may be excellent.

The diagnosis may be wrong.


The Most Expensive Person in the Room May Be Entering the Same Information Twice

Consider what happens when a patient's information changes.

A new insurance plan.

A new address.

A new referring physician.

A new diagnosis.

A new authorization requirement.

A new medication.

A new documentation requirement.

Somebody has to know.

Then somebody has to enter it.

Then somebody else has to check it.

Then another person may have to correct it.

Then the billing team sees something different.

Then the payer sees something else.

Then the claim comes back.

Then someone investigates.

Then someone calls.

Then someone sends a fax.

Then someone documents the call.

Then someone follows up.

And eventually someone says:

“Why wasn't this caught earlier?”

That question is usually asked after the expensive part.

The more interesting question is:

Why was the system designed so that catching it earlier was so difficult?

That is the upstream question.

And upstream questions are rarely as glamorous as AI.

But they can be much more valuable.


Healthcare Has Become Very Good at Rework

Here is an uncomfortable metric:

How much of the work your organization performs exists only because another piece of work failed?

Think about that.

A denial creates work.

A missing document creates work.

A bad demographic record creates work.

A failed authorization creates work.

A missed handoff creates work.

An incorrect insurance record creates work.

A coding correction creates work.

A claim correction creates work.

A duplicate entry creates work.

Then somebody builds a workflow to manage the work.

Then somebody builds software to optimize the workflow.

Then somebody sells analytics to measure the workflow.

Congratulations.

You now have a highly optimized machine for producing and measuring rework.

Healthcare calls this sophistication.

Sometimes it is.

Sometimes it is just expensive repetition wearing a blazer.


The Claim Is Not the Problem

A denied claim is often treated as a billing problem.

I would argue that the denial is frequently the crime scene.

The real question is:

Where did the problem begin?

Maybe the payer rejected the claim because information was missing.

Fine.

Why was the information missing?

Maybe the information was never collected.

Why wasn't it collected?

Maybe the workflow did not ask for it.

Why not?

Maybe the system did not know the information would be required.

Why didn't the system know?

Maybe the data was never structured at the point where it was created.

Now we're somewhere interesting.

Because the problem that eventually appeared as a denial may have started much earlier.

Possibly during registration.

Possibly during scheduling.

Possibly during intake.

Possibly during documentation.

Possibly during authorization.

Possibly at a handoff.

The billing department simply became the place where the problem became visible.

That is different from being the place where the problem began.


We Keep Optimizing Around Noise Instead of Removing It

This is where healthcare technology gets interesting.

The industry has spent years building better tools for downstream work.

Better coding.

Better claim submission.

Better denial management.

Better A/R reporting.

Better work queues.

Better automation.

Better analytics.

And these tools can absolutely create value.

But there is a dangerous assumption hiding underneath all of them:

The data arriving downstream is good enough.

What if it isn't?

What if the real opportunity is not another sophisticated downstream tool?

What if it is getting the data right earlier?

Because once bad information enters the system, every downstream department becomes a correction department.

The system starts compensating for variability.

People compensate for software.

Software compensates for missing information.

Billing compensates for documentation.

Clinicians compensate for fragmented records.

Patients compensate for fragmented care.

And everyone wonders why healthcare costs so much.


The AI Trap

Now enter AI.

Healthcare has understandably become fascinated with AI.

And there is good reason.

AI can summarize.

Predict.

Classify.

Draft.

Route.

Prioritize.

Extract.

Generate.

Automate.

But here is the question I think we should ask more often:

What happens when AI makes a bad process faster?

If the input is incomplete, AI can produce a beautifully organized incomplete answer.

If the workflow is broken, AI can accelerate the broken workflow.

If information is inconsistent, AI can summarize the inconsistency with remarkable confidence.

Garbage in.

Beautifully summarized garbage out.

The danger is not that AI is useless.

The danger is that AI is useful enough to hide the underlying problem.

That is why Dr. Toyin Ajayi's recent comment is so important.

She did not simply say technology is transformative.

She added the crucial qualifier:

“if done right.”

That three-word qualification may be the most important part of the sentence.

Technology is a lever.

It does not decide what to lift.


The Better AI Question

Instead of asking:

“What can AI automate?”

Healthcare leaders should ask:

“What work should no longer exist?”

Those are completely different questions.

The first produces automation projects.

The second produces system redesign.

Suppose an employee spends three hours every morning checking whether information is missing.

AI can potentially make that checking faster.

But maybe the bigger opportunity is preventing the information from being missing.

Suppose a billing team spends hours chasing authorization status.

AI can potentially automate the follow-up.

But perhaps the bigger opportunity is creating a process where authorization requirements are known before the patient reaches the point of failure.

Suppose staff repeatedly call patients for information.

AI can make the calls cheaper.

But maybe the better question is:

Why did we need to call five times?

That is not an AI question.

That is a systems question.


Luca's Story Makes This Personal

It would be easy to read Luca's story and think:

“This is about rare disease.”

Of course it is.

But it is also about something much more universal.

People have lives outside healthcare.

Luca's life happens between appointments.

Between medications.

Between therapies.

Between specialists.

Between hospital visits.

Between pieces of paperwork.

His parents are trying to protect those spaces.

That is what makes their story so powerful.

They are not trying to eliminate healthcare from Luca's life.

They are trying to prevent healthcare from becoming his entire life.

There is a lesson here for every healthcare organization.

The best healthcare experience may not be the one with the most touchpoints.

It may be the one that creates the most room between them.


The Hidden KPI: Time Returned to Life

Healthcare has thousands of metrics.

Length of stay.

Readmission.

Revenue per encounter.

Days in A/R.

Denial rate.

First-pass yield.

Patient satisfaction.

Provider productivity.

Utilization.

Cost per visit.

All useful.

But I think we need another metric:

Time returned to life.

How many minutes did we give back to the patient?

How many hours did we give back to the physician?

How much unnecessary follow-up disappeared?

How many duplicate requests disappeared?

How many calls became unnecessary?

How many forms disappeared?

How many handoffs disappeared?

How many problems were prevented instead of repaired?

That is not soft measurement.

Time is one of the most valuable resources in healthcare.

Patients know it.

Physicians know it.

Caregivers know it.

Healthcare organizations sometimes forget it.


The Physician's “Pajama Time” Problem Is Not Just a Burnout Problem

The Office of the National Coordinator for Health Information Technology recently reported that more than three-quarters of more than 8,400 family physicians experienced at least one substantial burden involving external information retrieval, prior authorization or after-hours documentation.

In 2026, substantial prior-authorization burden remained high, while substantial after-hours documentation burden improved from previous years.

That combination tells us something important.

Technology can reduce some administrative work.

But adding technology does not automatically eliminate administrative work.

Sometimes it simply moves the work.

The physician stops faxing.

Now the physician clicks.

The physician stops searching one system.

Now the physician searches three.

The physician stops writing one note.

Now the physician reviews an AI-generated note.

The work changes clothes.

It does not necessarily disappear.

That distinction matters.

Because automation is not the same thing as elimination.


We Should Stop Celebrating Activity

Healthcare dashboards are full of activity.

Tasks completed.

Messages sent.

Claims submitted.

Calls made.

Notes signed.

Prior authorizations processed.

Tickets closed.

But activity is not the same as completion.

A claim submitted is not a payment.

An authorization request is not an authorization.

A referral sent is not an appointment.

A task marked complete is not a problem solved.

A message delivered is not a patient reached.

This sounds obvious.

Yet entire systems are built around counting activity because activity is easy to measure.

Outcome is harder.

The uncomfortable question is:

Are we measuring what the system did, or what actually happened?


The Handoff Is Where Good Intentions Go to Die

Healthcare is a giant network of handoffs.

Patient to front desk.

Front desk to clinical staff.

Clinical staff to physician.

Physician to specialist.

Specialist to facility.

Facility to payer.

Payer to billing.

Billing back to practice.

Every handoff introduces the possibility of information loss.

And every handoff creates another opportunity for somebody to say:

“I thought they had that.”

The patient does not care who was supposed to have it.

The patient simply experiences the result.

That is why reducing handoffs can be more powerful than optimizing them.

The goal should not always be:

“How do we make this handoff more efficient?”

Sometimes it should be:

“Why is this handoff necessary?”

That question is far more dangerous.

And far more interesting.


What OnnX Is Trying to Look At

This is the thinking behind OnnX.

Not:

How do we build another tool for the billing department?

But:

Why did the billing problem happen in the first place?

Healthcare billing is often treated as a tooling problem.

I believe a significant part of it is a data-quality problem.

The revenue cycle is downstream.

The patient encounter is upstream.

Between those two points, information changes hands, gets interpreted, gets re-entered, gets transformed and sometimes gets lost.

By the time the claim is denied, everyone is looking at the symptom.

The opportunity is to move the intervention closer to the source.

Better information.

Earlier.

More structured.

More consistent.

Fewer unnecessary handoffs.

Less rework.

Less chasing.

Less correction.

And ultimately, less administrative burden on the people who should be spending their time caring for patients.

That is a very different philosophy from simply adding another layer of automation.


The Question Every Practice Should Ask on Monday

Pick one recurring administrative problem.

Not the biggest.

Not the most impressive.

Just one.

Then ask five questions:

1. Where does the problem first appear?

Not where it gets fixed.

Where does it first appear?

2. Where was the necessary information originally created?

Find the source.

3. How many people touch it afterward?

Count the handoffs.

4. How many times is the same information re-entered?

Count the duplication.

5. What would have to change for this problem never to appear?

This is the important question.

Do not automate the current process yet.

First challenge the process.

Otherwise you may simply build a faster treadmill.


A 30-Day Rework Audit

For the next 30 days, track five things:

1. Rework

How many tasks were repeated because something was incomplete or incorrect?

2. Preventable denials

How many denials could have been prevented upstream?

3. Duplicate data entry

How many times was the same information entered?

4. Handoffs

How many people touched a single issue?

5. Time spent chasing

How much staff time went into finding information, checking status or asking someone else for an answer?

Then calculate something most dashboards ignore:

Cost of administrative rework = volume × frequency × minutes × labor cost.

The number may surprise you.

Not because healthcare workers are inefficient.

Because the system may be manufacturing unnecessary work.


The Humorously Bad Test

Here's a simple test for every healthcare workflow:

If a competent employee disappeared tomorrow, would the process still make sense?

If the answer is no, you may not have a workflow.

You may have institutional memory disguised as a workflow.

Another test:

If you removed the spreadsheet, would anyone know what was happening?

If not, congratulations.

You have created a spreadsheet-based electronic health record.

And finally:

If three people are checking whether the first person did the thing correctly, why is the first person doing the thing manually?

These questions sound almost ridiculous.

That's the point.

Sometimes absurdity becomes visible only when we stop accepting the process as normal.


What We Should Stop Doing

Stop measuring administrative activity as though it automatically represents value.

Stop assuming the department where a problem appears is the department responsible for creating it.

Stop adding technology before understanding the process.

Stop celebrating automation that merely transfers work from one employee to another.

Stop calling every workflow “optimized” because it has a dashboard.

Stop treating patients as inputs moving through a system.

And stop assuming that more healthcare automatically means better healthcare.

Sometimes better healthcare means less healthcare administration surrounding the care that actually matters.


What We Should Start Doing

Start measuring rework.

Start tracing problems upstream.

Start designing around the patient's actual journey.

Start asking where information originated.

Start reducing unnecessary handoffs.

Start structuring data at the point of capture.

Start measuring time returned to clinicians and patients.

Start using AI to prevent work, not simply accelerate it.

And start treating administrative simplicity as a clinical experience issue.

Because it is.


Technology Should Give People Their Time Back

Dr. Toyin Ajayi's recent point about technology being potentially deflationary in healthcare is worth taking seriously.

But there is another kind of deflation we rarely discuss.

Deflation of administrative burden.

Fewer clicks.

Fewer calls.

Fewer faxes.

Fewer duplicate entries.

Fewer status checks.

Fewer corrections.

Fewer “just following up” messages.

Fewer tasks whose only purpose is to repair another task.

Imagine what happens when those minutes disappear.

The physician gets more attention for the patient.

The nurse gets more time for the patient.

The staff member gets more time for meaningful work.

The caregiver gets more time with the child.

And the child gets to be a child.

That is a much better definition of innovation.


The Point Isn't to Remove Humans

There is an easy mistake to make here.

If administrative work is wasteful, perhaps we should automate everything.

No.

That is the wrong lesson.

Healthcare is deeply human.

Judgment matters.

Empathy matters.

Trust matters.

Context matters.

A physician recognizing that something is wrong before a test confirms it matters.

A nurse noticing that a patient is frightened matters.

A caregiver knowing that a child is having an unusually difficult day matters.

Technology should not eliminate those moments.

It should protect them.

The best automation may be the automation that nobody notices.

The claim that submits correctly.

The authorization that never becomes a crisis.

The missing information caught before it becomes a denial.

The referral that arrives without someone calling to ask where it went.

The patient who never knows there was a problem because the system solved it before they encountered it.

That is the kind of invisible infrastructure healthcare needs.


And Then There Is Luca

Luca will turn five on October 7.

His parents cannot predict everything his future will bring.

But they can control some things.

They can take him outside.

They can create experiences.

They can celebrate small victories.

They can advocate.

They can build community.

They can laugh.

They can give him a childhood.

Mariah also founded The SPATA Foundation after realizing how little research and support existed around SPATA-related disorders.

She turned uncertainty into action.

That may be the most important part of the story.

She did not wait for the system to become perfect.

She asked:

What can we do with what we have?

Healthcare leaders should ask the same question.

Not:

“Can we fix the entire healthcare system?”

We probably cannot.

Instead:

What piece of unnecessary friction can we eliminate?

One form.

One handoff.

One duplicate entry.

One avoidable denial.

One unnecessary phone call.

One broken workflow.

One repeated question.

One hour of pajama time.

That is how systems change.

Not always through giant transformations.

Sometimes through subtraction.


The Future of Healthcare May Be Smaller Than We Think

We often describe the future as more.

More AI.

More data.

More automation.

More devices.

More monitoring.

More personalization.

More intelligence.

But perhaps the future should also be defined by less.

Less waiting.

Less repetition.

Less chasing.

Less rework.

Less paperwork.

Less uncertainty.

Less fragmentation.

Less administrative noise.

Less time spent proving that something was done.

Because the ultimate measure of technology may not be how much it can produce.

It may be how much unnecessary work it allows us to stop producing.


The Uncomfortable Question

Luca's story forces a question that has nothing to do with rare disease.

It is a question for every physician.

Every clinic owner.

Every healthcare executive.

Every technology founder.

Every person building the next healthcare workflow.

Are we building technology that helps healthcare organizations do more work?

Or are we building technology that makes unnecessary work disappear?

Those sound similar.

They are not.

One creates productivity.

The other creates capacity.

One gives the system more things to do.

The other gives people their time back.

And ultimately, that is what Luca's story reminds us healthcare is supposed to protect.

Not the workflow.

Not the dashboard.

Not the task queue.

Not the claim.

Not the authorization.

Not the revenue cycle.

The life on the other side of all of it.


But I Could Be Wrong

Maybe healthcare really does need another dashboard.

Maybe another notification will finally solve everything.

Maybe the 47th workflow will be the one that works.

Maybe the answer really is to add one more person to the queue.

I am skeptical.

Because if the same problem keeps returning, the question should not simply be:

“How do we handle it faster?”

It should be:

“Why does it keep happening?”

That question moves us upstream.

And upstream is where some of the biggest opportunities in healthcare may still be hiding.


A Different Definition of Healthcare Innovation

We have spent years asking whether technology can make healthcare more efficient.

I think the better question is:

Can technology make healthcare less burdensome?

For physicians.

For staff.

For caregivers.

For patients.

For families like the Georges.

That changes the design brief.

The objective is no longer maximum automation.

It is maximum human attention where human attention actually matters.

The objective is no longer more activity.

It is more completion.

The objective is no longer more data.

It is better data at the point where it enters the system.

The objective is no longer more workflows.

It is fewer problems that require workflows.

And the objective is no longer making healthcare organizations better at processing patients.

It is helping patients spend more time living their lives.

Luca's parents understand that instinctively.

Maybe healthcare needs to learn it technologically.


Final Thought

Luca's diagnosis is part of his story.

It is not who he is.

That distinction should stay with us.

Because patients are not diagnoses.

Physicians are not productivity units.

Nurses are not task processors.

Caregivers are not administrative coordinators.

And healthcare workers should not have to spend their best hours compensating for information problems that could have been prevented upstream.

We do not need a healthcare system that simply moves faster.

We need one that makes fewer people carry the weight of its broken parts.

Maybe the future of healthcare isn't about doing more.

Maybe it is finally about giving people more life.


The Conversation

What is one piece of healthcare administration that your organization has become so accustomed to that nobody questions why it exists anymore?

A denial?

A fax?

A duplicate form?

A referral chase?

A prior authorization?

A spreadsheet?

A handoff?

Something else?

Tell me in the comments.

And if this made you rethink what “efficiency” actually means in healthcare, repost it for a physician, clinic owner, healthcare operator or founder who should be part of this conversation.

I also share a free practice-improvement resource in my LinkedIn Featured section — no signup needed.


About the Author

Dr. Daniel Cham is a physician, entrepreneur and medical consultant focused on healthcare technology, healthcare management and medical billing.

His work explores a simple question:

How can technology remove unnecessary friction from healthcare without removing the humanity from it?

Connect with Dr. Cham on LinkedIn to learn more.


Disclaimer

This article is for educational and informational purposes only. It does not constitute medical, legal, financial or professional advice. Individual healthcare organizations should evaluate their own clinical, operational, compliance and technology requirements with appropriate professionals.

Continue the Conversation

Follow Dr. Daniel Cham for perspectives on healthcare, medical technology, physician entrepreneurship, medical billing and the future of healthcare delivery.

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References

  1. Shkurtaj, Tereza. “Parents of 4-Year-Old with Ultra-Rare Genetic Disorder Are Determined to Give Him as ‘Normal a Childhood as Possible’ (Exclusive).” PEOPLE, October 3, 2026. The primary source for Luca George, Mariah George, Nicholas “Nick” George, SPATA5L1-related disorder, and the family’s effort to give Luca a normal childhood.
    Read the PEOPLE story
  2. Ajayi, Toyin, MD. “AI Has More to Offer Health Care.” The Commonwealth Fund — The Dose, October 2, 2026. Source for the quote about technology being a potential “deflationary force” in healthcare and for the discussion of AI, outcomes, access, data, and closing care loops.
    Read the Commonwealth Fund interview
  3. Gabriel, Meghan; Patel, Vaishali; Richwine, Chelsea. “Less Pajama Time, More Patient Time: How Better Interoperability Can Reduce Physician Burden.” Office of the National Coordinator for Health Information Technology (ONC), September 30, 2026. Source for the 2024–2026 physician administrative-burden data, including prior authorization, external-information retrieval, and after-hours documentation.
    Read the ONC analysis

#Healthcare #HealthTech #MedicalBilling #HealthcareAI #PhysicianEntrepreneur #RevenueCycleManagement #HealthcareInnovation #MedicalPractice #AdministrativeBurden #PatientExperience #DigitalHealth #HealthcareLeadership #AIinHealthcare #PhysicianBurnout #HealthIT

 

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