The Diseases Killing Our Hospitals: Reflections on a Crisis of Meaning in Medicine

I was born in a hospital that was killed. Cause of death: private equity.

In 1983, I arrived at Crozer-Chester Medical Center in Upland, Pennsylvania. My mom, 25-year-old Janet, labored with me from Thursday to Sunday before going for a C-section. My two sisters were born at Crozer, too. The hospital's roots went back to 1893. By the time I was born there, it had become the backbone of healthcare in Delaware County. A Level II trauma center, the county's only burn unit, a teaching hospital where babies were delivered and lives were saved for over a century.

In 2016, Prospect Medical Holdings (backed by the private equity firm Leonard Green & Partners) acquired Crozer Health for roughly $300 million. What followed was the now-familiar extraction playbook: load the system with debt, execute sale-leaseback deals that turn hospitals into tenants of their own buildings, pay out hundreds of millions in dividends to investors, defer maintenance, cut services, walk away. Leonard Green's investors collected $424 million. Prospect's former CEO took home $90 million. The facilities deteriorated so badly that when other health systems came to evaluate a potential purchase, they called them teardowns.

By 2022, two of Crozer's four hospitals had been shuttered. In January 2025, Prospect declared bankruptcy. By spring, a federal judge approved the closure of the remaining hospitals, including Crozer-Chester. Delaware County went from six hospitals to two. A young man was shot a block from where the trauma center had been and died during the 30-minute drive to the next nearest hospital.

A state senator said it plainly: Crozer survived the Civil War, but it couldn't survive private equity.

My parents still live in Delaware County. The places that could care for them in an emergency are disappearing. This is not an abstraction for me. It is my mother and father, aging in a community that is becoming a healthcare desert.

And I think about the more than six thousand people who once worked at Crozer — the nurses, doctors, techs, and aides who only learned what private equity was by watching their hospital be stripped from the inside out. Who showed up because patients still needed them. Who didn’t know from one day to the next whether they’d have a job. By the time Crozer finally closed, more than 2,600 of them were laid off. All because investors in Los Angeles decided there was more money in dismantling hospitals than in running them.

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Recently, a doctor friend in another hospital system told me a story.

She was working on a hospital unit when a young woman — a family member of a patient who'd died — was overcome with grief. The woman flung herself onto the sink at the end of the hallway. The motion sensor activated, and water ran onto her head. Surprised, she jerked up and hit her head on the faucet.

The doctor asked a nursing assistant to grab a nearby chair so the woman could sit down.

He refused. Visitors weren't allowed to sit on chairs with wheels. Liability.

There were no non-wheeled chairs anywhere in the hallway. A grieving woman with water on her face and a bruise forming on her head and no place in the entire corridor for her to sit.

The doctor got her a wheeled chair anyway. She stood by the woman, her hand on her back. Another nurse informed her, again, that this was not allowed.

The policy didn’t exist to protect her. It existed to protect the balance sheet. And in the absence of a single stationary chair — a ten-dollar object — the protocol was to let a woman grieve on the floor, or draped over a motion-sensor sink.

As she told me this story, we laughed. The way doctors laugh when the absurdity becomes unbearable. I told her about a physician who nearly fell out of his rolling chair during one of my residency rotations. I’d warned him to be careful, or we’d all have to complete a hundred-slide training next year called “How to Sit in a Chair.” Everyone had cracked up, because it was so accurate.

The problem is that those mundane indignities accumulate. Each policy seems minor. A chair restriction. A training module. A form. But taken together, they are the mechanism by which the system squeezes humanity out of healthcare. And every day, physicians and nurses face the same quiet choice: follow the rule, or be a human being. Over time, the weight of making that choice — and the cost of making it — wears you down.

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A hospital where I was born, demolished by private equity. A chair that a colleague wasn’t supposed to offer a grieving woman. Two stories from two different scales. One institutional, one intimate. But both are stories of a system destroying itself.

If private equity is a cancer on healthcare — an external force that invades, extracts, and kills the host — then the bureaucratic machinery of liability and compliance is something closer to an autoimmune disease: the system’s own defenses turning against its purpose. One is malignant. The other is the body attacking itself. Both leave physicians standing in the wreckage, trying to heal.

For many physicians, medicine is not just a career. It is vocational. It is close to sacred. We took up this work to be present at the thresholds of life and death, to ease suffering, to bear witness. When the structures around that work are systematically corrupted, the injury is not just professional. It is spiritual.

I don’t use that word lightly. But in palliative care, we have a name for what happens when a person loses their sense of purpose and meaning in the face of forces beyond their control, driven by disease. The clinical name for it is demoralization. It is distinct from depression. It is a syndrome of helplessness, entrapment, and the collapse of hope. I spent years diagnosing it in my patients. Now I recognize it in my colleagues and in myself. This is not burnout. This is a crisis of meaning.

I know this crisis because I have lived it. I stepped away from full-time medicine. I started over. And the work I do now – coaching physicians who are in this same crisis – is my way of attending to it. The same way you would attend to any profound loss.

Naming it. Grieving it. Creating space for others to grieve. Shedding light on painful thoughts and feelings. Cultivating insight. Laying out options. Identifying what influence you still have. Developing clarity. Moving from clarity to action. That's the mission of my coaching practice — helping physicians cut through the fog, find clarity, and act on it.

Because the doctor with the chair? Together, we realized that hers is also a story about agency. She decided: I am the doctor. I have the standing to risk whatever consequence comes from breaking this policy, and I am going to do the right thing. She was told no twice, and she did it anyway. She stood with a grieving person and put her hand on her back. That is medicine. That small, defiant act of humanity — choosing the person over the policy — is what most of us signed up for. That is worth celebrating.

And the hospital where I was born? There is a fragile note of hope: new owners purchased the Crozer-Chester campus in early 2026 with plans to restore hospital services in partnership with a nonprofit health system. The community is fighting to rebuild what was taken.

They are rebuilding. And so will we.

Dr. Christie Mulholland is a Certified Physician Development Coach and the founder of Reclaim Physician Coaching. She is an Associate Professor and Associate Director of Well-being for the Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. She is board-certified in Internal Medicine and Hospice and Palliative Medicine. She is the Director of the Faculty Well-being Champions Program for Icahn School of Medicine's Office of Well-being and Resilience. Dr. Mulholland's mission is to help physicians navigate the crisis of meaning in modern medicine — reclaiming agency, purpose, and the humanity at the heart of their work.