Primary Care

The shifting meaning of supervision in modern health care

Physician
January 2, 2026

The discomfort I felt around supervising did not arise in the clinic. It arose while reading the agreements meant to define it.

Supervisory agreements. Collaborative designations. Regulatory language that needed to be reconciled (carefully, deliberately) because names, roles, and obligations matter. Like many physicians, I have signed these documents countless times. But reading them slowly, rather than reflexively, produced an unexpected unease, one that felt structural rather than personal.

The language was …

Read more…

Why doctors struggle with treating friends and family

Physician
January 1, 2026

Early in medical school, a professor warned us: “Never prescribe for someone who isn’t your patient.” He shared a story of writing a simple antibiotic for a friend who later developed Stevens-Johnson syndrome, a devastating outcome that haunted him long after. His message was clear: There is a bright line between caring and causing harm.

Fifteen years out, we now understand just how blurry that line really is.

“First, do no harm” …

Read more…

Lessons on leadership from a Navy surgeon and NFL doctor

Physician
December 31, 2025

In a valuable episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, spoke with Dr. Matthew Provencher, an orthopedic surgeon, Navy veteran, former team physician for the New England Patriots and Boston Red Sox, and current partner at The Steadman Clinic in Vail, Colorado. Dr. Provencher’s story spans small-town roots, elite military service, academic medicine, professional sports, and entrepreneurial ventures. His journey offers physicians …

Read more…

Why women’s symptoms are dismissed in medicine

Conditions
December 31, 2025

I walked out of my physician’s office steady and clear in my decision to transfer my care. I didn’t accuse her of anything. I didn’t raise my voice. I simply informed her that I would be transitioning to another clinician within the same concierge program.

She immediately assumed I was leaving for financial reasons and suggested physicians to see outside the system. When I clarified that her administrator had already approved …

Read more…

When racism findings challenge institutional narratives

Physician
December 31, 2025

In the annals of social science, few imperatives are more solemnly intoned than the necessity of measuring racism with the cold precision that only quantification can provide. Only when bias is reduced to p-values and effect sizes may one confidently proclaim, “Behold, the incontrovertible evidence of racism,” secure in the knowledge that no reasonable interlocutor can wriggle free on the strength of anecdote or wounded sentiment. Yet such measurements, to …

Read more…

Emotional awareness and expression therapy explained

Conditions
December 30, 2025

Most people assume that pain and illness are caused only by injury or disease. If your back hurts, it must be damaged; abdominal pain must come only from inflammation, infection, or tumor. Most physicians learn this in medical school, as I did. But treatment based on this assumption often fails to provide relief for persistent pain, leaving millions of patients and countless well-intentioned physicians frustrated and in despair. The result …

Read more…

Mindfulness in the journey: Finding rewards in the middle

Physician
December 29, 2025

I recently returned from a truly magical trip to Iceland. While there, my husband and I hiked, ate wonderful food, and soaked in a different culture.

On day five of six, we ventured out to find what was described as a “hot springs river,” a body of water fed equally by glacier melt and geothermal hot springs. As a floating enthusiast, this was a must-see for me.

We hiked for an hour, …

Read more…

Restoring clinical judgment through medical education reform

Physician
December 28, 2025

A modest proposal for the reform of American medicine might begin, improbably enough, in a suburban pediatrician’s office where, last week, a physician of evident earnestness instructed my adolescent son to sleep until noon whenever possible, on the theory that tardy rising is the royal road to superior intelligence. The authority cited was a single paper (published, with all due respect, in the journal Personality and Individual Differences) bearing the …

Read more…

Home for Christmas: a physician’s tale of prior authorization

Physician
December 27, 2025

It was Christmas Eve 2005, and the health plan was closing at 3 p.m. By 4 p.m., the nurses, doctors, pharmacists, and support staff who handled utilization management for HIP Health Plan were already on their way home. My usual role at the health insurance company involved creating quality profiles for physicians caring for our roughly 1 million members. But that afternoon, I was covering hospital admissions so colleagues could …

Read more…

Why U.S. health care outcomes lag behind other nations

Physician
December 27, 2025

The news headlines and the online chatter are full of chest-thumping claims from both political parties about saving democracy, scandalous finger-pointing at the other guys, battles over sound bites, and circus antics to grab the attention of the media. It is easy to get distracted by all the political drama and lose sight of important facts.

When it comes to health outcomes, the U.S. is leading the world in the amount …

Read more…

The quiet bravery of breast cancer screening

Conditions
December 26, 2025

There is a stillness in the waiting room,
not exactly silence,
but a quiet that settles over chairs,
minds diverted elsewhere.

Here, women sit in chairs
with their thoughts
floating in opposing directions,
pretending to read magazines,
while their minds
wander hallways
they would rather not travel.

My name is called softly,
and my heart skips a beat,
the time has come.

I follow the routine,
changing from street clothes
into bare arms and a borrowed gown
that never seems to fit properly.

I take a deep breath,
trying …

Read more…

Sustainable health care innovation: Why pilot programs fail

Conditions
December 25, 2025

I used to think the hardest part of building better health care was securing funding.

Then I watched the same cycle repeat itself: A promising pilot launches, early outcomes are celebrated, a report is written, and when the funding period ends, the program quietly disappears. The idea did not fail. It simply could not survive.

Nothing was wrong with the clinicians involved.
Nothing was wrong with the intention.

What was missing was a system.

Health …

Read more…

The 3 E’s: a physician-created framework for healing burnout

Physician
December 25, 2025

Medicine teaches us to recognize disease, to listen for the subtle signs of pathology, to read lab values and imaging scans as if they are languages unto themselves. Yet what many of us were never taught is how to interpret the quiet, internal signals of our own humanity. We can identify cardiac murmurs with precision, but we often miss the whispers of our own exhaustion.

As physicians, we spend years mastering …

Read more…

ADVERTISEMENT

Mind-body connection in chronic disease: Why traditional medicine falls short

Physician
December 25, 2025

Linda had seen seven physicians in three years. She was on five medications. And she was exhausted, not just physically, but existentially.

“Dr. Goel,” Linda said quietly, “I’ve done everything they told me. The diets. The pills. The exercise programs. Why isn’t anything working?”

At 54, Linda was a meticulous accountant living with hypertension, type 2 diabetes, obesity, chronic fatigue, and generalized anxiety disorder. Her lab results painted a picture of metabolic …

Read more…

Why intercultural competence matters in health care

Education
December 24, 2025

During one of my junior internships, I met a patient whose care challenged not so much my medical knowledge as my understanding of culture. Mr. L., a 20-year-old university student originally from China, presented to the clinic with complaints of low back pain. He firmly believed his back pain was caused by an “improper” posture. During our discussion aimed at clarifying this misconception, I encountered considerable resistance. After speaking with …

Read more…

Physician exploitation: Why burnout is the wrong diagnosis

Physician
December 24, 2025

“Doctors need to develop resilience against burnout!”

After 20 years in medicine, every time I hear this, my jaw tightens, and my TMJ reminds me I have a very limited tolerance for nonsense.

Let’s call this what it is: not burnout, exploitation.

You cannot “resilience” your way out of systemic extraction. You cannot mindfulness your way out of an industry built on squeezing more and more labor out of you for less and …

Read more…

Pediatrician vs. grandmother: Choosing love over medical advice

Physician
December 23, 2025

I am a pediatrician. I am a mother. And now, a grandmother. These identities don’t always move in harmony.

When I learned my twin granddaughters had been born at home, the physician in me reacted immediately. My mind began cataloging risks, reviewing worst-case scenarios, mentally scanning for everything that could have gone wrong.

The grandmother in me, however, was called to show up differently: with love, not fear. With presence, not panic. …

Read more…

How I got Dr. Luis Torres Díaz on Wikipedia: a grandson’s journey

Physician
December 23, 2025

I grew up hearing stories about my grandfather, Dr. Luis Torres Díaz, the way some children hear stories about national heroes. In our family, he was one of them. He was not a war hero or political figure but a quiet, thoughtful, and brilliant scientist. My grandfather was a chemist, a poet, a professor, a dean, a museum founder, a man whose life seemed to stretch across disciplines with an …

Read more…

Direct primary care vs psychotherapy models: Why they aren’t interchangeable

Physician
December 23, 2025

I read Zoe Crawford’s thoughtful KevinMD essay on the limitations of direct primary care (DPC) with great interest. Her frustration as a medically complex patient navigating a fragmented health care system will resonate with anyone who has struggled to obtain timely imaging, referrals, or specialty care. As a clinician who has spent a career thinking and writing about how health systems fail both patients and physicians, I agree with …

Read more…

The hidden depth of the rural primary care shortage

Physician
December 23, 2025

Today I am a urologist, a cardiologist, a psychiatrist, a rheumatologist. But truly, I am a rural family medicine doctor in one of the most underserved counties in the country. And I am tired.

I do not pretend to have the depth of each specialist. What I have is necessity, a toolkit built on scarcity. Practicing medicine on an island, where specialists are rare, calendars are full for months, and visiting …

Read more…

104
pages