Not Otherwise Specified

In this engaging discussion, Ed Bujo, a seasoned community family physician, shares his journey from anesthesia to family medicine, emphasizing the profound impact of long-term patient relationships. Benjamin Popok, a medical student passionate about rural family medicine, reflects on his transformative clinical rotation and advocates for early exposure to community practices. They delve into challenges in primary care, the joy of comprehensive care, and the need for reforms in medical training to prioritize primary care roles, highlighting the importance of financial support and cultural respect.

Mark Friedberg, a former primary care physician and current health services researcher, joins an anonymous first-year medical student, C, to discuss the systemic undervaluation of primary care. They dive into the cultural pushback against choosing generalism and how medical education often neglects primary care exposure. Friedberg shares research showing disparities in resourcing and reimbursement, shedding light on the burdens that PCPs bear. C emphasizes how primary care can address access and trust in healthcare while they both confront the troubling cycle of burnout among practitioners.

Priyatha Narasimharaj, a cardiology fellow, shares her guilt over moving away from primary care amidst its shortage. Ben Davis discusses the moral injury residents face when confronting systemic inequities in healthcare. Wright Clarkson, a family medicine resident, explains why he chose hospitalist work, citing inbox burdens and devaluation of primary care. Together, they explore how medical training and culture contribute to the decline in primary care interest, revealing the challenges of creating a robust healthcare workforce.

In a thought-provoking discussion, family physician Kurt Stange shares patient-centered stories that highlight the essential elements of primary care, focusing on the importance of relationships. Cultural anthropologist Rebecca Etz critiques the limitations of one-size-fits-all guidelines, emphasizing the social dimensions of health. Elizabeth Bradley discusses how social determinants, not just medical care, affect population outcomes, warning against offloading social needs onto primary care. Together, they explore the fragility of the primary care system and the urgent need for a more integrated approach.

In a captivating discussion, Steven Lin, a family medicine physician and AI implementation expert at Stanford, dives into the balance between AI's benefits and challenges in primary care. He explains how AI scribes can ease documentation burdens, but raises concerns about losing critical clinical thinking. The conversation explores AI’s potential to transform medical training and address the cognitive load for clinicians. Ultimately, Lin emphasizes that while AI can improve patient care efficiency, it cannot resolve the systemic issues plaguing primary care.

In the first podcast episode of NOS Season 3, "The Forever Crisis of Primary Care," Lisa Rosenbaum talks with primary care guru Asaf Bitton about the vast values gap between patients and the health care system.  A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2514232.

This season finale examines the moral injury that the current U.S. health care system inflicts on physicians and trainees — and how they may be able to offer care that aligns with their values. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400700.

This episode considers what happens when the rigors of training and the pursuit of excellence in in medicine collide with the mental health needs of trainees. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400698.

This episode asks how medical educators should navigate between demanding intense commitment and hard-won excellence from trainees and seriously threatening their well-being. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400697. Source from this episode: https://www.culturalcomplications.com/

This episode takes a sobering look at the mental health of U.S. medical students and trainees, in an era when the pressures can be intolerable but the culture still treats depression as weakness. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400696. Notes from this episode: https://www.nytimes.com/2020/07/11/nyregion/lorna-breen-suicide-coronavirus.html https://www.ama-assn.org/practice-management/physician-health/encourage-physicians-healing-make-it-ok-ask-help