All of the arguments for direct primary care (DPC) from a provider perspective are valid. As a psychotherapist and psychoanalyst, I have essentially run a direct care practice for the last 15 years. I don’t accept insurance and see patients as often and for as long as therapeutically necessary. So when DPC practices started rising in popularity, I was excited to try it. Unfortunately, as a patient who is medically …
“Doc, I’ve seen enough doctors. I only trust you. I want you to do my knee replacement and fix my heart.”
I heard the conviction in his voice when I heard these words from this patient. Sitting across from me was a 76-year-old army veteran I had cared for over two decades. He had seen multiple specialists, endured countless consultations, and, in the end, he wanted me, the physician who had …
Let’s discuss primary care. That’s primary care, as in P-R-I-M-A-R-Y C-A-R-E.
Why the emphasis?
Sadly, I don’t …
You are the expert of your body. You know when something isn’t right.
Yet many patients leave an exam room feeling worse than when they came in, not because of their illness, but because they were told, directly or indirectly, that nothing is wrong. Their symptoms are minimized, reframed, dismissed, or worse, attributed to anxiety, stress, age, or weight. They are left questioning their own experience and perception of reality.
This is …
The nurse adjusted my father’s blanket for the third time that hour, her voice soft as velvet. “We just hate to see him suffer like this,” she whispered. My mom and I watched her check his IV with the tenderness reserved for wounded pups.
Three floors down, four years earlier, this same hospital discharged me mid-vomit with a gastric outlet obstruction and a white blood cell count that screamed infection. “Go …
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Family physician Rebecca Thompson discusses her article, “The weight of genetic testing in a family,” an excerpt from her book. She shares a profoundly personal story from the memoir about a woman …
This morning, I woke up to a message from a friend that he had seen on social media a colleague he went to university with had, a few days ago, died by suicide. Last week, I had an email in my inbox from a young doctor in a training program informing me four of their trainee colleagues in the last 24 months have died by suicide. The week before, my …
There are pauses in life
that stretch like thin threads
between two cliffs
fragile, invisible,
yet holding everything that matters.
In those long silences
when the air thickens
and the mind becomes
a loud companion,
I wonder
are these pauses gifts of grace,
spaces to gather courage,
a chance to map the next step forward?
Or are they doorways through which
fear seeps in
and takes its seat inside my chest?
The world rushes on, demanding answers
before the question
has even settled in my heart,
results before thinking,
certainties …
Busy physicians are moving so quickly we almost never stop long enough to acknowledge the subtle ways medicine reshapes us. But every physician I’ve ever coached, including myself, can name a moment when they didn’t quite feel like themselves. Maybe it was:
A Guide and a Seeker walk into a bar.
The Seeker says, “I’m so glad I’m here, I’ve been searching far and wide for good beer to slake my thirst, and you, my Guide, have finally brought me here!”
The Guide says, “Ah, I know just the thing. I’ll get you some Dos Equis. A merchant’s representative told me it’s the most interesting beer in the world!”
The Guide tries to order a …
Busy physicians seldom pause long enough to feel the weight or the wisdom of the year behind them.
We know the end of the year is approaching not because we’ve reflected, but because holiday coverage discussions have begun. Someone needs to work Thanksgiving. Someone has to take Christmas. Someone will miss the department party again.
You look at the schedule and realize: This year, it’s you.
And in that moment, something inside you …
“He who has a why to live for can bear almost any how.”
– Friedrich Nietzsche
When I lost meaning in and for my life while questioning my career path as a surgical resident, I lost motivation to eat and isolated in guilt and shame. Looking back, I had given up the very things that I now realize give life meaning in the pursuit of my career: relationships (including friendship and community …
When I wrote my first novel last year, I grappled with the ethical implications of using a large language model to guide my writing process (one I have been carefully refining for decades). Prompt after prompt, my mind became inundated with the notions of how every query consumed a not insignificant amount of energy and the black box of the generated text’s origins. “Am I relying too heavily on this …
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In Japan’s far north, Hokkaido stretches across mountains, forests, and endless snow. For months each year, the landscape turns white, and travel slows to a crawl. This vast and beautiful region (known for dairy farms, fishing towns, and open space) is also one of the most sparsely populated parts of the country.
For people living here, health care access depends not only on medicine, but on geography, infrastructure, and weather. It’s …
There was a time when I thought burnout was easy to recognize, that it came with flashing red lights and emotional breakdowns. I imagined it as the dramatic kind of collapse you see in movies: a physician walking out mid-shift, tears in their eyes, leaving their stethoscope behind.
In those days, I didn’t really think about burnout. I believed burnout happened to other people, the ones who hadn’t mastered time management …
“If you tell me how you get your feeling of importance, I’ll tell you what you are. That determines your character. That is the most significant thing about you.”
– Dale Carnegie, How to Make Friends and Influence People
We all want to feel seen, recognized, and appreciated. That’s human nature. But where do you get your feeling of importance? What aspects of yourself are essential to who you are and how …
Something unsettling is happening in medicine, and many of us feel it even if we haven’t said it out loud: evidence-based medicine is slowly being eroded, not just by outsiders, but from within our own profession.
Patients today are searching more than ever before for quick fixes, and physicians are increasingly stepping into the marketplace to meet that demand. Hormone pellets. “Longevity protocols.” Peptides that sound scientific but have no real …
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Dentist Lincoln Harris discusses his article, “How cloud-based simulation training is revolutionizing dentistry.” Drawing on his background as a pilot, Lincoln exposes the critical training gap in modern dentistry, arguing that dentists …
Most midlife men don’t walk into our clinics asking for help. They walk in asking for labs.
They’ll tell us they’re “just tired,” “not as sharp,” or “feeling off.” They’ll blame work or age. They’ll ask for hormone testing or a quick fix. What they rarely say (and what most of us rarely ask about) is the deeper truth underneath the symptoms.
There is a silent crisis unfolding in midlife men, and …
In May, a published report indicated that changes indicative of Alzheimer’s disease (AD) were detected at age 24 via a blood test, which is increasingly available. These changes may begin earlier, but these were the study’s youngest participants. There are no medical treatments for these early manifestations, and aside from providing knowledge of a possible future and potentially causing anxiety, what value does the test hold? Unless a person has …
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