On sale November 3, 2026 · CMIO, LLC Publishing

The Diagnostician

American Healthcare Is Sick, Misdiagnosed, and Getting Worse; It's Time to Call the Doctor.

Thomas Powell, MD MS · Forewords by David Lubarsky, MD, MBA, and W. Ed Hammond, PhD

The argument

The disease was never the technology

American healthcare has a serious illness masquerading as a technology problem. The symptoms can be seen by all: spending and cost, quality, safety, burnout, and low patient satisfaction with the product.

For two decades the prescription has been more technology: a bigger EHR, a new analytics platform, the latest AI tool. Each arrived without a diagnosis of what it was meant to treat.

The Diagnostician applies the oldest tool in medicine, the diagnostic method, to the healthcare system itself: chief complaint, workup, differential, and a working diagnosis committed to in writing. Applied clinical informatics, led by a physician trained to read the whole chart, is the treatment.

When the prescription is hurting the patient, the standard of care is to change the prescription. In healthcare, we keep refilling it.

From the book
Inside · 17 chapters in 7 parts

Organized like a patient's course

Every chapter closes with Bedside Questions. Each set is a free exam in the Exam Room. Click any chapter to take it.

Praise

From the forewords and early readers

It is the rare book that takes a history, examines the patient, reads the data honestly, and reasons its way to a treatment. It is rarer still in being right.

David A. Lubarsky, MD, MBA · President & CEO, WMCHealth

This is one of the best books I have read. Dr. Powell writes from the perspective of a clinician and an informaticist, and he clearly knows what he is talking about.

W. Ed Hammond, PhD · Director, Duke Center for Health Informatics

The Diagnostician is a must-read for everyone in healthcare, and especially for those searching for solutions to a broken system.

Jacques Orces, DO, MS, FAAP · VP & CMO, Nicklaus Children's Hospital
Editions & where to buy

Choose your edition

Kindle eBook

Pre-order now

Delivered to your Kindle on November 3.

Pre-order openAmazon Kindle
Paperback

Black and white

ISBN 979-8-9961314-1-9

November 3

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Hardcover

Black and white

ISBN 979-8-9961314-0-2

November 3

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Premium hardcover

Full-color figures

ISBN 979-8-9961314-3-3

November 3

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For teams

Bulk copies

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For boards and retreats

A book session

A keynote or board session built on the book, with the Bedside Questions worked live.

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For press

Press kit

Bios, book facts, interview topics and images.

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Thomas Powell, MD MS
About the author

Thomas Powell, MD MS

Thomas Powell, MD MS, is a physician executive, career chief medical information officer, consultant, and applied clinical informaticist, with three decades of clinical and operational experience across academic, community, and integrated delivery systems. He is the founder of CMIO, LLC, providing interim executive leadership, consultation, project support, and the Diagnostician method from this book.