"What Iād like as a patient is to FEEL looked after."
It's amazing how little this would take and at the same time how low this bar is. Instead of feeling threatened by the availability of information, there's an opportunity to embrace it and use technology to improve health outcomes. Leveraging technology enables human doctors to be more...human. Unfortunately the business of medicine ends up taxing doctors instead of capitalizing on the opportunity to provide compassionate care.
Yes, that's exactly right. When they teach doctors how to bring more compassion to their care, it improves patient outcomes AND doctors' well-being (lower stress, lower rates of depression). I'm concerned, though, that as AI frees up more doctor time, the mega-corps are just going to try to optimize that by jamming more patients into their workdays. The change will have to come from somewhere else.
Anyway, thanks so much as always for the amazing feedback. š
Excellent essay Rob. Your first appointment encounter perfectly captures that inner feeling of hopelessness when it comes to healthcare. Good luck with your health journey. Curious about the new model you describe.
Thanks so much for the kind words, Rick. Glad to hear you're curious, too. I'll be sharing more about some of the things we can all do while we wait for mainstream medicine to catch up.
Oh, yes, and I bet it took months to get in for that primary care appointment, too. This has been our experience for years, but it's getting worse. The latest was a cardiologist who basically said don't bother to make lifestyle changes, just take medication. Sigh! Thanks, Rob.
Yes, it was 6 months past the physical date when they finally got me in. Sorry to hear you're in the same boat, and even sorrier to hear about the cardiologist. We all deserve so much better!
Great essay, Rob! Your experience has unfortunately become the norm instead of the exception.
As a former practicing physical therapist and practice director, I felt this line:
āThis doctor I met with all too briefly is surely overbooked, underpaid, and under-resourced. That new healthcare goliath certainly isnāt looking after him.ā
I started my PT career in 1998 in āone of the good corporate practices.ā My career trajectory skyrocketed to running a group of 7 clinics within 6 years. My income followed the same path - for the first 6 years.
I led practices for 20 years in a variety of settings from multi-clinic corporate to The Johns Hopkins Hospital and private practices - including my own.
In every role, I had to see a full patient caseload in addition to all my admin roles of business dev, leadership, marketing, operations, overseeing AR, etc. It was easy to get stressed and overloaded, potential impacting the care I delivered. Fortunately, an early mentor taught me to center myself as I crossed the threshold of each treatment room. He was a master. No matter how chaotic and stressful his day, he treated each patient like they were the only person in the office.
When I left clinic practice after 22 years, my income had remained relatively flat for the last 15 years while expected patient volumes and responsibilities increased.
I left because I was burned out. It impacted my quality of life and my effectiveness as a clinician. Iād always preached the importance of the healing environment, creating outstanding patient experiences, and avoiding transferring negative energy to our patients, but I couldnāt do it anymore.
Iām excited and optimistic about the attention that preventative care and digital health is getting. One day, I hope to combine my tech consulting and clinical experiences to have a greater impact on peopleās lives in a sustainable way.
Thanks so much, Budāso glad you found this piece. I'm grateful for your perspective in this thoughtful comment. Like you, I'm optimistic about preventative care with the help of technology, but it feels like we're in the transition period, where there's a massive scarcity of medical professionals, pent-up demand, and the tech's not quite there yet. Things do seem to be moving fast. I'm looking forward to following you, and hearing what you end up doing next with your clinical experience and interest in tech. Good to be connected.
Thanks Rob. Looking forward to following you as well.
A philosophical idea I wrestle with is whether the healthcare should even be a business industry - especially after many conversations with people outside the US.
This post is fantastic Rob. Iāve been battling my own doctor in trying to be proactive with lipid panels and tests for metabolic healthā¦ Iām 25 so he dismisses and disregards most of my concerns and reluctantly writes me a Rx for blood tests if I ask enough times. Youāre certainly right in that if you want to be proactive, itās gonna be expensive. But well worth it, I believe. And thanks so much for sharing my work, I appreciate you. Makes me so happy to hear youāre getting use out of the ebook!
Thank you, Jack. The e-book is great. Even for a health & wellness obsessive like me, the Attia book and Huberman Lab podcasts are a bit too long. I love a good summary.
I'm so glad you're asking for these tests now, and wish I'd known about them when I was your age. All we can do is keep asking, and hoping that these kinds of tests become more mainstream, and ultimately covered. It'll surely save lots of people from veering into metabolic syndrome before they hit the point of no return.
Absolutely, Rob. All we can do is keep pushing and keep asking (with respect of course). Itās also an exiting time, as you allude to, in that we are gaining more awareness as a society of medicine and the drivers of disease.
And yes both are very information dense. Took me a really long time to read outlive with all the notes I was taking and when I listen to a Huberman podcast it takes me about 10 hours to get through one as Iām pausing every 10 seconds to take notes. Iāve written a few articles breaking down the exercise series between Galpin and Hubermanā¦ if youāre looking for anything let me know and I might be able to send a good summary over.
Happily stumbling upon your other work that i've missed recently! Honestly, I agreed with this piece so much that it was hard to read because so much emotion was arising just reflecting on my own recent experiences with doctors and primary care. I've been waking up with stomach pain for several months, and was prescribed Pepcid, and I told him "I'm 28, am I supposed to just be taking this every day for the rest of my life? Any tests we should run..?" And he, irritated, just responded with "come back in 3 months if it's still an issue. Which means I will see him in 6 months, because it takes at least 3 months to get in! lol. I ended up going the holistic route and eating more gut-friendly foods and home made broth in the mornings - and the issue resolved itself. I'm highly intrigued by the new wave of medicine and really excited, actually, about how AI will help us humans better help one another. Still discouraged by the price, but it is what it is, for now. Thanks for this.
"What Iād like as a patient is to FEEL looked after."
It's amazing how little this would take and at the same time how low this bar is. Instead of feeling threatened by the availability of information, there's an opportunity to embrace it and use technology to improve health outcomes. Leveraging technology enables human doctors to be more...human. Unfortunately the business of medicine ends up taxing doctors instead of capitalizing on the opportunity to provide compassionate care.
This turned out great Rob.
Yes, that's exactly right. When they teach doctors how to bring more compassion to their care, it improves patient outcomes AND doctors' well-being (lower stress, lower rates of depression). I'm concerned, though, that as AI frees up more doctor time, the mega-corps are just going to try to optimize that by jamming more patients into their workdays. The change will have to come from somewhere else.
Anyway, thanks so much as always for the amazing feedback. š
Excellent essay Rob. Your first appointment encounter perfectly captures that inner feeling of hopelessness when it comes to healthcare. Good luck with your health journey. Curious about the new model you describe.
Thanks so much for the kind words, Rick. Glad to hear you're curious, too. I'll be sharing more about some of the things we can all do while we wait for mainstream medicine to catch up.
Oh, yes, and I bet it took months to get in for that primary care appointment, too. This has been our experience for years, but it's getting worse. The latest was a cardiologist who basically said don't bother to make lifestyle changes, just take medication. Sigh! Thanks, Rob.
Yes, it was 6 months past the physical date when they finally got me in. Sorry to hear you're in the same boat, and even sorrier to hear about the cardiologist. We all deserve so much better!
Great essay, Rob! Your experience has unfortunately become the norm instead of the exception.
As a former practicing physical therapist and practice director, I felt this line:
āThis doctor I met with all too briefly is surely overbooked, underpaid, and under-resourced. That new healthcare goliath certainly isnāt looking after him.ā
I started my PT career in 1998 in āone of the good corporate practices.ā My career trajectory skyrocketed to running a group of 7 clinics within 6 years. My income followed the same path - for the first 6 years.
I led practices for 20 years in a variety of settings from multi-clinic corporate to The Johns Hopkins Hospital and private practices - including my own.
In every role, I had to see a full patient caseload in addition to all my admin roles of business dev, leadership, marketing, operations, overseeing AR, etc. It was easy to get stressed and overloaded, potential impacting the care I delivered. Fortunately, an early mentor taught me to center myself as I crossed the threshold of each treatment room. He was a master. No matter how chaotic and stressful his day, he treated each patient like they were the only person in the office.
When I left clinic practice after 22 years, my income had remained relatively flat for the last 15 years while expected patient volumes and responsibilities increased.
I left because I was burned out. It impacted my quality of life and my effectiveness as a clinician. Iād always preached the importance of the healing environment, creating outstanding patient experiences, and avoiding transferring negative energy to our patients, but I couldnāt do it anymore.
Iām excited and optimistic about the attention that preventative care and digital health is getting. One day, I hope to combine my tech consulting and clinical experiences to have a greater impact on peopleās lives in a sustainable way.
Thanks so much, Budāso glad you found this piece. I'm grateful for your perspective in this thoughtful comment. Like you, I'm optimistic about preventative care with the help of technology, but it feels like we're in the transition period, where there's a massive scarcity of medical professionals, pent-up demand, and the tech's not quite there yet. Things do seem to be moving fast. I'm looking forward to following you, and hearing what you end up doing next with your clinical experience and interest in tech. Good to be connected.
Thanks Rob. Looking forward to following you as well.
A philosophical idea I wrestle with is whether the healthcare should even be a business industry - especially after many conversations with people outside the US.
This post is fantastic Rob. Iāve been battling my own doctor in trying to be proactive with lipid panels and tests for metabolic healthā¦ Iām 25 so he dismisses and disregards most of my concerns and reluctantly writes me a Rx for blood tests if I ask enough times. Youāre certainly right in that if you want to be proactive, itās gonna be expensive. But well worth it, I believe. And thanks so much for sharing my work, I appreciate you. Makes me so happy to hear youāre getting use out of the ebook!
Thank you, Jack. The e-book is great. Even for a health & wellness obsessive like me, the Attia book and Huberman Lab podcasts are a bit too long. I love a good summary.
I'm so glad you're asking for these tests now, and wish I'd known about them when I was your age. All we can do is keep asking, and hoping that these kinds of tests become more mainstream, and ultimately covered. It'll surely save lots of people from veering into metabolic syndrome before they hit the point of no return.
Absolutely, Rob. All we can do is keep pushing and keep asking (with respect of course). Itās also an exiting time, as you allude to, in that we are gaining more awareness as a society of medicine and the drivers of disease.
And yes both are very information dense. Took me a really long time to read outlive with all the notes I was taking and when I listen to a Huberman podcast it takes me about 10 hours to get through one as Iām pausing every 10 seconds to take notes. Iāve written a few articles breaking down the exercise series between Galpin and Hubermanā¦ if youāre looking for anything let me know and I might be able to send a good summary over.
Happily stumbling upon your other work that i've missed recently! Honestly, I agreed with this piece so much that it was hard to read because so much emotion was arising just reflecting on my own recent experiences with doctors and primary care. I've been waking up with stomach pain for several months, and was prescribed Pepcid, and I told him "I'm 28, am I supposed to just be taking this every day for the rest of my life? Any tests we should run..?" And he, irritated, just responded with "come back in 3 months if it's still an issue. Which means I will see him in 6 months, because it takes at least 3 months to get in! lol. I ended up going the holistic route and eating more gut-friendly foods and home made broth in the mornings - and the issue resolved itself. I'm highly intrigued by the new wave of medicine and really excited, actually, about how AI will help us humans better help one another. Still discouraged by the price, but it is what it is, for now. Thanks for this.