Doctors — Not Bureaucrats — Should Be Trusted to Tailor Alzheimer’s Care

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I’m a physician. But I don’t run my practice like most doctors.

My practice is cash-only. Prices for every service are posted at the door so that each patient – whether a billionaire executive or a blue-collar worker – knows exactly what they are signing up for when they walk in.

Patients from all walks of life come to me for a reason: no third-party interference, billing games, or coding gymnastics. And no insurance company dictating how I treat my patients.

That freedom matters because no two patients are the same. Each one needs an individualized plan to thrive. Good medicine depends on allowing doctors and patients to make personal care decisions together without bureaucrats overriding clinical judgment. (RELATED: Arizona Fines Care Facility $500 After 85-Year-Old With Alzheimer’s Wanders Out, Dies: Report)

Unfortunately, that is not how most of American health care operates – especially when it comes to Alzheimer’s disease.

Alzheimer’s is projected to affect nearly 14 million Americans by 2060. Yet the greatest obstacle to better care is not a lack of scientific progress. It is policy. Federal rules and insurance barriers impede both early diagnosis and access to intervention – tying the hands of physicians and limiting options for patients when fast action matters most.

In 2025, the U.S. Food and Drug Administration cleared a blood test that can help detect Alzheimer’s. Some studies have demonstrated that the test is more than 90% accurate in detecting changes linked to Alzheimer’s.

Early detection creates a critical window that allows patients to plan for the future and start simple interventions before permanent decline sets in. Research suggests that up to 40% of Alzheimer’s and dementia cases may be prevented or delayed through early lifestyle interventions such as exercise, quality sleep, heart-healthy diets, and social interactions.

But you cannot intervene in a disease you cannot detect.

Even when early diagnosis does occur, Medicare’s payment structure discourages the preventive interventions patients need most. Preventive counseling is often inadequately reimbursed. Healthcare providers spend hours coordinating care, educating families, and following up on care plans, but much of that work is non-billable. That makes it nearly impossible to sustain at scale, regardless of how dedicated healthcare providers are.

And when lifestyle interventions are not enough, other treatment barriers persist. (RELATED: Banker Admits To Major Medicare Fraud Scheme Tied To International Criminal Syndicate)

The FDA recently approved two anti-amyloid therapies that have been shown to slow disease progression in many patients when administered early. It takes between 10 and 15 years for a medicine to gain FDA approval, which requires rigorous scientific review of safety and efficacy. By the time a treatment reaches that milestone, it has cleared the highest evidentiary bar in American medicine.

Yet, even though Alzheimer’s treatments have already met the highest evidentiary standard, Medicare categorized these therapies under its “Coverage with Evidence Development” policy, which limits coverage to patients enrolled in clinical trials or data-collection programs. In practice, that means patients must jump through new hoops to access treatments already deemed safe and effective.

It is time for a more personalized approach to Alzheimer’s care.

Most importantly, policymakers must trust physicians to match patients with the right intervention. Some patients benefit most from lifestyle changes. Others benefit from medication. Many would benefit from both. Bureaucracy cannot tailor care to the individual, but doctors can.

Alzheimer’s care works best when it is individualized. That means earlier diagnosis for those who can benefit from lifestyle changes, and timely treatment for those who need it. The government’s role should not be to micromanage these decisions. It should be to step aside and allow doctors and patients to make them together.

Dr. Jules Madrigal is a physician, owner of a direct primary care practice, and former president of the Association of American Physicians and Surgeons.

The views and opinions expressed in this commentary are those of the author and do not reflect the official position of the Daily Caller.

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