A patient comes in with hip pain. It is not dramatic hip pain. There is no trauma and no fall. It is just a gradual ache that now wakes her up at night. She cannot sit comfortably. Getting in and out of the car is harder, and she is worried. The X-ray is normal. Now what?
In another era, this is where medicine began, not ended. It began with history, examination, and watching her walk. It meant assessing range of motion, thinking about the kinetic chain, and considering lumbar referral. We would look for gluteal weakness, labral irritation, early degenerative change not yet visible on imaging, or even hormonal shifts that alter tissue resilience and pain thresholds.
That kind of thinking takes time. Hip pain is common, but it is also complex. And complexity does not compress well. So we do what the system trains us to do. We order imaging, refer to orthopedics, start physical therapy, try an NSAID, document thoroughly, and move on.
The compression of primary care
The schedule demands it. We see four to six patients an hour with double bookings, telling ourselves that this will be quick. We are charting between visits, doing refills during lunch, and answering lab messages at the end of the day.
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Somewhere in that compression, something shifts. Primary care was meant to be the conductor of the orchestra, the physician who gathers the notes from orthopedics, endocrinology, and cardiology, and weaves them into a coherent plan. Instead, we have become referral managers. The visit becomes a transaction. The lab result becomes a portal message. The explanation becomes a follow-up appointment, because that is the only reimbursable way to have the conversation.
Patients feel it too. They leave thinking that it was fast, that they still do not really know what is wrong, and that they will Google it tonight.
When scrolling becomes a medical surrogate
And so the late-night scrolling begins. Facebook ads promise a revolutionary hip reset or an inflammation root cause protocol. They claim that doctors will not tell you this. Marketing is powerful and seductive. It speaks in certainty and offers time, even if it offers very little truth. When we do not have time, scrolling becomes medicine’s surrogate.
This is not about blaming patients, and it is not about blaming physicians. It is about acknowledging something uncomfortable: We have built a system that measures productivity in minutes, but complexity in human lives. So we compensate. We rely on imaging earlier than we should, and we refer sooner than we want. We follow guidelines that fit inside time constraints rather than biological nuance. This happens not because we do not know better, but because the clock is louder than the patient.
Grieving the loss of time
And here is the deeper truth: Many of us are grieving medicine, quietly. We do this not because we do not love it, but because we remember what it was supposed to be. We entered this profession to help people, to think, to solve, to restore function, and to see the whole person. Instead, we are asked how much medicine fits into 10 minutes.
Patients feel rushed, physicians feel compressed, and both feel unheard. Into that vacuum rush algorithms, influencers, quick fixes, and a marketplace that never sleeps. This is not sustainable.
But here is the part that matters: We still know how to practice real medicine. We know how to take a history that leads somewhere. We know how to examine a hip without an MRI. We know how to think in systems instead of symptoms. The question is not whether we have the skill. The question is whether we are willing to reclaim the time, even in small ways, to use it. Because if we do not, the scrolling wins, and medicine becomes something that fits inside a screen.
This is happening to us, and it deserves to be named.
Ann Lebeck is a family medicine and sports medicine physician affiliated with Kaiser Permanente, Hawaii Region, as a locum physician. Her clinical background includes complex musculoskeletal pain and regenerative medicine. She has also served as a civilian physician with the U.S. Army.
Dr. Lebeck writes about clinical reasoning, the body, and what modern medicine misses on Substack and KevinMD. Her essays include “Institutional misrepresentation harms vulnerable patients,” “The cost of time constraints in primary care: Why doctors feel rushed,” “When diagnosis becomes closure: the harm of stopping too soon,” and “A physician and her COVID-free island.” She is the author of the 2025 Zenodo preprint, “Platelet-rich plasma for a Morel-Lavallée lesion,” and has a manuscript under review with Arthroscopy, Sports Medicine, and Rehabilitation. She shares updates on LinkedIn.
