Every Seat
I've worked nearly every tier of dialysis — technician, nurse, charge nurse, manager, medical-device sales, and now quality and safety. Moving through those levels is what let me see the common denominators: the same problems wearing different clothes depending on where you're standing.
Make It Understandable
I like solving problems, and I like making complicated things understandable. Most of what's broken in this system isn't hidden — it's just illegible.
Show the Work
What I publish is my interpretation of how the system works, shown openly so it can be corrected. That's part of the point, not a disclaimer.
Working as Designed
The outcomes aren't accidents. The system produces exactly what its incentives are built to produce — so I read the design, not the people. Most of the harm isn't anyone being wrong; it's everyone optimizing locally for the part they can see.
A public atlas of how the U.S. dialysis system connects: care, money, regulation, and accountability. Built so the people inside it and the people governing it can see the same picture.
→ the-access.coThe verified dataset underneath The Access — 47 entities, 62 relationships. One data model; every plate is generated from it, so the map and the data can never drift apart.
An academic medical center. Governance architecture, quality infrastructure, and survey readiness for a home-dialysis program.
Fifteen years. I didn't specialize down one lane — I went across. That line is the qualification.
Twelve views of the U.S. dialysis system.
Each one started as a question I couldn't find a straight answer to — what happens to a patient, how the money moves, when everything's due. Three to start with:
All twelve live on The Access — each generated from one verified dataset, each carrying its sources and the date it was last checked.
→ Explore all twelve at the-access.coThe long-form read: how the U.S. dialysis system actually fits together, written from inside it.
→ the-access.co/essayWrite to me.