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The Missing Middle in Healthcare—And Why It Matters | Part One

Palliative Care Hospice Patient-Centered Care End-of-Life Care Healthcare Leadership Healthcare Innovation Interdisciplinary Teams Caregiver Support

What happens between a life-changing diagnosis and hospice care? In Part One of this thought-provoking conversation, Chris Comeaux welcomes Mettle Health co-founder Sonya Dolan and Director of Counseling & Programs Bridget Sumser to explore what they call healthcare’s “missing middle.”

Drawing from their extensive experience in hospice, palliative care, caregiving, and serious illness support, they discuss the critical gaps that exist for patients and families navigating the emotional, relational, practical, and existential realities of illness—often long before they qualify for hospice services.

Together, they unpack how Mettle Health was created to provide a different kind of support: one centered on accompaniment rather than treatment, resilience rather than answers, and human connection rather than healthcare transactions.

The conversation challenges traditional assumptions about serious illness care, caregiver support, and the limitations of a system designed primarily around reimbursement models. Along the way, they offer fresh insights into interdisciplinary care, the power of language, and why helping people build their own “mettle” may be one of the most important forms of care we can provide.

Key Takeaways

The healthcare system often leaves patients and caregivers unsupported in the critical space between diagnosis and hospice eligibility.
Mettle Health was created to address the emotional, relational, practical, existential, and aesthetic dimensions of serious illness and caregiving.
Caregivers deserve dedicated support for their own experiences—not simply as extensions of the patient’s care plan.
True interdisciplinary care values the contributions of physicians, nurses, social workers, chaplains, therapists, and other professionals equally.
Building resilience, coping skills, and emotional capacity can help individuals navigate uncertainty, grief, illness, and caregiving long after a single healthcare encounter.

If this conversation challenged the way you think about serious illness, caregiving, and healthcare support, be sure to subscribe to TCNtalks /Anatomy of Leadership and share this episode with a colleague, caregiver, or healthcare professional. And don’t miss Part Two episode coming this Friday, where the discussion continues with deeper insights into accompaniment, human connection, and the future of compassionate care.

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