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 …
The National Academy of Medicine defines diagnostic error as “the failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient.” Office-based practices are the predominant setting for malpractice claims related to diagnostic error.
Yes, office-based care settings.
Fast-paced, high-acuity emergency departments (EDs) have fewer malpractice claims related to diagnostic error than physician offices, according to recent research. Furthermore, 53 …
In the vast, undulating expanse of rural America (those counties where the horizon stretches like a taut bowstring, evoking the stoic endurance of Steinbeck’s Joads) one might expect the pulse of health care to beat with the resilient rhythm of native ingenuity. Yet, as a recent study in the Journal of the American Medical Association reveals, physicians sponsored under the H-1B visa program are twice as prevalent in these bucolic …
I strongly believe that working harder in medicine is making us as doctors poorer, and it’s quietly harming patients too. Not because we don’t care, but because rushing destroys the very thing patients need most: Time, attention, and real care.
Let me explain.
If you’re a medical doctor or another primary care clinician, you’ve probably heard this your whole career: “Work harder. Work faster. See more patients. Push more. Do more.” And …
Take a look in your medicine cabinet. What you see isn’t a sign of weakness; it’s a testament to one of the greatest partnerships in modern life: the one between your body and medical science. From the vaccine you got as a kid to the pill that keeps your blood pressure in check, these interventions aren’t just treating sickness. They are part of who you are. In a world still …
Primary care innovation has always been framed around access, autonomy, burnout, and patient experience. Direct primary care (DPC) in particular is often positioned as a solution for physicians exhausted by fee-for-service complexity and for patients who want a more personal relationship with their doctor.
This article focuses on how the broader economic landscape has shifted in ways that directly affect DPC, especially in light of the rapidly evolving national discussion around …
Not long ago, a friend told me, “I switched insurance and can’t find a doctor who will take me.” Another said, “I left Kaiser after going on Medicare and now no one will see me.” These aren’t isolated complaints. They’ve become the new reality in Silicon Valley: It’s easier to buy a multimillion-dollar home than to find a new primary care doctor.
I saw this problem firsthand before I retired from …
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Counselor and certified coach Mary Remón and oncologist Tiffany Troso-Sandoval discuss their article, “Clear communication is kind patient care.” They explore the common scenario of patients leaving the office more confused and …
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We entered medicine with a shared calling (to heal, to serve, and to make a difference). Yet somewhere along the journey, between the never-ending charting, late-night calls, and invisible emotional burdens, many of us forgot how to heal ourselves.
Every few months, another survey or report confirms what so many of us already sense in our bones: physicians are burning out at staggering rates. But what remains under-discussed, and perhaps even …
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Health care strategist Dana Y. Lujan discusses her article “Why direct primary care (DPC) models fail.” Dana argues that the DPC community’s obsession with “purity” is missing the point, stating that these …
Even the most “affordable” DPC models struggle in lower-income markets because the behavioral economics of these populations create high churn and unstable revenue. Practices that succeed in underserved areas nearly always diversify into employer partnerships, institutional contracts, or expansion into higher-income neighborhoods. Without understanding these behavioral and economic realities, physicians risk building a model the community cannot sustain long-term.
I previously argued that physicians must answer five market questions before …
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 …
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., …
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 …
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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