Diane Alexander

For 26 years as a plastic surgeon, I have given my patients the same advice after surgery: Listen to your body. Pain, fatigue, and swelling are not inconveniences. They are signals. They are the body’s language, guiding us toward healing or warning us when we have gone too far. What I have learned this year, at 65, is how difficult that advice can be to follow. In January, I was training on my Peloton treadmill, preparing for three races scheduled at the start of the year.

Introduction The United States spends more on healthcare than any other developed nation–$4.5 trillion or 17.3% of GDP in 2022–yet faces persistent problems with healthcare access (Centers for Medicare & Medicaid Services, 2023, ECG Management Consultants, 2023, Doty et al., 2021). These problems include long wait times for appointments and widespread physician shortages, with the American Association of Medical Colleges (AAMC) projecting a deficit of up to 86,000 physicians by 2036 (AAMC, 2024).

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