When I was in television, I was friends with the late Gene Siskel (the film critic’s syndicated show would shoot in our Chicago CBS studio). Siskel would drop by my office to talk and get free medical advice.

Siskel was, you might say, frugal. I remember when I was in contract negotiations with CBS, my bosses couldn’t praise me enough — but the money wasn’t there. When I told Siskel about …

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When my children were growing up, I advised them, “Don’t choose any profession in which your worth is determined by knowing a body of information or using algorithmic thinking. If you do that, you’re toast.”

”Toast” because monopolies on information have been supplanted by the internet, and algorithmic thinking replaced by computers and artificial intelligence. Incredibly, this seismic shift in what society values has occurred in just a single generation.

And that’s …

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As a physician and businessman, I wish the future looked better for PCPs. But history suggests things will get still worse.

The history of business teaches us disruptive innovation always starts from below. The “untouchable” market leader is threatened by a less expensive version of its own product. The smug incumbent ignores the unprofitable downscale threat. Then the new competitor decides to go upscale, is forced to innovate as a result, and …

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My generation of physicians was much like yours.

My were also “the best.” We’d risen to the top of every academic pyramid: middle school, high school, college. We could be anything we wanted to be.

We chose medicine, partly for noble reasons. Our bodies were wondrous and we got to help people. But also for some not so noble reasons: the money was good, everyone would look up to us, and we’d …

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When I was in medical school, “real” doctors saved lives. Period.

Specialists who focused on a patient’s quality of life, (the plastic surgeons, bariatric surgeons, holistic practitioners, infertility experts, etc.) were considered sellouts. (We won’t even consider the med school status of future psychiatrists.)

We disparaged these doctors because they could be saving lives and chose not to, because they were often paid (God forbid) out-of-pocket by their patients, and because they …

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