As a parent and a doctor of nearly four decades, I’ve often found myself navigating the rugged terrain of a dual existence: the life of a devoted physician, and the life of a dedicated parent. I have not always succeeded in both arenas. My wife and I both bear the weight of our professions, drawn into the noble yet demanding world of medicine. Our missions and ambitions, while fulfilling, have …
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Amanda Heidemann, family physician and senior clinical content consultant for clinical effectiveness at Wolters Kluwer Health, discusses her article, “Gen Z’s DIY approach to health care.” Amanda explains how digital natives are …
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Infectious disease physician Tyler B. Evans discusses his article “Meeting transgender patients where they are: a health care imperative.” Tyler, an infectious disease specialist and author of Pandemics, Poverty, and Politics: Decoding …
“Who would you go on a date with, and why?” That was the question that came up in a recent speech workshop. People shared fun, lighthearted answers. But for me, the answer came straight from my heart. I would go on a date with my dad.
My father passed away nearly fifteen years ago, just before my life was about to begin a whole new chapter. I was newly married, preparing …
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Rheumatologist Ananta Subedi discusses his article “The 4 foundations that sustain physicians through burnout and balance.” Ananta reflects on his journey from medical education in Nepal to building a rheumatology practice in …
Every week, I see patients not because they need to, but because their insurance company says they must. A patient came in recently for one reason only: Her insurer required a referral before she could see a specialist. She didn’t want to. I didn’t need her to. But we both had no choice. After a 20-minute visit neither of us needed, I did what the insurer required: document, click, submit. …
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Internal medicine physician Sally Daganzo discusses her article “How functional medicine fills the gaps left by conventional care.” Sally explains how a systems-based, evidence-informed approach can uncover root causes of complex conditions …
When I first stepped onto a college campus, I was the first in my entire family to do so. Coming from a humble immigrant background, community college was my gateway. Like many community college students, I was nontraditional, new to the country, starting from scratch. This was my first exposure to the American educational system, and I was just trying to figure it out while working multiple jobs.
Eventually, I served …
To be honest, I never imagined myself treating A-list celebrities and professional athletes in Manhattan. As a young physician in Juárez, Mexico, I spent my earliest years working in community clinics and even pharmacies on the city’s impoverished peripheries. Back then, the idea of practicing at one of the most prestigious hospitals in the United States (let alone as a pain management specialist) was unthinkable. And yet, only a few …
On my first week of onboarding as an attending, before I had seen a single patient, I met the boulder in a training room.
It arrived as a screenshot. The EHR instructor clicked into a demo chart and a cascade opened: quality gaps, refill requests, preventive care nudges, “smart” routing rules that promised efficiency and smelled faintly of delegation without authority. I had imagined the threshold to attendinghood as a clean …
When most people talk about obesity, the blame often falls on donuts, McDonald’s, fast food, lack of exercise, or lack of willpower.
But as a primary care physician, I see a different reality. Obesity is not always born from a donut, and it is not always caused by time poverty. Yet in many cases, it grows out of time poverty, a system that robs people of the space to think, to …
Physicians tell me they want out of the insurance grind, but they’re terrified to actually do it. That fear is costing them years of autonomy they could already have.
As someone who supports both DPC and concierge physicians, I believe in the purity of the DPC model, but I also believe in practical pathways to get there. Hybrid models aren’t the compromise position; they’re the strategic bridge that makes the transition …
We were walking up the fairway on the ninth hole when one of my patients asked, “Larry, when should I come in for my annual?” I had a seven-iron in hand, breeze at my back, and I answered without thinking: “Doesn’t matter.” He looked at me like I had just duffed a wedge. To him, it sounded like I did not care. In a way, I suppose I mishit that …
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Burnout isn’t a personal shortcoming; it’s a system warning. A peer-reviewed Annals of Internal Medicine cost estimate pegs the annual bill for physician burnout near $4.6 billion in turnover and reduced clinical time, an operational risk with human consequences. As an executive who works across clinical and administrative teams, I see this as both a human tragedy and an operational failure that demands leadership attention. The good news: There …
As a pharmacist, I have spent years behind the counter filling prescriptions, answering questions, and giving quick consultations. Most of my days felt routine: scanning barcodes, checking drug interactions, and moving from one patient to the next. But one encounter changed the way I saw my profession forever.
It was a quiet afternoon when an elderly woman walked into the pharmacy. She handed me a prescription for blood pressure medication, but …
In the grand edifice of American medicine, where the Enlightenment’s promise of rational progress once shone brightly, a shadow now lengthens across the corridors: the tyranny of the metric. Conceived in the spirit of Taylorism’s efficiency and Deming’s quality control, these numerical arbiters were meant to elevate the healer’s art, transforming subjective judgment into objective excellence. Yet, as with so many well-intentioned intrusions of bureaucracy into human affairs, they have …
My mind became the centerpiece of my identity early on in life. I lived so intimately with my thoughts that I came to believe this is who I was. As academic success and the praise of being “the smart one” set me apart, I internalized a sense of uniqueness. Others saw it too, which created early recognition… and isolation.
And here lies the hidden cost:
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Patient advocate Timothy Thomas discusses his article “The Cap’n Crunch philosophy of medicine.” Timothy shares his personal experiences with gaps in primary care, from learning of his diabetes diagnosis at a Walmart …
Cap’n Crunch never held a true naval rank; he was called “Cap’n” because he was the highest-ranking person present, not because he replaced someone more qualified. In some clinics, it is the same: the system is built so you rarely, if ever, see a real doctor. Whoever is around with the right badge simply gets the title and responsibility by default. This “Cap’n Crunch” phenomenon is not limited to one …
For years, concierge medicine and direct primary care (DPC) were viewed as fringe alternatives, reserved for affluent patients or entrepreneurial physicians willing to step outside the insurance system. But in my opinion, these models are no longer “nice-to-have” side projects. They’re becoming essential pathways for physicians to reclaim careers, reduce burnout, and meet patient expectations in an evolving health care landscape.
Burnout is pushing physicians to the edge.
The pandemic only magnified …
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