Friday, November 7, 2025

BeautyHealth Upgrades 2025 EBITDA Guidance to $37M–$39M Amid Strong Margin Management

BeautyHealth Upgrades 2025 EBITDA Guidance to $37M–$39M Amid Strong Margin Management

BeautyHealth Upgrades 2025 EBITDA Guidance to $37M–$39M Amid Strong Margin Management

Strategic Shifts and Operational Improvements

Pedro Malha, CEO & President of The Beauty Health Company, opened the earnings call by expressing gratitude for the previous leadership and team efforts in stabilizing the business. He emphasized the company's potential to leverage its Hydrafacial device platform and expand it into a category-leading ecosystem of skin health technology solutions. Malha highlighted the unique recurring razor and blade business model and the company’s position to benefit from a market shift toward less invasive, personalized, and science-backed treatments.

Malha outlined four strategic priorities: protecting and growing the Hydrafacial installed base of over 35,000 devices, driving consumable utilization, innovating across device and consumable platforms, and strengthening operational discipline in areas such as cost control, margin expansion, supply chain, and quality.

For Q3, Malha reported total net sales of $70.7 million, noting a 10.3% year-over-year decline but stated this was "slightly ahead of the high end of our forecast for the quarter." Device segment revenue was $20.8 million, down 24.6% year-over-year, while consumables revenue was $49.8 million, down 2.6% year-over-year, mainly due to the China business model transition. He emphasized that excluding China, consumables sales would have increased modestly, with the consumable mix rising to 71% of net sales.

Malha noted operational achievements, including inventory levels below $60 million—"the lowest in 3 years"—and cited Q3 adjusted gross margins at 68%, down approximately 150 basis points year-over-year. Adjusted EBITDA reached $8.9 million, up 11% from Q3 last year, reflecting "tight control of cost and a solid operational execution." He announced a raise in adjusted EBITDA guidance and the midpoint of full-year revenue guidance.

CFO Michael Monahan stated, "I'm pleased to share another quarter of steady execution and disciplined financial performance in which we once again exceeded our initial expectations." He highlighted the impact of operational discipline, reporting net sales at $70.7 million, with device sales declining 24.6% and consumables down 2.6%. Monahan also pointed to regional revenue declines and outlined the company’s strategy for managing inventory and cost controls.

Outlook and Financial Results

The company raised the low end of its full year 2025 revenue guidance to between $293 million and $300 million and increased adjusted EBITDA guidance to between $37 million and $39 million. For Q4, expected net sales are between $74.5 million and $81.5 million, with adjusted EBITDA between $6.9 million and $8.9 million. Management stated the guidance reflects "reduced year-over-year revenue declines and continued cost management discipline."

Financial results showed Q3 net sales were $70.7 million compared to $78.8 million in the prior year, with device revenue at $20.8 million and consumables at $49.8 million. The Americas declined 7% to $48.3 million, APAC dropped 41.5% to $6.3 million, and EMEA remained flat at $16.1 million. GAAP gross profit was $45.6 million, with a GAAP gross margin of 64.6%. Adjusted gross margin was 68%, driven by a higher mix of consumables. Operating expenses fell 16.5% to $51.9 million, led by reduced sales and marketing spending (down 24.2%) and G&A expense (down 12.5%). Operating loss improved to $6.2 million from a loss of $21.5 million in the prior year.

Adjusted EBITDA was $8.9 million, up from $8.1 million, with margin improving to 12.6%. The company ended the quarter with $219.4 million in cash, reflecting refinancing activities and improved cash flow from operations.

Q&A Highlights

Oliver Chen, TD Cowen, asked about regional performance and cautious trends in the Americas. Malha responded that "Americas was down 7%...devices was down 16.3%," citing macro pressures but noted stabilization in device declines. For EMEA, "overall, we were flat...devices were down in EMEA about 21%." Consumables in EMEA grew double digits, driven by Germany and the medical channel.

Chen inquired about near-term vs. long-term strategic focus. Malha outlined that immediate priorities include driving utilization and device placement, with innovation and commercial execution as ongoing efforts, and highlighted targeted strategies for both devices and consumables.

John-Paul Wollam, ROTH Capital Partners, queried international strategy and channel mix. Malha stated there is continued reliance on distributor networks internationally, with plans for targeted commercial programs and investment in education and training.

Wollam also asked about the recent consumable price increase. Malha confirmed, "the team has been very pleased how the market...took that price increase," and noted average selling price is up.

Susan Anderson, Canaccord, asked about stabilizing device sales. Malha emphasized improving pipeline and commercial execution, predicting "the performance of our ability to sell devices into the market to get better and better as the quarters progress."

Anderson followed up on consumables focus. Malha disclosed a pause on the skin care initiative: "we have decided to actually pause the skin care initiative...our competitive advantage lies rather on the clinical differentiation, on recurring consumables, on stronger provider partnerships."

Lillian Moffett, Raymond James, asked about channel trends and consumer behavior. Malha described stability in medical and non-medical segments but noted pressure among plastic surgeons as consumers shift toward less invasive care. Monahan added, "booster attachment rates were very high...the end consumer...has been under a bit of pressure."

K. Gong, JPMorgan, asked about balancing growth vs. profitability for 2026. Malha stressed focus on top line growth and recurring revenue, indicating momentum heading into next year is contingent on improved macro conditions.

Joseph Federico, Stifel, queried guidance raise and margin dynamics. Monahan explained Q3 outperformance and Q4 margin expectations, noting, "gross margins tend to be a little bit lower quarter-over-quarter because we run the consumables promotion in the fourth quarter."

Federico asked about churn. Malha acknowledged churn is elevated at 1.8%, attributing it to "financial pressure being the primary factor" among low-volume providers, with proactive reengagement initiatives underway.

Sentiment Analysis and Risks

Analysts maintained a neutral tone, probing regional trends, strategic focus, pricing, and stabilization efforts, with particular attention on macro headwinds and device sales challenges. Management projected cautious confidence, with Malha stating, "we are encouraged by the momentum we are building as we enter 2026." Monahan’s tone reflected operational focus and discipline, noting "continued cost control even in the face of lower top line volume."

Compared to the previous quarter, management’s prepared remarks showcased increased optimism on stabilization and improvement in guidance, while analyst tone remained neutral but focused on risk factors and execution.

Quarter-over-Quarter Comparison

The current quarter featured a new CEO, Pedro Malha, succeeding Marla Beck, and a strategic pause on the skin care initiative. Guidance for full-year revenue and adjusted EBITDA was raised from the prior quarter’s range of $285 million–$300 million and $27 million–$35 million, respectively, to $293 million–$300 million and $37 million–$39 million.

Device revenue pressure persisted, but consumables mix improved. Operational discipline and cost controls remained central, while innovation shifted focus from skin care to clinically backed boosters and core consumables.

Analysts in both quarters concentrated on device sales, churn, and regional performance, but this quarter’s Q&A included increased scrutiny of churn and pricing power.

Management’s tone moved from cautious progress in Q2 to greater emphasis on momentum and margin resilience in Q3.

Risks and Concerns

Management cited ongoing macroeconomic headwinds, persistent inflation, challenging access to financing for capital equipment, and uneven consumer confidence as key external risks. Device sales remain under pressure, especially in the Americas and APAC, with churn elevated at 1.8%. The China market transition continues to impact results, though mitigation includes inventory planning and a shift to distributor models.

Proactive measures include greater support and training for low-volume providers, a focus on innovation in consumables, and a pause on non-core initiatives to preserve capital.

Final Takeaway

The Beauty Health Company delivered resilient Q3 2025 results amid challenging macro conditions, highlighted by improved profitability, disciplined cost control, and strategic clarity under new leadership. The company raised guidance for both revenue and adjusted EBITDA for the year, underscoring confidence in its recurring consumables model, operational improvements, and targeted innovation. Management remains focused on stabilizing device sales, reactivating providers, and leveraging its core strengths to drive growth into 2026.

Ben and Candy Carson's Struggle for Families

Ben and Candy Carson's Struggle for Families

A Lasting Partnership

Dr. Ben Carson, a renowned neurosurgeon, former Republican presidential candidate, and former U.S. Housing and Urban Development secretary, is known for his strong public presence. However, those who follow his social media accounts will notice that he is not alone in sharing the spotlight. His wife, Candy Carson, plays an equally significant role in their public life. She is credited on the cover of many of his books and has been a constant presence in his career. The Carsons have built a partnership that extends beyond personal life into professional endeavors, making it difficult to find a public-facing platform where they are apart.

This close collaboration is by design. The Carsons, who will be honored by the Sutherland Institute at its 30th anniversary awards dinner, are recognized as prominent advocates for the American family. Their work, particularly in the 2024 book "The Perilous Fight," highlights their commitment to defending the family as a core institution. The Sutherland Institute’s decision to present the Family Values Award to both Dr. and Candy Carson together reflects the deep connection between their lives and work.

Rick Larsen, president and CEO of the Sutherland Institute, explained that while the award was initially considered for Dr. Carson alone, the team realized how integral Candy Carson is to their message. “When you read their book and Candy’s book, ‘A Doctor in the House,’ you realize they’re inseparable,” Larsen said. “They’re in this together.”

A Half-Century of Partnership

Dr. Carson and Candy have been married for 50 years, and their relationship has evolved over time. In the early days of his medical career, Dr. Carson was incredibly busy as a pediatric neurosurgeon. When he became director of pediatric neurosurgery at Johns Hopkins, the division was not well-known. He spent years working to elevate its reputation, which eventually led to it being named the No. 1 pediatric neurosurgery division by U.S. News and World Report in 2008.

During this time, Candy focused on raising their children. Despite having an advanced degree from Yale and an MBA, she put her career on hold to care for their family. At the same time, she was also starting the Carsons Scholars Program, which provides college scholarships to students who excel academically and serve their communities.

Defending Family and Faith

In today’s political climate, discussing families and communities of faith can be controversial. The Sutherland Institute has long defended these institutions based on data and historical evidence. “Data shows that intact families in communities of faith tend to thrive,” Larsen said. “We’re completely aligned with Dr. Carson and Candy Carson’s new book where they make these points.”

The Carsons argue that the American family is under attack from various forces, including modern-day Marxists, socialists, and globalists. They reference W. Cleon Skousen’s 1958 book “The Naked Communist,” which outlines strategies aimed at undermining traditional values. These include discrediting the family and encouraging promiscuity and easy divorce.

The Perilous Fight

The title of the Carsons’ book, "The Perilous Fight," is inspired by a line from "The Star-Spangled Banner." They use this metaphor to describe the ongoing challenges facing the American family. Like Fort McHenry during the War of 1812, the family is under sustained attack, with enemies chipping away at its foundation for decades.

For Dr. Carson, the importance of a strong, two-parent family stems from his own childhood. His father left when he was young, and his mother worked multiple jobs to support her sons. Despite having only a grade-school education, she instilled a love of learning in her children. One of the most poignant stories involves her requiring her sons to write book reports every week, even though she could not read them herself.

Education as a Solution

Dr. Carson believes that education is key to addressing many of the challenges facing society. He argues that ignorance is a major issue, citing examples of people who lack basic knowledge. “We have to fight that,” he said. “We have to educate people so they understand the values that have made this nation prosperous.”

Through the American Cornerstone Institute, the Carsons are working to promote conservative principles and policy solutions. Their Young Patriots program aims to teach children to value faith, liberty, community, and life. “We have a wonderful story to tell with this nation,” Dr. Carson said. “It has a moral base, and as we allow all of that to recede, we’re suffering the consequences.”

Melatonin May Harm Your Heart, Experts Warn — 5 Ways to Sleep Fast Without It

Melatonin May Harm Your Heart, Experts Warn — 5 Ways to Sleep Fast Without It

Key Findings of the Study

A recent preliminary study has uncovered a potential link between long-term use of melatonin supplements and an increased risk of heart failure, as well as other serious health outcomes. The research, set to be presented at the American Heart Association’s Scientific Sessions 2025, analyzed five years of health data for 130,828 adults with insomnia. Half of these individuals had used melatonin supplements for at least a year, while the other half had not been prescribed it.

The results showed that those using melatonin long-term had a 4.6% chance of developing heart failure over five years, compared to 2.7% in the non-melatonin group. This means that melatonin users had a 90% higher risk of heart failure than those who did not take the supplement. Additionally, they were three and a half times more likely to be hospitalized for heart failure and twice as likely to die from any cause during the same period.

However, the researchers emphasized that their findings show an association, not causation. They noted that people with insomnia may already have underlying health issues that could contribute to both the need for melatonin and the risk of heart problems.

Should You Be Concerned?

Dr. Fady Hannah-Shmouni, MD FRCPC, Medical Director at Eli Health, advised caution but not panic. He explained that the study does not prove that melatonin directly causes these health issues. Instead, he pointed out that insomnia itself can lead to hormonal changes, such as increased cortisol levels, which may affect cardiac health. He also noted that the study's limitations include the lack of information on the severity of insomnia and the possibility that some participants in the non-melatonin group may have taken over-the-counter melatonin.

Despite these uncertainties, Dr. Shmouni stressed the importance of consulting a healthcare provider before starting any new supplement, including melatonin.

Tips for Falling Asleep Without Melatonin

If you're looking for alternatives to melatonin, experts suggest several strategies to improve sleep quality:

  1. Keep Your Sleep Schedule Consistent
    Maintaining a regular sleep and wake time helps regulate your circadian rhythm. This consistency ensures that your body releases the right hormones at the right times, promoting better sleep and alertness during the day.

  2. Practice a Nighttime Routine
    A calming bedtime routine signals to your body that it's time to wind down. Activities like taking a bath with Epsom salts, drinking chamomile tea, or reading can help reduce stress and prepare you for sleep. Avoid screens before bed, or use night mode settings to minimize blue light exposure.

  3. Try Relaxation Exercises
    Techniques such as deep breathing, yoga, progressive muscle relaxation, or meditation can lower cortisol levels and promote mental balance. Guided meditations or visualization exercises can also help ease you into a relaxed state.

  4. Stay Physically Active
    Regular exercise can improve sleep quality by reducing stress and regulating cortisol levels. However, it's best to avoid strenuous workouts close to bedtime, as they may interfere with sleep onset and quality.

  5. Create the Ideal Sleep Environment
    A cool, dark, and quiet bedroom supports better rest. Aim for a temperature between 65 to 70°F (18 to 21°C) and use tools like earplugs, white noise machines, or eye masks to block out disturbances.

Foods Needed During SNAP Freeze — Safe Donation Guide

Foods Needed During SNAP Freeze — Safe Donation Guide

The Crisis of Food Insecurity Amid Government Shutdown

Amid the uncertainty surrounding a government shutdown and the ongoing debate over whether Supplemental Nutrition Assistance Program (SNAP) benefits will be released to nearly 42 million Americans, food banks and giving networks across the country are working tirelessly to meet the growing demand in their communities. This situation has placed many food banks in what is being called "crisis mode," as families who rely on SNAP benefits face an uncertain future.

Jason Jakubowski, President and CEO of Connecticut Foodshare, explained that the uncertainty around SNAP benefits combined with the approaching holiday season has created a "nightmare scenario" for families. He noted that people who depend on SNAP don’t know when or if their full benefits will arrive, which has led to a surge in demand at food pantries and mobile food distribution sites. “For every one meal we can provide at the food bank, SNAP can provide nine,” he said.

With increased demand, there is also a growing number of individuals looking to help. Operation Food Search in St. Louis reported that a recent food drive with City Foundry saw 20,000 pounds of food donated—enough to feed 5,000 people in a day. However, in triage situations, it can be difficult for those new to food rescue and donation to understand how they can make the most effective impact.

Experts in food donation and safety provided guidance on how to ensure donations are as helpful as possible. Before making any donations, reaching out to the specific organization you're interested in supporting is a key step. This helps avoid well-intentioned but potentially unnecessary donations that may not align with the needs of the community.

“Before making a donation, the most helpful thing donors can do is check the guidelines of the organization they’re donating to,” said Kyle Waide, president and CEO of Atlanta Community Food Bank. “Food banks, pantries, and community fridges often have different storage capacities, safety requirements, and community needs.”

Jakubowski echoed this advice, noting that “a quick phone call can make your gift more impactful” and prevent donations from going to waste. He emphasized that each pantry serves a different community with unique needs and storage capacities, so checking in first ensures that donations go where they are needed most.

In addition to food donations, monetary contributions and volunteering are also valuable ways to support these networks. “We need donations to help us purchase food and transport it to our pantries and mobile sites. We need volunteers to help sort through donated food before it goes out on our mobile trucks,” Jakubowski said.

What to Donate: Tips from Experts

When choosing what to donate, experts recommend considering what you would feed your own family. Melissa Weissler of Operation Food Search advised, “Think about what you and your family enjoy eating, and let that be your guide.” She noted that food banks and pantries serve a wide variety of personal and cultural preferences, and it's important to be sensitive to these differences.

Kyle Waide added that donors should choose items that are nutritious, shelf-stable, and easy to prepare. He also stressed the importance of ensuring that items are unopened, in good condition, and within their expiration period.

Some of the most commonly requested items include:

  • Peanut butter
  • Canned meats (tuna, chicken, etc.)
  • Canned vegetables and fruits
  • Rice, beans, and pasta
  • Cereal
  • Shelf-stable instant meals
  • Shelf-stable milk
  • Granola bars
  • Fruit cups and applesauce
  • Crackers
  • Soups, stews, and broths

Jakubowski noted that protein-rich foods and dairy products are among the most sought-after items. However, he also mentioned that under-donated items like meat proteins can vary depending on the community’s needs. Calling ahead to check on under-donated items is a great way to build a relationship with your local food pantry.

Common Mistakes to Avoid

There are several common mistakes that donors can avoid by reaching out before donating. Wagner highlighted that many people tend to bring items high in carbohydrates that don't promote a balanced diet. These types of items are already abundant at food banks, so balancing them with more needed items is ideal.

Specialty items that require specific storage conditions can also be problematic if the pantry isn’t equipped to handle them. Additionally, holiday-specific items may sit unused for too long, leading to waste. Glass containers, condiments, specialty sauces, homemade foods, and baby food are also less effective, as they may not be versatile enough for the diverse needs of the community.

Weissler also pointed out that some staples, like rice and beans, while nutritious, can be time-consuming to prepare. People on SNAP benefits are often working and may not have the time or resources to prepare dried beans properly.

By following these guidelines, donors can make the most impactful contribution to their local food banks and help address the growing need in their communities.

The One Thing 95% of Healthcare Execs Agree On, Says HFMA CEO

The One Thing 95% of Healthcare Execs Agree On, Says HFMA CEO

This is a preview of the November 6 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox. Good morning. Yesterday was the submission deadline for Rural Health Transformation applications, and some states have started releasing overviews of their plans. Here’s what we know so far (a special thanks to my colleague Lauren Giella for her reporting on this topic).

At the time of writing on Wednesday, three state governors had publicly unveiled their blueprints: North Dakota Governor Kelly Armstrong, Missouri Governor Mike Kehoe and Mississippi Governor Tate Reeves. Unsurprisingly, telehealth expansion and stronger workforce pipelines were core to their proposals.

But I did find another common thread throughout the states’ plans: They all called for some level of interoperability between health care stakeholders. Missouri aims to create a “unified, regional network” that will connect providers, public health agencies, at-home resources and digital health tools to expand access, according to Kehoe’s news release. Mississippi wants to build a “connected, data-driven network of emergency, clinical and community-based services,” Reeves said. And Armstrong outlined four strategic initiatives for his state, including “connecting technology, data and providers for a stronger North Dakota.”

A few weeks ago, on the heels of the Summit on the Future of Rural Health Care, I wrote about the skepticism that many health care executives expressed when asked about the $50 billion transformation fund. (If you missed it, you can check out that newsletter here.) I’ve come across a few recurring concerns: (1) that the plans will be too broad to effect real change, (2) that they’ll set up costly programs that won’t be sustainable once the cash infusions end and (3) that $50 billion is not nearly enough to offset the $1 trillion in Medicaid and CHIP cuts that hospitals are expecting in the next decade.

We don’t have every state’s plan yet, and the information we do have isn’t very detailed. But so far, those concerns I outlined above appear to be valid—especially when it comes to the sections on “connected networks.”

Health care IT executives know that data exchanges aren’t easy to build. Leaders spoke about this in depth at My healthy of life’s Digital Health Care Forum, chronicling privacy concerns, internal data silos and complex relationships among competitors. And those are concerns from well-funded health systems, which have more solid IT infrastructures than their rural, independent counterparts.

Plus, maintaining a connected network will undoubtedly take resources, and the fund only lasts five years. It is unclear how these projects will sustain themselves over the next few decades.

Fortunately, states won’t be working toward these goals on their own. This week, a coalition of health tech companies launched the Collaborative for Healthy Rural America, specifically designed to advance the Rural Health Transformation projects. The group intends to address access challenges through “shared infrastructure, unified data and modern technology,” and will work up an “AI-enabled interoperable operating platform” to help states carry out their visions, according to the Collaborative’s website and news release.

Founding members include Lumeris (primary care), Teladoc Health (virtual care), Nuna (an app with an AI “coach” for chronic disease patients), Deloitte (for data systems interoperability expertise), and Unite Us (a company that builds networks to coordinate care and improve communications between health care and human services organizations).

Plus, the Collaborative aims to improve access nationwide, not just in awarded states. Perhaps these companies, which are well-resourced and nationally scaled, could give some of the state-wide plans a helpful boost—and keep this entire endeavor from being a bust. We’ll know more when the winners are announced December 31, and as the funds are distributed in early 2026.

What stood out to you from the early Rural Health Transformation Fund proposals? Send me an email at a.kayser@newseek.com and let me know.

In Other News Major health care headlines from the week

My healthy of life will host a live webinar, “Traveler to Teammate: Becoming a Hospital Where Nurses Choose to Stay,” on Wednesday, November 19, at 2 p.m. Eastern.

My colleague Aman Kidwai will host the discussion with Dr. Regina Foley (Chief Nursing Executive and Chief Clinical Transformation and Integration Officer, Hackensack Meridian Health), David Rutherford (Senior Advisor, HR Transformation, OhioHealth) and Dr. Vikas Sinai (President of the Lown Institute). Learn more and register for free here. I hope to see you there!

Athenahealth announced an ambient scribing tool and a clinical copilot named Sage at its annual customer event on Tuesday. The new capabilities will begin user testing in the first half of 2026, at no additional charge to customers.

I spoke with the EHR vendor’s CEO, Bob Segert, about his decision to build these tools internally—and what it might mean for external solutions that currently live atop the platform. Get the scoop here.

Hospitals and health systems across the nation are rebranding. At least six organizations shared new names this week, with many of them symbolizing new visions.

BJC Health System in St. Louis is dropping the “system” from its name and adopting a new tagline (“Because every moment deserves exceptional care”). Franciscan Missionaries of Our Lady Health System in Louisiana will now be known as FMOL Health. CHI Memorial hospitals across Tennessee and Georgia will adopt the name of their parent company, Chicago-based CommonSpirit Health. The national senior living provider CareSouth Health System is rebranding across all its divisions and lines of business, launching an updated website and logo.

Some of the updates apply to recently acquired facilities. For example, Washington Regional Medical Center in Fayetteville, Arkansas, is renaming Physicians’ Specialty Hospital once it assumes operations of the facility on December 1. The new name will include “Washington Regional” ahead of the existing title. And HCA Healthcare has rebranded more than 35 care sites across Charleston, unifying them under the for-profit system’s name, according to The Summerville Journal Scene.

These announcements come as many health systems seek to create a more seamless health care experience for patients—and some look to form competitive brands that can go head-to-head with household names like Amazon and marketing wizards like Hims & Hers.

The government has been closed for more than a month, and anxieties are festering amid lingering policy questions—especially the fate of the Affordable Care Act (ACA) enhanced premium tax credits (APTCs).

On Monday, a pair of House Democrats and a pair of House Republicans released a bipartisan statement of principles, proposing a temporary two-year extension of the APTCs, among other reforms to prevent fraud and “ghost beneficiaries.” It’s not a guarantee, but it is a welcome signal of compromise.

Pulse Check Executive perspectives on key industry issues

Financial sustainability is a top concern for health system CEOs and CFOs. That’s why I sat down with Ann Jordan, president and CEO of the HFMA, for this week’s Pulse Check.

The HFMA (or the Healthcare Financial Management Association) is in a unique position. It’s a non-lobbying organization and expands beyond the traditional definition of a professional association because it speaks to a number of players rather than to a single trade, like nursing or cardiology. In other words, it occupies a “horizontal lane of an industry that is becoming increasingly dynamic and destabilized,” as Jordan put it.

Currently, the HFMA is focused on equipping members with insights to advance their organizations’ financial management and applying that acumen to guide strategy in the broader health care industry, Jordan said. To advance that goal, the HFMA recently launched the business initiative Vitalic Health, which focuses on convening stakeholders to discuss industrywide solutions. In mid-August, they launched a “Vitals Tracker” to rapidly assess the health of the health care system—and declared that it is in “serious condition.”

Here’s what Jordan told me about the new tool and the work to stabilize health systems’ finances.

Editor’s Note: Responses have been edited for length and clarity.

What are the main barriers to financial sustainability for hospitals and health systems right now, and how are you working to address them?

Point number one is understanding what we should look at in terms of financial sustainability and from what perspective. When your practice [is] horizontal [like the HFMA’s], should it be from the perspective of sustaining a business, a stakeholder group or the overall “greater system,” if you want to call it that, to advance health care generally to our communities?

When you talk about sustainability, one, naturally, is making sure that there is financial sustainability so that service can be delivered right, at the end of the day. If health systems and hospitals cannot stay open, health care is not going to be delivered. So that’s primal, that’s basic.

But this longer-term play in terms of financial sustainability and outcomes, there really has not been a meaningful and objective conversation on what that means, and that’s a little scary, given the fact we have a $5 trillion industry pushing upward to 20 percent [of the nation’s] GDP. So, part of this initiative underlying Vitalic Health and the tracker was, for the first time, to start identifying those measures and sub-measures, how they have interconnectivity and [whether they are] getting better or worse. It’s strange that that has not been done before at the macro level.

For me, in terms of what are we thinking about [when it comes to] how we become financially sustainable, we’re trying to educate and understand [that] ourselves, and we want the whole industry to help us.

Tell me a little bit more about the Vitals Tracker. As you were building this out, what did you find that is pertinent to call out?

When we began this initiative of Vitalic Health, we didn’t want to tell people what we were doing and why, because then they would bring bias to the table. So there was a whole working task force for about a year behind the scenes that looked into the components and elements of financial sustainability from the top lines in health care. That was done generatively, and that was purposeful. [We] gathered up a big vat of knowledge to begin with, starting with the question, do you believe the system is financially sustainable? Over 95 percent of that big group said “no.” And you can’t get experts to agree with that percentage on anything, right?

Then [we started] breaking down all the components: First of all, what matters from a macro-economic standpoint? Our intuition is to go mezzo, to go [are] organizations surviving? That’s not what this [tracker focuses on]. This is really looking at that dynamic part of the industry, year over year. Are we getting better or worse?

Of all these different factors that we’re hearing, there are two main buckets. One is the cost, the financial element, so we wrestled it as expenditures and affordability. The other is the outcome, which we’re calling functional longevity, and that takes into account not only the wellbeing of the population, but the social determinants of health that are interconnected with those outcomes. Think of it as your hardcore financial components and what’s going into it, and then the outcome side of them, breaking down all the measures and sub-measures that are seen as the most critical indicators, year over year.

The beauty of this tracker is we didn’t have to invent sub-measures on our own and collect data. There are enough first-class institutions that have been collecting this for a very, very, very long time. But how do we create a storytelling and a measurement device that can not only look backwards to allow us to learn, but proactively be turned forward to see how potential policy could impact us in the future?

You mentioned that 95 percent of experts said the health care system is not financially sustainable. But how many believe that it can become sustainable? Is there optimism there?

This is where you begin to have different views. If you go back to innovative disruption models—incumbents versus disruptors, builders versus fixers—we’re at that epicenter right now, and I think it’s going to be a combination.

So, do we think we can get there? We don’t have a choice. There’s too much on the line when you’re talking about health care. To serve our communities, we have to figure out a way to do it, and there are a lot of brilliant people out there looking at this.

But what needs to happen is a concerted effort so [that], at the end of the day, it’s not a few that survive; there is that interconnectivity across all stakeholders to go forward together. Right now, you see a lot of trends going around the country where different groups are incubating together, right? They’re forming these different initiatives, where stakeholders, maybe 10 or so, are coming together to look at how our model can be successful. Well, that’s going to just lead to bigger silos across the country.

How do we make sure there is that ongoing concern, so that overall, we’re delivering health care in a way that is available to all Americans? I believe there is optimism that it can become sustainable. I believe there are very divergent theories right now in terms of the incumbents versus the disruptors, on what that looks like.

From your perspective, what does a path to financial sustainability require? How do we get the entire health system on the same page?

We’re calling it solve-based convening. There needs to be a purposeful effort to bring together stakeholders that are aligned in purpose, [that] put down [their] own self-interest and bias. Look at the opportunity or the problem before you, and come together and solve it, because there’s so much of that collaboration that can occur, starting with payers and providers.

I think everyone can admit there’s a lot of administrative waste that’s driving up cost in health care. There are ways to solve that. An army of the willing, if you want to call it that, can do this in a safe, unbiased place.

Now, going back to HFMA, we’re non-money, we are apolitical, and we play in that horizontal plane, and that’s why we do feel it’s upon us to step forward at this time, to be one of those few organizations that can set a table and bring everyone to it. I truly believe, too, when your mission is leading the financial management of health care and the data is showing that your system is financially unsustainable…what obligation do we have to step up right now? That is the soul-searching that we had to do, and it’s critical for all the players in health care to do right now.

The other comment that I’ll say is, if we are the leaders of health care financial management [and] we don’t [take action], if not us, who? Eventually someone is going to have to lead this. We can either be active leaders and participants, or we can let someone else come that might have bias or different interests than our own.

What’s one thing that you would recommend all hospital and health system CFOs do to improve their organizations’ financial sustainability?

I want to thank them for their perseverance and resilience. They have been going through [a lot, from] the pandemic to this current environment of drastic change. Whether it be from AI and technology or the [Trump] administration, the role of the CFO in the United States health care realm has changed so much. And, man, are they stepping up to the task.

Number one, I want to recognize that [at a] higher level, they have become the ultimate risk managers, and to understand the consequences to the community of not making this work. That’s a lot of pressure. I want to give credit to those financial professionals leading us through all this change.

But in terms of what we need to be mindful of for sustainability, when you’re in a financial realm, it comes down to your payment model. All these different changes that are going on, we’re going to assess that a lot of it comes down to their payer mix, and a lot of it comes down to understanding risk pools.

So, as we’re going through all of this, be mindful [that] despite the fact we have all these things going on from supply chain, or going on from accelerating labor costs, the core comes down to that payment model—and that’s going to have to change, too.

The complexity of the CFO…think about it. They’re getting hit from all these macro-factors, [including rising] litigation costs. But to serve the patient, you gotta have that payment model intact.

It’s a very hard role right now. I definitely don’t have all the answers, but I think through the convening that we’re seeing, particularly of CFOs across the country, we’re trying very hard to figure it out.

C-Suite Shuffles Where health care leaders are coming and going

Dr. David Kirk has joined Regard as chief medical officer. He comes to the technology company—which specializes in proactive documentation solutions that review EHR data to recommend diagnoses—from WakeMed Health & Hospitals in Raleigh, North Carolina. He most recently served as the system’s chief clinical integration officer and executive medical director of critical care medicine and eICU.

AdventHealth named Todd Goodman its new CFO, just months after David Banks took the reins as president and CEO. Goodman has worked at the Altamonte Springs, Florida-based health system since 1991. He was promoted to CFO after serving as its executive vice president of finance. Read more at My healthy of life.

In Montgomery, Alabama, Jackson Hospital is assembling a power team to guide it through ongoing Chapter 11 bankruptcy proceedings— including a few former executives from the for-profit health system giant, HCA Healthcare. The 344-bed hospital appointed John Quinlivan as CEO. He spent nearly two decades at HCA Healthcare, overseeing hospitals in Florida and Georgia, and is charged with leading a restructuring to “avoid hospital closure,” according to a press release from Jackson Hospital.

The hospital also selected a new three-person board of trustees to help carry out the restructuring plan. That team includes Charles Evans (former president of HCA Healthcare’s Eastern Group), Jeff Crudele (former CFO of Allegheny Health Network) and Gary Murphey (a former CEO, CFO and chief restructuring officer at financially distressed companies in various industries, and the current managing director of Resurgence Financial Services). Click here for the full scoop from My healthy of life Senior Reporter Lauren Giella.

Executive Edge How health care execs are managing their own health

We’re heading into that end-of-year push, and many leaders are feeling the pressure to finish out 2025 strong and set expectations for 2026. But 10 tumultuous months behind us, it’s not uncommon to feel a little bit burnt out—and to feel like that holiday break can’t come soon enough.

This week, I asked Ellen Sexton, executive vice president and chief growth officer at Blue Shield of California, how she prioritizes herself while juggling the demands of health care leadership—especially as part of a team that serves 6 million members in the nation’s most populous state. Here’s what she told me.

Editor’s Note: Responses have been edited for length and clarity.

“Working in the health care industry means that every day, we are working for our members. Over the years, I’ve learned I have to take care of my own health and stay grounded to keep showing up fully for my team, my family and the members, partners and communities we serve. For me, that grounding comes from doing what I love, what brings me joy and by giving back to the community.

“In addition to making sure I schedule regular checkups (including dental and vision appointments) and follow preventive care recommendations, I find that how I spend my free time also impacts my overall health. After all, what we find joy in doing impacts our mood, our overall outlook on life and how we feel each day. I spend my free time listening to podcasts, reading (I highly recommend Poor Charlie’s Almanack, a collection of speeches and lessons encouraging lifelong learning), attending music festivals, walking my dog, Sugar, and doing anything that gives me an opportunity to get away from my desk and have fun.

“I also find that laughing with my family (I’m a proud hockey mom to a teenage son), friends and colleagues plays a big role in how I feel. I also strongly believe in giving back, and for me, that is expressed through service. It’s how I reconnect to the reason I chose this field in the first place: to support the whole person, including body, mind and spirit. That same belief guides my professional work, seeing our members as individuals with stories, families, and dreams.

“Giving back doesn’t always have to mean large-scale volunteerism. Sometimes it’s mentoring a colleague, checking in on a team member, or offering encouragement to a peer after a tough meeting. These seemingly small gestures create a ripple effect—lifting others while restoring my own sense of balance and purpose.

“Whether I’m volunteering with the Salvation Army, preparing for a Milwaukee Public Library Foundation Board of Directors meeting, or contributing to the Wisconsin School of Business External Advisory Board, these experiences remind me of the ‘why’ behind my work and the broader impact we can make when we lead with empathy.

“Through the years, I’ve learned that service is sustaining. It recharges my energy, deepens my empathy and reminds me that leading with heart is the best strategy for longevity, and thus, professional wellbeing.”

CEO Circle Insights from health care thought leaders around the world

Before you go, check out this profile of Dr. Bhana Chandrakamol, the director overseeing eight hospitals for the BPK Hospital Group in Thailand, and a member of My healthy of life’s CEO Circle. His interview traces his path from the “aha” moment that sparked his career in medicine, to the top of an innovative health system.

This is a preview of the November 6 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox.

Related Articles Sutter Health Study Finds Ambient AI Can Ease Physicians Burnout Cigna Group Appoints New Chief Medical Officer States Submit Plans for Rural Health Transformation Funding Start your unlimited My healthy of lifetrial

Top Cat Food for Urinary Health Support

Top Cat Food for Urinary Health Support

Understanding Urinary Health in Cats

Urinary problems are among the most common health issues affecting cats, and they can range from minor and uncomfortable to life-threatening. In conjunction with your veterinarian’s guidance, the right cat food for urinary health is essential. Diet plays a vital role in supporting urinary tract health by helping cats maintain a proper pH balance.

Cats can be masters of hiding their pain and discomfort, so pet parents must pay close attention to signs and symptoms of urinary issues. Symptoms include, but are not limited to, frequent urination, bloody urine, and even urination outside the litter box after the problem has lingered. Without treatment, urinary blockages may turn into medical emergencies within hours.

Whether it’s urinary crystals, stones, blockages, or a urinary tract infection, your veterinarian should correctly diagnose the issue and provide treatment. In this guide, we’ll explore urinary cat food in both traditional and prescription formulas. Whether your cat has long-standing urinary problems or you are proactively managing things, understanding available options will help you make the best choice for your feline best friend.

Cat Food for Urinary Health: What Is It?

Cat food for urinary health is more than a fancy label; it’s designed to reduce issues that cause urinary problems in cats. Mineral balance, for example, is the foundation of urinary support. You’ve probably heard of the essential elements magnesium, calcium, and phosphorus. However, high levels of them may contribute to stone and crystal formation in your cat’s urinary tract and bladder. This is where problems begin.

Moisture and hydration are the most essential factors in urinary health, and for most cats, that means proper water intake. It’s always a good idea to monitor how much water your cat drinks, but as busy pet parents, that may not always be possible. Wet foods, which generally contain 75-to-80 percent water, help dilute urine and flush the bladder. Some cat food formulas slightly increase sodium to encourage drinking, but this should be closely monitored in cats with kidney or heart conditions.

Urinary diets may also help keep your cat’s urine on the acidic side, which is about 6.0 to 6.5 on the pH scale (your veterinarian can monitor this, and you can do so with specific urine strips at home). A pH reading in this range may help dissolve struvite crystals and prevent their formation. The right pH balance comes from the right ingredients, such as cranberry support, herbal ingredients, and natural acidifiers like DL-methionine.

Pro Tip:

Food is not a cure-all or complete preventative for urinary health in cats, which is why your veterinarian should closely monitor your cat.

Vetstreet’s Top Healthy Cat Food Choices for Mineral Balance

Best Overall for Urinary Health:

Tiki Cat Solutions & Mineral Balance Adult Chicken Recipe

Buy at PetSmart

Key Urinary Health Features Formulated for mineral balance support, the guaranteed analysis of Tiki Cat Solutions & Mineral Balance Adult Chicken Recipe reveals a maximum magnesium level of 0.15 percent and a maximum phosphorus of 1.4 percent, both of which may help reduce crystal formation.

The high level of 34 percent crude protein helps support overall adult cat health in this grain-free recipe. Scientifically balanced with vitamins A and E, it also contains omega fatty acids to support overall feline health.

Pros The low maximum magnesium content of 0.15 percent, compared to other standard dry foods, is ideal for urinary health. The formula is grain-free and high in protein, ideal for cat moms and dads who prefer a premium cat food. The kibble formula is easy for pet parents and great for cats who enjoy dry food. Deboned chicken is packed with essential nutrients cats need. Reviewed and recommended by Tiki Cat veterinary nutritionists. Rich in omega-3s and 6s.

Cons Dry food tends to have lower moisture than canned or wet varieties, but a topper can be added for more moisture. Some of the formula’s ingredients may have a higher carb content (such as chickpeas and peas), which may be a consideration for felines with metabolic risks. The guaranteed analysis of 1.4 percent phosphorus max is moderate; check with your veterinarian to see if this percentage is acceptable. (All cats are different).

Why It Made the List We chose this formula because it boasts a strong combination of features designed for urinary health in cats. While not a prescription food, this is a higher-quality dry food with controlled minerals in a grain-free formula.

Best Wet / High-Moisture Option:

Tiki Cat Luau Succulent Chicken in Chicken Consomme

Buy at PetSmart

Key Urinary Health Features Tiki Cat’s Succulent Chicken Recipe in Chicken Consomme contains non-GMO ingredients, is grain-and-potato-free, and has 70-to-80 percent moisture to support hydration and help dilute urine, which may reduce the formation of crystals. The lower mineral levels of 0.10 percent magnesium and 1.04 percent phosphorus are ideal.

Pros The wet formula may benefit cats with urinary issues, as this helps with hydration. The shredded chicken in broth is likely to appeal to even the most finicky cat. Grain-free and potato-free formula means minimal filler ingredients. Chicken is free of hormones and antibiotics.

Cons This is not a prescription formula. Even with more moisture than dry food, cats must still drink water if they also eat dry food. Some cats may not care for the flavor if they just don’t like chicken.

Why It Made the List The Tiki Cat’s Succulent Chicken Recipe in Chicken Consomme is species appropriate, has a controlled mineral foundation, and is high in moisture. We like that it does not require a prescription and that its ingredients are transparent. Many reviews indicate cats devoured the food and really enjoyed the taste, too, which is a bonus.

Best Dry Option:

Purina ONE +Plus Urinary Tract Health Formula

Buy at PetSmart

Key Urinary Health Features With real chicken as the first ingredient, every ingredient in the bag has a purpose. The Purina ONE +Plus Urinary Tract Health Formula is low in magnesium and may help reduce urinary pH. We like that it contains four antioxidant sources to support a strong immune system.

Pros Two important urinary health factors with lower magnesium and urine pH control. Combines urinary support and overall adult cat needs, like proper protein and immune/antioxidant support. Real chicken is ideal for most cats that enjoy it as a protein source. Veterinarian-recommended in an easy-to-serve kibble format.

Cons Like most dry foods, it has a lower moisture content than wet foods, so additional hydration is necessary. Exact mineral thresholds are not fully revealed (i.e., magnesium, phosphorus, calcium, and sodium). Contains corn protein meal, which may not appeal to some cat parents.

Why It Made the List The Purina ONE +Plus Urinary Tract Health Formula provides urinary support for cats without a hefty price tag or prescription. This is one of the few readily available dry foods for cats with urinary issues that promotes a healthy pH level while keeping magnesium levels in mind. Purina is a name that most pet parents know and trust, thanks to their extensive research in the pet food market.

Best for Picky Eaters:

BLUE Buffalo True Solutions Urinary Care Chicken Recipe

Buy at PetSmart

Key Urinary Health Features Formulated by veterinarians and animal nutritionists, BLUE Buffalo’s True Solutions Urinary Care canned food focuses on maintaining recommended urine pH levels and a controlled magnesium level in cats. The high moisture content of up to 78 percent helps promote hydration, which may help prevent urinary crystals.

Pros The wet texture is more ideal for urinary health than kibble aloe. Picky eaters may love the natural ingredients of real chicken, free of by-products. Contains no corn, soy, or wheat. No artificial flavors or preservatives.

Cons This is not a prescription diet, which may be required for some cats. There is no guarantee a finicky cat will consume this or any other food. Not highly available online, other than sources noted.

Why It Made the List This formula stands out by combining clinical urinary support with clean, natural ingredients, which is rare in the non-prescription world. The wet format promotes hydration while maintaining healthy urinary pH and mineral balance, but what sets it apart is its appeal to health-conscious pet parents seeking holistic options without sacrificing functional benefits for finicky cats.

Best Vet-Formulated / Premium Option:

Hill’s Prescription Diet c/d Multicare Stress Urinary Care

Buy at PetSmart

Key Urinary Health Features This veterinary diet requires a prescription and is clinically tested and formulated by Hill’s nutritionists and veterinarians to reduce recurrence of urinary signs by up to 89 percent. It is specifically designed to help dissolve struvite stones in as little as 7 days, though the average is 27 days. It may help promote a urinary environment in your cat’s bladder, reducing the risk of calcium oxalate or struvite crystals. The controlled levels of key minerals are ideal, too.

Pros Potassium citrate may help acidify urine and reduce crystal formation. Designed for lifelong feeding to cats suffering from urinary health concerns. Requires a veterinary prescription because it is a therapeutic strength diet. The 89 percent reduction in recurrence according to Hill’s is a strong point. Easy-to-serve kibble formula.

Cons Some pet parents may balk at the need for a prescription. A bit pricier due to its ingredients and veterinarian-recommended formula. It may not solve all urinary issues, including blockages and stone removal. Some cats may not find it palatable.

Why It Made the List This formula earns the Best Vet-Formulated or Premium Option designation for its combination of clinical research, veterinary endorsement, and proven results in managing urinary conditions. Further, Hill’s c/d Multicare represents the gold standard for cats with diagnosed or recurrent urinary issues, offering precise mineral control and urinary-specific ingredients backed by extensive clinical testing from a leading veterinary nutrition brand.

Best Budget-Friendly Option:

IAMS ProActive Health Urinary Tract Health Adult Dry Cat Food

Buy at PetSmart

Key Urinary Health Features Formulated to reduce urinary pH and promote feline urinary tract health, the IAMS Proactive Health Urinary Tract Health chicken formula is well-priced. It features DL-methionine for urinary acidification support and has chicken as the first ingredient.

Pros Widely available at most retailers and online. High-quality chicken protein from a trusted brand. Convenient dry format makes feeding easier. More affordably priced than others. Contains essential ingredients like calcium and potassium.

Cons It has a lower moisture content than wet food, which isn’t ideal for cats who don’t drink much water. Contains grains such as corn and rice. Does not explicitly disclose the specific mineral levels in each bag.

Why It Made the List This IAMS formula earns its place as the Best Budget-Friendly Option because it makes urinary support achievable for cat parents. It bridges the gap between everyday kibble and costly prescription diets by providing meaningful urinary-tract nutrition and gentle pH balance without the hefty price tag or veterinary authorization.

How We Selected & Evaluated Foods

We used the following criteria when selecting and evaluating each cat food for urinary health on our list: - Mineral content and balance - Ingredient transparency and quality - Moisture content and hydration support - Veterinary involvement or nutritionist input - Real-world feedback and reviews from pet parents - Price point - Accessibility - Need for a prescription or not - Palatability, even for finicky cats

Buyer’s Guide: What to Look For in a Cat Food for Urinary Health

Before you start your cat on a new food, for urinary health or otherwise, it’s always a good idea to speak with your veterinarian or veterinary nutritionist. Here are some other key points to look for: - Low Magnesium Levels - Balanced Urinary pH - Ample Hydration Support - Seek High-Quality Animal Proteins - Smart Sodium & Filler Choices - Transparent Formulas & Reliable Brands - Taste & Feeding Compliance

Pro Tip:

If your cat eats when you are away, consider using an in-home camera to monitor the behavior and the amount eaten.

Consider Prescription Diet

For cats diagnosed with stones, blockages, chronic urinary issues, or recurring infections, non-prescription diets may not be enough. Veterinary-prescribed formulas provide the precise mineral and pH control needed for accurate therapeutic results.

Feeding Tips & Best Practices

Be aware of these time-tested tips and best practices when switching or feeding your cat a diet for urinary health: - Gradual Diet Transition - Encourage More Water Consumption - Monitor the Litter Box

Pro Tip:

Take photos or video of your cat’s litterbox to show your veterinarian.

Caution & When to Consult a Veterinarian

Never second-guess things if your cat seems off, and keep in mind that a diet is not a cure-all for cats with urinary issues. For example, some stones need surgery, infections require antibiotics, and blockages demand emergency treatment.

If your cat strains to urinate, produces little or no urine, cries or is very vocal in the litter box, urinates outside of it, or you see blood, contact your veterinarian immediately. Male cats are especially at risk of life-threatening blockages within 24 to 48 hours.

Final Thoughts On Cat Food For Urinary Health

The right food plays a vital role in your cat’s urinary wellness in helping balance pH, regulate minerals, and support hydration to keep the urinary tract functioning smoothly. It may also reduce the risk of crystals, prevent recurrences, and keep your cat comfortable long term.

However, the best urinary health diet is the one your cat will actually eat every day. Consider their taste preferences, texture likes, health status, and your budget. Cats with a history of urinary issues have different needs than those without, so match the food to your cat’s individual situation. No two cats are alike.

Before switching diets, especially for cats with past or current urinary problems, consult your veterinarian. They can help identify the cause, recommend the right formula, and ensure the diet truly supports your cat’s health and comfort. Here’s to happy, healthy cats everywhere.

Friends and Colleagues Raise Over $40K for UPMC Nurse Attacked by Patient

Friends and Colleagues Raise Over $40K for UPMC Nurse Attacked by Patient

Friends and Colleagues Raise Over $40K for UPMC Nurse Attacked by Patient

Travis Dunn's Recovery and the Call for Workplace Safety

Travis Dunn, a patient care technician at UPMC Altoona, has been released from the hospital after being severely injured in an attack by a patient. His recovery is now taking place at home, with continued support from his employer. "I am pleased to share that Travis Dunn, our patient care technician injured in the horrific attack on Saturday, has been released from the hospital and will be continuing his recovery at home with continued support from us," said Mike Corso, president of UPMC Altoona, in a statement.

Dunn was attacked in the emergency room, where he suffered a fractured skull, bleeding on the brain, and other serious injuries. The incident left him unconscious and required immediate medical attention. While recovering at UPMC Presbyterian Hospital in Pittsburgh, friends and colleagues began raising funds for his medical expenses. A GoFundMe page was created, which has raised over $40,000 — close to its $60,000 goal.

UPMC has assured that Dunn will receive full pay and benefits during his recovery and will not need to use any paid time off. Worker’s compensation is already in place, with a priority process for insurance claims and no out-of-pocket expenses for the employee.

A Growing Concern: Workplace Violence in Healthcare

The incident has sparked renewed calls for action from UPMC Altoona employees, who have long expressed concerns about the increasing violence in healthcare settings. Nurses and staff have reported daily incidents of verbal or physical assaults, with some describing the current situation as a crisis.

Jaime Balsamo, a nurse at UPMC Altoona, shared her frustration with Pittsburgh's Action News 4 reporter Sheldon Ingram. "We've been telling UPMC for years that we need more safety measures implemented, and we kept saying something bad is going to happen, and it did." Leann Opell, another nurse, echoed these sentiments, stating that the recent attack was the worst she had seen.

State Rep. Bridget Kosierowski, a co-sponsor of the Pennsylvania Healthcare Workplace Violence Prevention Act, has also spoken out. Although the bill passed the House in May, it has yet to move forward in the state Senate. Kosierowski highlighted the dangers faced by healthcare workers, citing incidents such as a man entering an intensive care unit with a gun and using it against staff.

Recommendations for Safer Workplaces

Employees at UPMC Altoona are urging administrators to take stronger steps to prevent future attacks. Some of the recommendations include:

  • A full and transparent investigation into the incident, including how and why current safety protocols failed, and what measures could have prevented it
  • A clear, enforced zero-tolerance policy for violence or threats against healthcare workers — by patients, visitors, or staff
  • Posted signs in every area of the hospital that assaulting a healthcare worker is a felony
  • Panic alarms installed in every patient care area
  • Metal detectors installed at all patient and visitor entry points
  • Enhanced security presence and faster response times, particularly in high-risk areas such as the ER, and during off-peak hours
  • Mandatory de-escalation and workplace safety training for all staff, with regular refreshers
  • Comprehensive support for affected employees, including paid leave, trauma counseling, and legal or workers’ compensation assistance as needed
  • Direct involvement of frontline employees and union representatives in developing and implementing safety improvements

UPMC's Response and Commitment to Safety

In response to the incident, UPMC Altoona released a statement emphasizing their commitment to a safe environment. "We are committed to maintaining a safe environment in which to give and receive care. When any member of our UPMC family is injured, our first priority is their health, recovery, and well-being."

The statement also highlighted the swift actions taken by UPMC Police and Emergency Department teams, who arrived within 47 seconds of the initial contact. The assailant was arrested and transferred to Blair County prison without bail. UPMC has also mentioned ongoing efforts to enhance safety, including advanced education and de-escalation training, active drills, panic buttons, secure rooms, and enhanced facility entrance technologies.

Recent Updates and Community Support

On November 5, 2025, UPMC Altoona President Mike Corso sent an internal email addressing the incident. He reiterated the organization’s commitment to safety and provided clarity on the situation. "We are incredibly grateful for the swift, courageous response of our UPMC Police and Emergency Department teams, whose actions prevented further harm and ensured our colleague received immediate care."

The email also emphasized the importance of supporting affected employees, with resources available through CISM-ASAP, LifeSolutions, and Spiritual Care teams.

Friends and coworkers continue to show their support for Travis Dunn, with many expressing hope for his full recovery. As the healthcare community grapples with the growing issue of workplace violence, the incident at UPMC Altoona serves as a reminder of the urgent need for systemic change.

Thursday, November 6, 2025

Legislature Advances 'Medical Aid in Dying' Bill for Governor's Review

Legislature Advances 'Medical Aid in Dying' Bill for Governor's Review

The Debate Over Medical Aid in Dying

CHICAGO, Ill. – A new bill has been passed by the Illinois legislature that could allow terminally ill adults to access life-ending medication prescribed by a physician. This legislation, known as Senate Bill 1950, is currently awaiting the governor’s signature and, if signed, would take effect after nine months. The measure has sparked a heated debate between advocates and opponents, with supporters emphasizing compassion and autonomy while critics raise concerns about potential risks and ethical implications.

How the Bill Was Passed

The bill was approved by the Senate with a vote of 30-27 on Oct. 31, following its passage in the House with a 63-42 vote in May. It now only needs the governor's approval to become law. Advocates believe this will provide terminally ill individuals with a sense of control over their final days, while opponents express worries about the impact on vulnerable populations and religious values.

Support from Advocates

Suzy Flack, an advocate from Chicago, has been a strong supporter of the bill. She pushed for it in memory of her son Andrew, who died of cancer in 2022. Andrew chose to live in California, where medical aid in dying options were available, and he experienced a peaceful death. Flack believes that the bill will bring comfort to others in similar situations.

"Inevitably, losing a child is the hardest thing that anyone could go through," Flack said. "I am just comforted every day by the way his death was so peaceful. He had some control over things."

What the Bill Includes

Senate Bill 1950 outlines specific requirements for eligibility. Patients must be Illinois residents aged 18 or older with a terminal illness that is expected to result in death within six months. Two physicians must confirm the diagnosis. A diagnosis of major depressive disorder alone does not qualify patients for the medication.

Patients must make both oral and written requests for aid in dying. Physicians are required to evaluate the patient’s mental capacity and assess for any signs of coercion or undue influence. They must also inform patients of alternative hospice care and pain management options before prescribing the medication.

Those who qualify must be able to self-administer the medication, and they retain the right to withdraw their request at any time or choose not to ingest the medication.

Death certificates for those who use the medication will list the cause of death as the underlying terminal disease, not suicide.

Safeguards and Concerns

Bill sponsor Linda Holmes, D-Aurora, emphasized that there are over 20 safeguards in place to prevent abuse or coercion. She cited Oregon’s 28-year history of medical aid in dying, noting that no substantiated cases of coercion or abuse have occurred there.

However, critics like Jil Tracy, R-Quincy, expressed concerns about the six-month prognosis window. She argued that medical advancements can sometimes extend a patient’s life beyond the initial diagnosis. Holmes responded that doctors typically overestimate patients’ prognoses and that most patients who qualify do not end up taking the medication.

Tracy also raised concerns about the potential for potent drugs to fall into the wrong hands, particularly among young people struggling with mental health issues.

Impact on Physicians and Culture

Sen. Steve McClure, R-Springfield, drew parallels between veterinarians and physicians, suggesting that providing end-of-life care could create a mental health crisis among medical professionals. The American Medical Association has long opposed physician-assisted aid in dying, calling it incompatible with the physician’s role as a healer.

The bill does not require physicians to prescribe the medication and protects them from legal consequences for either prescribing or refusing to do so.

"Nobody who doesn’t want to be involved is going to have to be involved," McCurdy said.

Opposing Views

Sen. Chris Balkema, R-Channahon, called the bill a "slippery slope" and warned against introducing a "culture of death" in Illinois. He pointed to other states that have expanded medical aid in dying options over time.

Advocates argue that the bill is not about promoting death but about giving agency to those who are already dying. Suzy Flack emphasized that the term "assisted suicide" is misleading and insulting to those who seek to live.

Compassion, Not Suicide

Sen. Laura Fine, D-Glenview, described the issue as one of choice and compassion. She stressed that the bill is not about suicide but about allowing terminally ill individuals to make decisions about their own lives.

Flack hopes Gov. JB Pritzker will sign the bill to provide agency to people like her son. At a recent news conference, Pritzker said he was reviewing the legislation and acknowledged the pain of those facing terminal illnesses.

"I know how terrible it is that someone who’s in the last six months of their life could be experiencing terrible pain and anguish," Pritzker said.

How to deal with a returning married man: Expert guidance

How to deal with a returning married man: Expert guidance

Understanding the Emotional Complexity of Being Pursued by a Married Man

In the intricate web of human relationships, few situations are as emotionally challenging as being pursued by a man who is already married. This scenario is riddled with confusion, emotional turmoil, and moral questions that can leave a person feeling lost and vulnerable. Navigating this situation requires not only emotional strength but also a clear understanding of personal values, self-worth, and the importance of setting healthy boundaries.

The woman involved in such a situation often experiences a wide range of emotions—from initial confusion and hope to frustration, anger, and feelings of being used. These emotions are natural but can be dangerous if left unchecked. The persistence of a married man may lead to unrealistic expectations or fantasies, which can ultimately erode one's self-esteem and prevent the pursuit of healthier, more fulfilling relationships.

Exploring the Motivations Behind His Behavior

To better understand the dynamics at play, it’s important to examine the possible reasons behind his actions. Is he seeking an escape from his current marital life? Is he looking for validation, or is this a selfish impulse? According to clinical psychologist Dr. Ana Garcia, "his pursuit is rarely about genuine love and more often about unmet personal needs, an escape, or an ego boost. It's not your responsibility to fill that void or rescue him from his own life."

This perspective helps to depersonalize the situation and view it from a more objective standpoint. Recognizing that his actions are not necessarily about you can be a crucial step in protecting one's emotional well-being.

Prioritizing Your Own Emotional Well-Being

The first and most important priority in this situation should always be your own emotional health. Maintaining any connection—no matter how small—with a married man is likely to lead to pain and frustration. The hope that he will eventually leave his wife is often an illusion that prolongs suffering.

Dr. Ricardo Soto, a relationship specialist, warns that "every message responded to, every secret meeting, is another brick in an emotional prison that you are building yourself. Your peace of mind and dignity must be non-negotiable."

Setting Clear Boundaries

Setting firm and clear boundaries is essential in these situations. Dr. Elena Morales, an expert in codependency, emphasizes that "setting firm and non-negotiable boundaries is an act of self-love. You don't have to justify your decision or feel guilty for protecting your space and heart."

It's common for a woman to cling to the fantasy that the man will eventually leave his wife for her. However, promises of a future together while he remains married are rarely fulfilled. When they do happen, the resulting relationship is often built on a foundation of distrust and guilt.

Seeking Professional Support

Navigating this complex situation can be overwhelming, and seeking professional support can be invaluable. A therapist can offer tools to process emotions, strengthen self-esteem, and develop strategies to close this chapter healthily. Talking to trusted friends and family can also provide a much-needed support network.

Clinical psychologist Dr. Laura Perez states, "A therapist can help you unravel emotional complexities, strengthen your self-esteem, and develop strategies to close this chapter healthily, allowing you to heal and rebuild."

Tips for Moving Forward

  1. Don’t idealize his return
    The fact that he’s reaching out doesn’t mean he’s changed or that his current relationship is broken. Often, what he’s seeking is emotional validation or a temporary escape from routine, not a real reunion.

  2. Recognize what it really triggers in you
    When he comes back, it’s natural to feel a mix of surprise, excitement, and confusion. However, recognizing those emotions allows you to make decisions from clarity, not nostalgia.

  3. Maintain firm boundaries
    If he’s already married, your role in his life should be nonexistent. Don’t accept personal conversations, dates, or memories disguised as friendship.

  4. Remember why the relationship ended
    It’s common for memory to select only the good moments. However, it’s important to bring to mind the reasons that separated you.

  5. Don’t become his emotional refuge
    Some men seek support outside their marriage when facing difficulties. If you fall into that role, you expose yourself to an unbalanced and futureless bond.

  6. Don’t confuse attention with love
    A message, a call, or an "I miss you" doesn’t always mean genuine feelings. Often, they're just looking to feed their ego or see if they still have power over you.

  7. Remember that his new partner deserves respect
    Regardless of your history with him, he now belongs to another relationship. Being part of an emotional triangle only generates guilt and pain.

  8. Avoid justifying him
    Phrases like "He's confused," "He doesn't really love her," or "He seeks me because he still feels something" are common but dangerous.

  9. Don’t respond immediately
    If he contacts you, take time to think before responding. Impulsivity can make you say something you'll later regret.

  10. Protect your self-esteem
    Accepting that someone you loved chose someone else can hurt, but it doesn’t define your worth.

  11. Seek emotional support if needed
    Talking to a therapist or someone you trust can help you sort out your emotions.

  12. Don’t fall into the "just friends" game
    That phrase is often the disguise of an emotional bond that hasn’t ended.

  13. Accept that the best is already over
    Acceptance isn’t forgetting; it’s understanding that what was lived fulfilled its purpose.

  14. Rebuild your inner world
    Use this situation as an opportunity to strengthen your self-esteem, personal goals, and well-being.

  15. Close with love, not resentment
    Closing with serenity is an act of maturity. You don’t need to hate him or seek emotional justice.

Urban Life and the Rise of Chronic Stress in Modern Society

Urban Life and the Rise of Chronic Stress in Modern Society

The Rise of Chronic Stress and the Evolutionary Mismatch

Chronic stress is becoming more prevalent, according to evolutionary anthropologist Colin Shaw. He argues that this increase stems from an evolutionary mismatch—our bodies and brains, which have evolved over hundreds of thousands of years for hunter-gatherer conditions, are now exposed to industrialized, urban environments. Is there a solution?

It's the end of July, and it's raining heavily in Zurich. I'm sitting on a foldable chair under the canopy of old-growth beech trees, protected by an umbrella. I take deep breaths as I listen to birdsong breaking through the steady sound of raindrops hitting the forest floor. Water flows down the wide tree trunks, having collected from the branches above. A knotty maze of roots ahead seems to form a natural enclosure. "How was it?" asks a voice.

Colin Shaw walks over from where he had been standing barefoot, in his trekking sandals in the rain for the past few minutes. As an evolutionary anthropologist and head of the Human Evolutionary EcoPhysiology (HEEP) research group at the University of Zurich, he gave me an assignment when we arrived at this clearing on the edge of Zürichberg forest: choose your favorite spot, take in the environment, and focus on each sense step by step. What sounds can you hear? What can you smell? What movements can you observe?

Rolling in the Mud for Science

With these instructions, we aim to recreate part of an experiment that Shaw and his research group conducted last summer. The team, consisting of specialists from ecology, immunology, microbiology, cognitive psychology, and exercise science, had 160 people spend three hours walking and sitting in one of three different environments: Sihlwald, a coniferous forest just outside Zurich; Mont Tendre, a deciduous forest outside Lausanne; and Zurich's Hardbrücke area, an urban setting.

"In the forest," Shaw laughs, "we got people down and dirty, hugging trees, playing with the soil microbiome, and everything else."

Before and after being exposed to the natural and urban environments, the researchers measured a range of biomarkers in participants' blood, saliva, and cognitive capacity. In the woods, people showed significantly lower blood pressure, better immune response, and improved psychological state. In contrast, those in the urban environment exhibited higher blood pressure and strong physiological and psychological stress reactions.

Although we aren't taking any measurements in today’s torrential rain, I can feel the effect of the experiment. In the woodland environment—which, as Shaw points out, is "closer to our ancestral condition than a city environment"—I feel calm. My pulse is steady, and my stress level dissipates. Shaw jokes that the rain may have even improved the dispersal of phytoncides, volatile organic compounds released by trees that offer immune-boosting benefits to humans—as demonstrated by the forest bathing (shinrin-yoku) movement in Japan.

Lions Everywhere

The next experimental setting for today will be a busy intersection. As we walk along a small path and climb over fallen branches to rejoin the main forest road, Shaw gives me a summary of his main research hypothesis. From an evolutionary standpoint, he says, the industrialized, urbanized environments we've built place a chronic stress load on our bodies, taking a toll on both physical and mental health.

"Whereas physicians would talk about this as 'ill health,' we try to determine the evolutionary context to understand whether our surroundings are making us sick—and which environment will help us recover," he says.

In a recent research paper co-authored with Daniel Longman, a longtime collaborator and fellow Cambridge alumnus from Loughborough University, Shaw argues that the extensive environmental shifts of the Anthropocene have undermined human evolutionary fitness.

Evolutionary success of a species amounts to survival and reproduction, and, according to the authors, both factors have been severely compromised in the last 300 years since the beginning of the Industrial Revolution. They support their theory with evidence of declining global fertility rates and increases in chronic inflammatory conditions such as autoimmune diseases. They also cite impaired cognitive function in urban environments. Chronic stress plays a key role as the cause of many of these conditions.

"In our ancestral state, we were well-adapted to deal with acute stress to evade or confront predators. Fight or flight. The lion would come around occasionally, and you had to be ready to defend yourself—or run," Shaw explains. "The key is that the lion goes away again. Such an all-out effort guaranteed survival, but it was very costly and required lengthy recovery."

This acute stress response was ideal for mobilizing adrenaline and cortisol while fighting for survival in our hunter-gatherer past. However, it is mismatched for today's steady stream of challenges.

"Our body reacts as though all these stressors were lions," he continues. "Whether it's a difficult discussion with your partner or your boss, or traffic noise, your stress response system is still pretty much the same as if you were facing lion after lion after lion. As a result, you have this very powerful response from your nervous system, but no comedown."

The Hidden Costs of Progress

As we continue our walk down Letzistrasse into the city, the water gushes down the gutter, and the traffic noise, amplified by the rain, swells. "Essentially, there's a paradox where, on the one hand, over the last three hundred years we've created this tremendous wealth and comfort and healthcare for a lot of people on the planet," Shaw speaks louder to be heard over the roar of a large construction vehicle passing by on Winterthurerstrasse.

"But on the other hand, some of these industrial achievements are having quite detrimental effects on our immune, cognitive, physical, and reproductive functions. For example, since the 1950s sperm count and motility rates have dropped dramatically in men, which is tied to pesticides and herbicides in food, but also to microplastics," Shaw says.

As we arrive at the intersection with Irchelstrasse, I get to choose where to set up my foldable chair again. Instinctively, I opt for a corner where I can at least feel the greenery from Irchel Campus behind me. For the next 15 minutes, I observe the heavy traffic approaching from all sides, my eyes darting around. The deafening noise—a mix of roaring engines, water spraying from the wheels, plus jackhammers from roadworks—drowns out any other thought in my brain. My breathing becomes shallower, the entire body tenses up. I'm relieved when Colin Shaw tells me we can now move on to friendlier surroundings, and we head into Irchel Park.

"There was no real danger, yet my jaw is clenched," he states. "It's the constant stimulation. We didn't evolve to be constantly stimulated."

Of course, compared to megacities with tens of millions of inhabitants, such as Tokyo, Delhi, and Shanghai, "Zurich is barely a city," Shaw concedes. "It's surrounded by forests; there's a lake and a river. It also has a comfortable public transit system."

However, research by the HEEP group clearly indicates that even in a city that is frequently ranked among the most livable, urban exposure is physiologically and psychologically stressful and impairs immune function.

Today, an estimated 4.5 billion people—more than half the world's population—live in urban agglomerations. By 2050, that figure is projected to rise to 6.5 billion, or more than two-thirds of humanity. Recognizing industrialization and urbanization as health risks will be crucial for safeguarding public health—or, in evolutionary terms: the fitness of our species.

We Can't Adapt Our Way Out of This

It's hard to believe that our brains have grown accustomed to juggling ever-new digital innovations—yet remain rooted in a prehistoric past when it comes to regulating our nervous systems. Why haven't we adapted to the living conditions that our species has created?

"You could argue that the stress responses we're seeing today are a form of adaptation. However, biological adaptation is very slow. Longer-term genetic adaptations are multigenerational. So that's tens to hundreds of thousands of years," Shaw points out.

"From an evolutionary perspective, if people are dying from chronic stress or stress-related diseases, you could say that this is natural selection taking place. If you let that go on for hundreds of generations, people would probably become better able to deal with chronic stress," he says. Clearly, that's not a feasible solution to our current predicament—a physiological conundrum with no quick evolutionary fix.

So, if there's no way our current physiology will buffer chronic stress, how can we redress this mismatch? According to Colin Shaw, one solution is to fundamentally rethink our relationship with nature—treating it as a key health factor and protecting or regenerating spaces that resemble those from our hunter-gatherer past. Another is to design healthier, more resilient cities.

"I'm not an engineer or an architect," he says, "but our research can identify which stimuli most affect blood pressure or heart rate and pass that knowledge on to decisionmakers."

And both avenues are deeply interconnected, he argues: "We need to get our cities right—and at the same time regenerate, value, and spend more time in natural spaces."

We have returned to his office with a standing desk and no chair. It seems like a small act of defiance against today's sedentary lifestyle, which is so distant from our ancestral condition.

"As an evolutionary anthropologist, my earlier work focused on Neanderthals and bone adaptation, which was fascinating in its own right," Shaw reflects. "But the challenges we face today feel more urgent. Those with the resources—financial or intellectual—have a responsibility to invest them in solving these problems. To me, it's a moral imperative to do the right thing."