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 …
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 …
Twenty years ago, when I started medical school, I had no idea that this would be my path. Coming from a research background in cancer biology and biophysics, I did not have much exposure or interest in integrative medicine. My path to practicing integrative and functional medicine and incorporating new modalities to my foundation as a general internist, was not linear, and not expected.
I was pregnant twice during my three-year …
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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 …
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“I was excited to see you today because I thought you were going to answer all my questions,” a patient once told me. I smiled, masking the insecurity. “I wish I could.”
The truth is, I often cannot (at least not in a single visit). Medicine is rooted in curiosity and lifelong learning. Patients expect certainty, but doctors live with uncertainty. We know enough to know how much we do not …
Let me just start by saying: If you are reading this and thinking, “Who voluntarily takes medical board exams at 63?” You are absolutely right. Normal people do not do that. They take up golf from the Green tees, try to marry off their kids, and complain that the younger generation cannot drive. But me? I spent four precious months of my remaining life cramming for the ABIM boards like …
Lifestyle medicine is now a known, respected and utilized aspect of medical care to help patients live healthier lives and ward off chronic disease. Clinicians often counsel their patients on the pillars of LM: movement, nutrition, sleep, stress management, connection, and avoiding risky substances. These pillars are powerful and proven to be effective. But after integrating my training as a physician and health coach to lead group wellness travel adventures …
The door closes with a soft click, sealing me inside a room that smells of alcohol and cotton swabs. The light is too bright, pouring down from overhead panels that have withstood the test of time. The entire room is bathed in a white-wash of light, leaving no shadows, except those that lie within me. A token landscape or two adorn the antiseptic walls, attempting to distract me from the …
The overlooked treasure of primary care: Why this field is more rewarding than most realize
Primary care often carries a reputation: long hours, too much paperwork, and not enough pay. Many providers see it as a burden, a stepping stone, or simply “less glamorous” than other specialties.
But here is the truth most clinicians overlook: Primary care holds hidden rewards, both financial and emotional, that can transform not just your practice, but …
One thing I know for sure is that, as a whole, our medical training system has gotten it all wrong when it comes to helping students correctly identify which specialty they want to apply to.
Coming from undergraduate school to medical school, I spent four years learning about myself. I went to graduate school, worked for a few years in the real world, and gained real-life experiences. During that time, I …
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Family physician Amir Atabeygi discusses his article “Building trust in dyad leadership partnerships.” Amir explains why trust is the foundation of successful dyads, highlighting how implicit follow-through and consistent communication turn a …
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