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Primary care physician Jerina Gani discusses her article “My journey to loving primary care again.” Jerina shares her deeply personal story of nearly walking away from medicine after burnout, exhaustion, and endless administrative burdens drained the joy from her work. She explains how a shift in mindset — treating her role not just as physician but as CEO of her own practice — helped her reclaim time, energy, and fulfillment. By tracking patterns, optimizing visit flow, protecting time, and building authentic patient relationships, Jerina now works fewer days, earns more, and feels renewed passion for patient care. She offers listeners candid insights into setting boundaries, redefining value beyond CPT codes, and designing a sustainable, joyful version of primary care that honors both purpose and peace.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Jerina Gani. She’s a primary care physician. Today’s KevinMD article is “My journey to loving primary care again.” Jerina, welcome to the show.

Jerina Gani: Thank you, and I’m very pleased and thankful to be here.

Kevin Pho: All right, so let’s start by briefly sharing your story and then we can talk about your KevinMD article.

Jerina Gani: OK, so I was born in Europe. I was born in Albania, which is a small country next to Italy and Greece, a Mediterranean country. I finished my medical degree there. Then I won one of the two scholarships in Albania, so I was so proud of that, and I ended up doing a master’s degree in health services management in London, United Kingdom back in 1994. I was there for a year. Then I went briefly to Milano for a short bit. My parents didn’t want me to come all the way to America; it was so far for them. But my desire was to come to America. I don’t know why, I always wanted to come here. Maybe it was my destiny.

When I think back, in 1995, I ended up in New York City and now I had to start struggling, working in many different places to become a doctor again and to get my diploma validated. That was very difficult. I didn’t think it was a difficult beginning. I had to work different jobs. I had to work as a waitress, and I wasn’t a good waitress to begin with because I never worked in my country before. Then I had to work as a travel agent. I worked in retail, and I really liked retail because I was connecting with people.

One of my favorite jobs, if I can mention it briefly, was working on Fifth Avenue at the famous Bergdorf Goodman selling jewelry. I had no clue when I got in that people were making so much money there. They were on a commission salary and were making, back in 2000, 200,000 dollars a year, more than a doctor. I was supposed to be a primary care doctor. It changed my idea about medicine. Not that I didn’t want to go into medicine, because I love medicine, it was my passion. But I realized that you don’t have to be a doctor and think that you’re so important. You can study, do your thing, and learn from other people because there were so many educated people who worked there. We are still friends today. And in the meantime, I did research at NYU in cardiology so I didn’t want to get out of medicine. Finally, I did my training in Brooklyn and started working in Boston as a physician in primary care back in 2007.

Kevin Pho: All right, so just tell me that background, that story. You said that you love working with people, you worked in retail. How has that influenced you as a primary care physician today?

Jerina Gani: I think all these jobs I did in New York City while struggling to become a doctor made me the best doctor I could be. At first, I thought that I was privileged to be a doctor, and I was looking at people from up down. I was thinking, “I’m the doctor, they’re the patients. Whatever I say, they have to do.” After working in retail and dealing with so many different people, I realized that you are a person too, and they are people too. So if you listen to their story better, if you communicate with them and connect with them, they will trust you more.

Because seeing a patient, I believe, is not just dealing with medical issues. If you’re a smart enough doctor, and you have been working for many years like me and you, you can deal with a medical issue in a second or in a minute. It takes some time, but you do it. But the connection is the most important part, and the words you say to that person who is sick to make them feel better. That’s very important. So in retail, I was making people feel good by selling them something that they loved. Here, I’m trying so hard to make them feel good by saying a good word, not just taking care of their medications or their illness, but to connect with them and make them feel good when they come.

My motto, if I can say it quickly, is that for every patient, I am their doctor. Sure, I may have 2,000 patients, but for every one of them, I’m the only doctor they deal with every day in their life. So I think that they’re coming into my living room when they come to the exam room. And I’m there to welcome them. So I start always with a smile. No matter what, no matter how tired I am, I have to give them that smile because they feel so relaxed after that. They can open up and share their medical stories and other stories. I mean, we’re privileged. They tell us so many stories. We learn so much from life because we become a psychiatrist, not only a doctor. We deal with so many problems, as you may know, Dr. Pho. But we can turn it into our advantage.

Kevin Pho: Your article is titled “My journey to loving primary care again.” For those that didn’t get a chance to read your article, tell us what it’s about.

Jerina Gani: Yes. So, as with everybody in primary care, I was working so many hours. I was working full-time for so many years, and there was no time for anything. No time for my family, no time for myself, and not enough time for every patient to connect and talk to them. I had to, I was like a robot because you have to take care of them in fifteen or twenty minutes. Then you have to deal with things in between, with no time in your schedule; your schedule is full. One patient after another, and in between you have to deal with refills, you have to answer quickly any emails or phone calls, whatever.

So I became a robot, honestly, like everybody else. So burned out. And at one point I was thinking, “Do I have to continue this or do something else?” Always in the back of my mind was that easy job on Fifth Avenue, selling jewelry, smiling at people, making all that money easily. But I love medicine. I didn’t want to betray my patients. I had patients for so many years, so I said, “I have to find a way to change this on my own.” We know the system is broken, honestly, in primary care, so how can I change that to make it better, to be happy to take care of patients, make enough money to satisfy myself, and have some free time for myself and my family?

At the beginning, it looked impossible. But I took things into my own hands and I started speaking up. I said to the people that I work with, the management, “Can I have, instead of twenty minutes for every visit, can I have thirty minutes for every visit?” I know at the beginning, maybe everybody would think that I would make less money, but it wasn’t the case because I was able to connect more with patients, to write better notes, document better, and I was even making more money seeing them every thirty minutes. So seeing only sixteen patients a day instead of more than twenty-two or twenty-four.

So then I said to myself, “I can do this only for three days. How about I do this only Monday, Wednesday, Friday, and Tuesday, Thursday are my days off?” Of course, we’re in an RVU business and system and many doctors are. So, at the beginning my salary was cut. I was making honestly over 300,000 working full-time, if I can share that with the audience, and then I ended up at 220,000 to begin with. But I said to myself, “I can do this. I can do this.”

So I started being very organized, managing my time correctly, and documenting. I learned about RVUs, I learned about billing. Billing is very important. I have a master’s degree in health service management, so that helped me manage my time and realize what is important and what is not in documenting. Because I think that all our medical providers in primary care, we deal with so many issues, but at the end don’t have time to document what we do. That’s where we’re underpaid. If you don’t document, it looks like you’re not doing what you’re supposed to do, so you’re billing less. If you bill less and not correctly, you’re underbilling, and you’re getting paid less.

You have to learn about billing. I created a course and I can talk later about it, and I explain in my course how to bill correctly. On the other side, if you connect with patients, they love you. They bring everybody; they bring their family. We’re lacking primary care. We have the mother, the father, the children, the grandchildren as patients. It’s amazing. No other subspecialty or specialty has this privilege. If you’re a cardiologist, you deal only with the heart. If you’re a hospitalist, you deal two or three days with a patient. That’s it. You don’t see them anymore. We see them all the time. We have created a relationship with them.

I feel so honored when a patient goes to a specialist, for example, a cardiologist or GI, or they go to a surgeon for surgery and they don’t decide on the surgery unless they talk back to me as their primary care provider. I’m pretty sure many doctors have noticed this in primary care. They come back and they say, “Dr. Gani, what do you think? Do I have to do this surgery? Is this a good doctor? What do you think?” So I go over the note with them. I go through pros and cons. This is the best compliment you can get in primary care. You are an advocate for them.

So I was able to do this only by switching to part-time, working three days a week and having the visits every thirty minutes. Otherwise, I didn’t have time to discuss and to be the advocate for them. And to my surprise, I was able, even with three days a week, seeing only sixteen patients a day, and I’ve done this for the last three years, to make over 300,000 dollars a year. This is unbelievable. At the beginning, I didn’t believe it, but it’s true because I’m documenting properly and I’m not overbilling at all. I’m billing correctly. That’s very important because I’m ethical. I’m writing exactly what I’m doing with patients and these are the things I want to share with all providers, primary care doctors, but even nurse practitioners or physician assistants who are now having their own patient panel, because we know that we need so much help in primary care. New medical residents don’t want to go to primary care. They don’t know this part of primary care that is beautiful, and there is room there for improvement. Everybody talks about burnout, but it’s not only that.

Kevin Pho: You talk about the importance of setting those boundaries. Like you said, you only want to see patients every thirty minutes instead of every twenty minutes, and you want to see patients three days a week. Now, when you set those boundaries, and by the way, I completely agree with you that we do need to set those boundaries or else that’s going to lead us to burnout if we don’t. Did you get pushback from the administration or the powers that be? Because I know a lot of doctors who want to set those boundaries, administrators aren’t going to agree, and they’re just going to want their doctors to see as many patients as possible in as short a time as possible. Did you get any pushback when you set those boundaries?

Jerina Gani: I agree with you. At the beginning, I had a little pushback when I decided, while I was working full-time, to move from twenty minutes to thirty minutes. But I talked to them and I said, “I’m so burned out. I have to do it every thirty minutes.” Because honestly it takes five minutes, at least for a medical assistant to bring the patient in the office, as you know. So it’s not twenty minutes. You end up with fifteen minutes. What are you going to do? More patients come with a list of questions.

So that was the thing. But I knew and I said to them, “OK, fine. We’ll see if I can make the same amount of money or less, but I cannot help it anymore.” If you are a hardworking person, if you work very well in any company, they’ll honor that because they don’t want to lose you. Wherever you are, if you’re a hardworking person, they love you, they see how much patients love you, they can accommodate you slowly. So this was the first thing I did working full-time, but seeing patients every thirty minutes. Then I realized, “Oh, I’m making very good money. I’m making great money, so why don’t I go to three days?”

So I talked to them and I said, “I would love to work three days and I’ll do my best to make as much as I can. But this is my thing. I cannot handle it like this anymore.” I was never afraid to speak up. Maybe because of the fact that I left everything in my country. I mean, I had a great life. I cannot say that I didn’t have a good life in Albania. I lived in the capital of the country and I had a master’s degree that nobody else had back in 1994, 1995 there. And I left everything and started all over again from scratch in New York City. So that made me more bold to ask, because if you don’t ask, you never get it.

And many doctors are stuck in their place because they think they cannot move, they cannot ask, they cannot do. I was never afraid because I started from scratch. I left everything in Europe. I came to New York City, a big city. I was nobody. Nobody cared that I had two degrees. They said, “Work as a waitress, do this. You have to survive.” So that was the best thing that happened to me, to tell the truth. If you can speak up and you’re a good, hardworking doctor, nobody will replace you that easily. They will try to accommodate you. And I believe if they don’t accommodate you, there are so many places you can go if you’re confident enough to ask for what you deserve.

Kevin Pho: I talk to a lot of physicians who are scared of speaking up because they say that they will be labeled as a disruptive physician or not working as a team player. Now, how do you reconcile that perception with your experience in terms of asking for in the first place? Because of course we don’t get what we don’t ask for. How do you reconcile that preconceived perception a lot of physicians have about speaking up?

Jerina Gani: You know what? I think overall physicians don’t have a community that they connect with because they’re so overburdened. They work so hard and they never talk to even each other. So that’s the main thing. If I could share, I mean, I’m sharing this through your podcast and I cannot share this otherwise because I don’t see these people. I wish we had a community that we can communicate more and people can get more empowered by other people who are doing it.

Like myself, I know that many physicians, many medical providers, are still scared of asking, but what are you losing if you ask is my question. They’re either going to say no or they’re going to say yes. And if you ask, you realize how important you are for that company that you work with. So I don’t think it’s going to be the end of the world. You can ask politely. You don’t have to be mean. You just ask, and if you’re honest, and I notice that with patients too, if you’re honest with everybody, they’ll appreciate what you’re saying and what you’re doing, and they respect you more.

Kevin Pho: Now, when physicians talk to their administrators and ask them for whatever they need, some of the things that we talked about, do you have any tips for them? You said, of course don’t be mean, but is there a way of framing their ask so we can get administrators on our side and see things from our perspective?

Jerina Gani: It’s the burnout. That’s the biggest thing. And it’s obvious everybody knows that all physicians are burned out in primary care. We work so much and everything comes to us. We have to check the mails, we have to check the emails, the phone calls, the paperwork. We have to sign labs, we have to send back the results, to deal with these perfect notes that everybody wants. So it’s so much that we have, and I think without physicians, how will a clinic survive if the physicians are not happy?

But physicians keep taking more and more burden without speaking up that, “This is not fair, this is not good.” It’s about time for them to do this in a nice way. That’s the way I see it. You have to talk, and you have to talk again. It may not be the first time you ask them. You have to have the meeting face to face with them and express that you’re totally burned out, how this could be better. I mean, that’s the way I always did it in my life, and everybody respected that. I didn’t have any pushbacks. I was happy and I’m still happy where I work because they recognized that and they appreciated that.

Kevin Pho: Now as a primary care physician, you said you see about sixteen patients a day every thirty minutes, three days a week, so less than full-time. So by implication, are you saying that it’s very difficult to practice primary care in a full-time setting where you will have to see patients every fifteen minutes because that is the position of a lot of primary care physicians today?

Jerina Gani: I totally agree. And if I knew this before, I would’ve done it a long time ago to see patients every thirty minutes. Because seeing patients every fifteen minutes, you cannot document much, you cannot do much, and you’re not going to get reimbursed much. If you see them every thirty minutes, you can document a lot more. You spend more time with them. Time is one of the factors of billing better and you deal with more problems that they have.

So, honestly, I have calculated and I’ve seen myself, if I see patients every fifteen or twenty minutes the same day, versus seeing them every thirty minutes. Because in thirty minutes I can do all these annual wellness visits, I can do the physicals and the problems they have, I capture everything. The patients are very happy, I’m happy, and the finance department is happy because I’m making good money.

So I think that fifteen minutes should come out. It shouldn’t exist, honestly, because it’s not a way to see people. We’re dealing with patients, we’re dealing with human beings. So it shouldn’t be like a factory every fifteen minutes. You have to see somebody. Even when you work full-time, I think you have to at least go to thirty minutes, because as we both know, five or seven minutes it takes for a medical assistant to put them in the room. So how are you going to see in ten minutes a patient who has so many problems, and then you’re going to cut them off? Many doctors say, “OK, one or two problems today, and then you come back again.” They don’t have room in my schedule. People have to wait four months to see me because they never cancel because they’re happy now. They’re very happy. I deal with everything, so this is better. It’s better for me, it’s better for everybody. So, in my opinion, that fifteen-minute visit should not exist. That’s my opinion.

Kevin Pho: We’re talking to Jerina Gani. She’s a primary care physician. Today’s KevinMD article is “My journey to loving primary care again.” Jerina, let’s end with some take-home messages for the KevinMD audience.

Jerina Gani: I have created a website called drganissecret.com, where I share all my secrets through an online course, how to be successful with patients, how to be very, very efficient in working part-time or full-time. And that’s the way I help many physicians, even nurse practitioners or physician assistants who have their own panel, to thrive in primary care. My wish is all of us in primary care can thrive, not get burned out. And my motto is, “Work less, earn more in primary care,” not vice versa. So this is my saying at the end, my last word I can say to everybody in primary care in the United States.

Kevin Pho: Jerina, thank you so much for sharing your story, time and perspective, and thanks again for coming on the show.

Jerina Gani: It was a pleasure.