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Articles by Wayne Altman
MAHA has the right diagnosis and the wrong treatment plan [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! The same Robert Kennedy Jr. who sued Monsanto over glyphosate in 2017 is now defending an order to expand its production. What does a functional medicine physician do with that? Shiv K.
Primary Care as a Public Utility : The Case for a Common Fund
Abstract Importance More than one-third of US adults lack access to primary care, which has increasingly become a commodity rather than the common good envisioned by the National Academies of Sciences, Engineering, and Medicine. Many states are working to bolster primary care, but face common challenges related to federalism, fragmentation of health insurance, and administrative hurdles that undermine their efforts to invest in primary care.
Primary care offers unexpected financial and emotional wealth [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Primary care physician Jerina Gani discusses their article “The hidden rewards of a primary care career.” Jerina challenges the common narrative that general practice is merely a stepping stone filled with paperwork and low wages. She explains how physicians can unlock scalable income and schedule flexibility to build a prosperous career in health care without sacrificing personal well-being.
Senior financial scams: a guide for primary care physicians
In an increasingly digital world, older adults are often viewed as prime targets for financial scams. These malicious schemes exploit vulnerabilities inherent in aging, such as social isolation, cognitive decline, and trustfulness. As primary care physicians, we are in a unique position to recognize the signs of vulnerability in our older patients.
Waking up at 4 a.m. is not required for success [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Physician, former health care executive, certified coach, speaker, and organizational consultant Laura Suttin discusses her article “Why the 4 a.m. wake-up call isn’t for everyone.” Laura shares her personal struggle with the popular productivity advice that claims early rising is the only path to high performance.
How an AI medical scribe saved my practice
When I wrote my first novel last year, I grappled with the ethical implications of using a large language model to guide my writing process (one I have been carefully refining for decades). Prompt after prompt, my mind became inundated with the notions of how every query consumed a not insignificant amount of energy and the black box of the generated text’s origins. “Am I relying too heavily on this new technology? When does this cease to be my work?
Why physicians must not suffer in silence [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Neurologist Scott Abramson discusses his article “Why ‘the best physicians’ risk burnout and isolation.” In this YouTube-optimized episode, Scott reflects on the ancient Talmudic teaching that warns how pride and perfectionism can become a physician’s downfall. He explores how the culture of grit, self-sacrifice, and fear of vulnerability leads many doctors to burnout and emotional isolation.
Passing the medical boards at age 63 [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Internal medicine physician Rajeev Khanna discusses his article, “I passed my medical boards at 63. And no, I was not having a midlife crisis.” He shares his journey of studying for the ABIM exams decades after medical school, balancing family skepticism, humor, and determination. Rajeev reflects on aging in medicine, the evolution of study tools, and the deeper purpose behind lifelong learning.
Why the MAHA plan is the wrong cure
“Make America Healthy Again (MAHA).” Finally, something we can all agree on. The new MAHA report with its pages of promises taps into something real, something we see daily in primary care practice: Many Americans feel unwell, unheard, and unprotected by the very institutions meant to support them. , , and even our children are less healthy than they were a decade ago.
IMGs are the future of U.S. primary care
The U.S. primary care system is unraveling. Fewer graduates are choosing it, and patients are struggling to find someone who stays. But in the background, one group continues to step up: international medical graduates (IMGs). Quietly and steadily, they are filling the spaces others have left behind. They are physicians who trained abroad, adapted to new systems, passed more hurdles than most of their U.S.-trained peers, and still chose to serve. And yet, they are often treated as an afterthought.
This isn't burnout, it's moral injury [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Family physician Jonathan Bushman discusses his article, “The hidden moral injury behind value-based health care.” He shares the story of a young physician who was told to remove her most complex patients from her panel to protect the health system’s performance metrics. Jonathan uses this powerful example to explain moral injury: a deep, ethical wound that is fundamentally different from burnout.
Decoding your medical bill: What those charges really mean
Most people don’t read their medical bills—they panic over them. After all, receiving a multi-page statement full of confusing codes, unexplained charges, and unclear payment instructions isn’t just frustrating—it’s intimidating. I’ve worked with countless individuals who feel helpless in the face of these documents, unsure of what they owe, why they owe it, or whether the charges are even correct. This confusion isn’t just common—it’s systemic.
Who will train the next generation of primary care clinicians without physician mentorship? [PODCAST]
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How organizational culture drives top talent away [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Surgeon Suhaib J. S. Ahmad discusses his article, “Why even the best employees are silently quitting health care.” Suhaib explores the phenomenon of highly competent and once-passionate health care professionals disengaging and leaving their roles, often without overt complaint.
Why medical student debt is killing primary care in America
For as long as I can remember, I’ve wanted to be a physician. My journey to medicine is not unique. My motivations ring familiar to all health care workers. Many medical students are cut from the same cloth in this regard. We want to help people, to use science to alleviate human suffering, and to push the envelope of medical research. But we also want to earn a living and have a stable career.
What’s driving medical students away from primary care?
As we entered medical school, we were starry-eyed and hopeful about becoming primary care physicians. We romanticized building relationships with patients, providing high quality health care, serving our communities, and removing obstacles patients face when seeking care. However, rotation after rotation, we were bombarded with discouragement.
Does Higher Spending On Primary Care Lead To Lower Total Health Care Spending?
High-quality primary care is the foundation of a high-functioning health care system. It ensures patients have access to essential services, prevents emergency department visits and hospital admissions, leads to better health outcomes, and improves quality of care and equity. The secret sauce that allows high-quality primary care to deliver on all these benefits is long-term relationships between patients and their primary care clinicians and other team members.
Primary care in Mass. needs major overhaul
MASSACHUSETTS IS RECOGNIZED as having one of the best healthcare systems in the country, home to some of the most forward-thinking physicians, hospitals, and medical research. Our medical schools remain world-class, attracting some of the profession’s premier experts as well as the next generation of physicians. Time and again, our state has been the leader of innovation in healthcare reform, driving change and acting as a beacon for systems across the country.
The Challenges of External Letters for Promotion: Academic Family Medicine’s Attempts to Address the Issue
Academic promotion to the Associate Professor and Professor rank has traditionally required external letters of review from colleagues who are not personally connected to the individual being considered for promotion (“arm’s length”). Helping our family medicine colleagues achieve academic promotion is important. While we believe that the faculty promotion process ought to be rigorous, the “arm’s-length” letter of review is both burdensome and out of date.
FROM ADFM: AMPLIFYING ADVOCACY IN FAMILY MEDICINE
Family physicians provided primary health care for patients, families, and communities despite great risks to themselves and their loved ones throughout the COVID-19 pandemic. Our comprehensive scope of practice provides us with unique perspectives regarding the basic conditions needed for all people to thrive such as safety, shelter, education, recreation, social support, access to healthy food, and primary health care.
Applying a Medical Wellness Group Visit Model to a Community Setting Yielding Weight Loss and Improved Laboratory Results
1. Flegal, KM, Carroll, MD, Kit, BK, Ogden, CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307(5):491–497. Google Scholar | Crossref | Medline | ISI 2. Parikh, M, Rajendran, I, D’Amico, S, Luo, M, Gardiner, P. Characteristics and components of medical group visits for chronic health conditions: a systematic scoping review. J Altern Complement Med. 2019;25(7):683–698. Google Scholar | Crossref | Medline 3.
Quality Measures: How to Get Them Right
Pay-for-performance programs have produced disappointing results. Fewer and more appropriate, evidence-based quality measures could help. Ronald Adler, MD, FAAFP, Sami Hamdan, MPH, Courtney Scanlon, MD, and Wayne Altman, MD, FAAFP Fam Pract Manag. 2018 Jul-Aug;25(4):23-28. Author disclosures: no relevant financial affiliations disclosed. This content conforms to AAFP CME criteria. See FPM CME Quiz.
Taking a Shot at Immunization Adherence Group Visits for Vaccine-Averse Parents
Introduction: Decreased vaccination rates in children have played a role in the deaths of several children in the United States over the last decade. Interventions to date have been ineffective at changing vaccination patterns. No studies have evaluated a conciliatory patient-centered approach where parent concerns were acknowledged and addressed in a group setting. Methods: Vaccine-averse parents with incompletely vaccinated children were recruited from a family medicine practice.
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