Medically Lost: Inside Medicine’s Systemic Dysfunction

By Robert Spearman. First published June 23, 2025.

Why I Wrote This

Why do so many patients fall through the cracks—misdiagnosed, dismissed, or left to navigate illness alone? This longform essay explores why our medical system fails complex patients—not because of bad actors, but because of structural blind spots, misaligned incentives, and a culture that resists complexity.

Drawing on systems thinking, economics, and personal experience, it maps out the deeper causes of diagnostic delay, mislabeling, and invisible suffering—and why even well-meaning care often goes wrong.

What You’ll Find

Why chronic, multisystem illness is so often misunderstood
How diagnostic culture, insurance coding, and institutional norms derail care
What gets missed when medicine focuses on symptoms instead of systems
Why patients are forced into self-advocacy—and what we can learn from them
Ideas for change—from policy to mindset to practice

Who It’s For

Whether you’re a patient, clinician, policymaker, or just trying to understand why modern medicine feels so broken, this piece is meant to help you see the system more clearly—and think differently about how it could change.

Read the Full Document

Download the Free PDF Read the Web Version

Like What You Read?

This essay is part of the foundational thinking behind Sympa, a platform we’re building to help patients with complex or chronic illness make sense of their symptoms, history, and genomics.
Learn more about Sympa.