Primary Care

Why the 4 a.m. wake-up call isn’t for everyone

Physician
November 18, 2025

I thought that’s what I had to do to be successful: Wake up at 4 a.m., get after it, hustle before the world wakes up, and join the club of high performers who swear by their pre-dawn routines. So I tried it. And I was miserable. I’m talking dragging-myself-out-of-bed, foggy-brain, counting-down-the-hours-until-I-could-go-back-to-sleep kind of miserable.

As a brand-new full-time entrepreneur, I was forcing myself into a routine that felt like punishment, all …

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Why do doctors lose their why?

Physician
November 15, 2025

There’s a quiet heaviness that has settled over medicine, not always visible, but deeply felt. It lingers in hospital corridors and hovers over clinic desks cluttered with charts and cold coffee cups. You can see it in the nurse scrolling through yet another new policy update, her shoulders sagging under invisible weight. You can hear it in the tired sigh of a physician glancing at the clock at 9 p.m., …

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The paradox of primary care and value-based reform

Policy
November 13, 2025

An excerpt from Wonderful and Broken: The Complex Reality of Primary Care in the United States.

In a health care system full of paradoxes, this is perhaps the most striking. Primary care delivering value-based care is seen by many as the solution for an inefficient, inequitable, and poorly-performing health care system. Yet it is a shocking mess of burnout and depletion. With all the radical intention of Lenin, we must …

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Why health care needs empathy, not just algorithms

Conditions
November 12, 2025

The algorithm flagged a potential drug interaction in milliseconds. It suggested an optimal dosing regimen based on kidney function, weight, and genetic markers. It even generated patient education materials in the right language and reading level. But the patient sat there, hands trembling, unable to ask the question that mattered most: “Am I going to die?”

That’s where artificial intelligence ends and where health care truly begins.

The seduction of technological solutionism

Health …

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Moral injury, toxic shame, and the new DSM Z code

Physician
November 12, 2025

The recent inclusion of moral injury as a Z code in the DSM marks a moment for mental health. Z codes place a diagnosis in an environmental or psychosocial context. After years of advocacy from clinicians and veterans, moral injury has entered our clinical lexicon. This action validates the linkage between our embeddedness in the world and our individual struggles, from soldiers and first responders to physicians navigating a broken …

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Redefining health care through agency and partnership [PODCAST]

Podcast
November 10, 2025
YouTube video

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Patient advocates Alan P. Feren and Joyce Griggs discuss the article “Why agency and partnership are vital in modern health care.” In this episode, Alan and Joyce explore how collaboration, advocacy, and shared …

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Physician burnout and the cost of resistance

Physician
November 10, 2025

“Why don’t they see?” “Why can’t they understand?” “Why are they doing this to us?”

These questions echo in exam rooms, in meetings, in the hallways of hospitals and clinics across the country. They are often sparked by policy changes, institutional decisions, or administrative mandates that feel disconnected from the physicians providing the care. Underneath the questions is the hope that the reality in front of us isn’t actually true. That …

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Is modern medicine losing its soul?

Conditions
November 10, 2025

They tell me the physician’s art lies in the stitching of skin,
the analysis of shadows on X-rays,
and interpreting numbers in a medical chart.
Yes, there is skill involved.
a steady hand, a quick eye,
and a good memory for pathways and procedures.

But I wonder.
where, in the span of 20-25 minutes,
is the art that cannot be quantified
or coded?

It’s found in the stillness of listening,
in the weight of one person’s story
resting in another’s hands.

A doctor …

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Rebuilding the backbone of health care [PODCAST]

Podcast
November 9, 2025
YouTube video

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Family physician Grace Yu discusses her article “The backbone of health care is breaking.” In this episode, Grace reflects on the urgent decline of the primary care workforce and the growing crisis …

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The 5 percent problem: the low value of primary care

Physician
November 9, 2025

I spent 11 years becoming a family physician.

Four years in undergrad, four in medical school, three more in residency.

That’s a decade of delayed income and about $300,000 in debt, all for the privilege of practicing in one of the most critical, underappreciated corners of medicine: primary care.

I came out idealistic. I wanted to build relationships, prevent disease, and guide people through the chaos of a broken system. But I quickly …

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Why physicians must not suffer in silence [PODCAST]

Podcast
November 6, 2025
YouTube video

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Neurologist Scott Abramson discusses his article “Why ‘the best physicians’ risk burnout and isolation.” In this YouTube-optimized episode, Scott reflects on the ancient Talmudic teaching that warns how pride and perfectionism can …

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Quality metrics in medicine vs. patient trust

Physician
November 6, 2025

The woman sits across from me, hands folded around a list of her medications.

We review the cholesterol guidelines. I explain the evidence. She listens carefully, then says, almost apologetically, “Doctor, I know what the data says. I just don’t want to take another pill.”

There is no anger in her voice, only fatigue, the quiet exhaustion of someone who has lived long enough to know her own limits.

I pause, because this …

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Why DPC market-model fit matters most

Physician
November 5, 2025

In my previous article, I examined why direct primary care (DPC) practices fail, focusing on financial modeling, compliance risks, and the gap between what’s legal and what’s sustainable. But there’s a more fundamental issue that precedes all of those concerns: market-model fit.

The direct primary care community loves to debate panel size, membership pricing, and model purity. We dissect what went wrong when practices fail. We blame insufficient commitment, poor …

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Silicon Valley’s primary care doctor shortage

Physician
November 3, 2025

Not long ago, a friend told me, “I switched insurance and can’t find a doctor who will take me.” Another said, “I left a leading integrated health plan after going on Medicare and now no one will see me.” These aren’t isolated complaints. They’ve become the new reality in an affluent U.S. region: It’s easier to buy a multimillion-dollar home than to find a new primary care doctor.

I saw this …

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Why women in medicine need to lift each other up [PODCAST]

Podcast
November 2, 2025
YouTube video

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Board-certified pediatrician and certified coach Jessie Mahoney discusses her article, “Why don’t women in medicine support each other?” She explores how scarcity, competition, and cultural conditioning have discouraged women physicians from advocating …

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A poem about being seen by your doctor

Conditions
November 2, 2025

I come to you with stories
I cannot name.
They press against my chest
waiting for a moment when
it feels safe
for them to be set free.

Pain is a language
I find difficult to speak aloud,
and the silence between us
feels like a waiting room
that will never empty,
pressing in on me,
catching my breath.

Two strangers,
white walls between us,
your eyes move toward the clock,
while mine look at my folded hands
resting in my lap.

I wonder
am I just a time …

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Why humanity matters in medicine [PODCAST]

Podcast
November 1, 2025
YouTube video

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Certified coach and professor Kathleen Muldoon discusses her article, “The humanity we bring: a call to hold space in medicine.” She shares how her experience as a mother in the neonatal intensive …

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Small habits, big impact on health

Physician
November 1, 2025

As an internal medicine physician practicing in Southaven for more than eight years, I’ve learned one simple truth: Prevention is often more powerful than treatment. Every week, I see patients who wish they had come in sooner, before diabetes, hypertension, or heart disease quietly took hold. These conditions rarely appear overnight; they build over years of small imbalances in diet, stress, and lifestyle. The encouraging news is that small, steady …

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Why are we devaluing primary care?

Physician
October 31, 2025

The first day I walked into my residency clinic, I realized this was the part of medicine I understood the least. The waiting room was full, and every patient carried not just a diagnosis but the weight of a system already stretched thin. We learned to triage, to document, and to move quickly. But we did not learn how to lead, how to build continuity, or how to see the …

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Why plain language isn’t enough for patients

Conditions
October 30, 2025

In modern medicine, the use of plain language is a fundamental clinical skill. This is especially critical when health decisions can profoundly affect a patient’s life, impacting their financial stability, ability to work, personal independence, and mental well-being, as well as their capacity for managing daily care, recognizing warning signs, and adhering to treatment plans. Considering the patient as a partner in their care, an informed decision can only be …

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