Thoughts

Joel Selanikio Joel Selanikio

The First Healthcare Demand Shock of the 21st Century

GLP-1 medications may do far more than treat diabetes or reduce weight. If they substantially cut obesity and metabolic disease, they could trigger the first large-scale decline in healthcare demand seen in the modern era. This piece explores how earlier demand shocks reshaped medicine, why GLP-1s pose a similar challenge for chronic-disease–based service lines, and what hospitals must do now to prepare for a world with fewer cardiometabolic patients.

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Joel Selanikio Joel Selanikio

The New York Times Got Smaller — Healthcare Is Next

The New York Times built one of the best digital products in media—yet its real revenue and profit have fallen by more than half. That’s what disruption actually looks like: the work moves elsewhere while the industry shrinks. Healthcare is now entering the same pattern, driven by consumer tech, GLP-1s, and safer mobility. We’re heading toward better health—and a smaller healthcare system.

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Joel Selanikio Joel Selanikio

Disruption for Doctors 1: What’s Disruption?

Most doctors, nurses, PAs, techs, and others in healthcare aren’t familiar with the term “disruption” and are unaware of how technological trends have already begun disrupting their current business models. This post is the first of three that will provide a basic understanding of the term, and the phenomenon.

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