How the Patient-Doctor Relationship Evolves in the Early Years of a Medical Career

Dr. Nundy reflects on building a career that spans patient care, health systems, and technology. He describes thinking of himself as an “accidental technologist” and explains how his interest in innovation grew from a practical question: can new ideas actually work for patients in the real world? The conversation also turns to meaning in medicine. Dr. Nundy talks about why he still finds deep fulfillment in clinic and how personal experiences have shaped his desire to focus on work that creates impact in the near term. Along the way, he shares a thoughtful perspective on how individual physicians fit into the larger healthcare system and where meaningful change can happen.

Dr. Michelle Kittleson and Dr. Adam Cifu get real about the patient-doctor relationship, especially when the stakes are high and the answers are not simple. She shares a small move that can ease a patient’s anxiety in seconds: showing you came prepared, with their story already in your hands. They talk through shared decision making, why patients should steer, and why clinicians still need to give a clear recommendation. They also spend time on the toughest pivot of all: when cure is off the table, what do you say next, and what can you still do to reduce suffering?

Dr. Adam Cifu sits down with cardiologist Dr. Amber Johnson to peel back the curtain on what happens behind the clinic door. Dr. Johnson gets candid about her career evolution, from the reserved, impersonal style she once thought was required of a doctor to a physician who now shares personal experiences to build trust with patients. The two dive into the silent tug-of-war of shared decision making. They explore the challenge of patients who prefer not to choose their treatment path, a hurdle Dr. Johnson encountered firsthand with veterans who were more likely to ask her to simply tell them what to do. It is a raw look at the ego check required when a patient makes a choice the doctor disagrees with and why the most "difficult" cases often lead to the greatest professional joy.

Dr. Adam Cifu talks with Dr. Tom Yates, a general internist and assistant professor at the University of Chicago, about how a physician’s approach to care evolves during the early years of practice and how that shapes patient relationships and clinical decision making. Dr. Yates talks about resisting the urge to rush into problem lists and instead listening for what patients care about most. They discuss why preventive care conversations can be hard when patients are asked to weigh risks and benefits, especially when trust or health literacy is limited, and how building relationships connects to professional fulfillment.

Trauma surgery doesn’t end when the operation is over. Dr. Tanya Zakrison joins Dr. Adam Cifu to reflect on the patient-trauma surgeon relationship, and the frustration of caring deeply for patients while knowing you cannot fix everything that led them there. She discusses how trauma care exposes challenges rooted in patients’ living conditions and circumstances, why surgeons cannot ignore what happens outside the hospital, and how to stay present with patients and families without absorbing all of that pain. The conversation centers on the emotional weight of trauma work and how trauma surgeons learn to carry it without becoming detached or burned out.

Genetic information can raise the stakes of a clinical conversation in ways that go far beyond test results. Dr. Adam Cifu and Dr. Sonia Kupfer reflect on how uncertainty, evolving evidence, and family implications shape the way physicians counsel patients. Kupfer draws from her experience in clinic to illustrate how recommendations may shift over time, while emphasizing the responsibility of helping patients feel supported, informed, and firmly in control of decisions that can affect far more than just one person.

Winner of the 2025 Bucksbaum-Siegler Institute Clinical Excellence Award, Dr. Kertesz reflects on the work of building a relationship before clinical decisions take shape, particularly with patients who arrive wary after difficult experiences with healthcare. He describes how poorly chosen language can instantly make a patient feel judged, forcing him to slow down and work his way back into the interaction. The discussion also underscores why understanding what a patient wants from an encounter is essential to how care is explained and delivered.

Dr. Mary Rinella, a transplant hepatologist, talks with Dr. Adam Cifu about the human side of caring for patients with complex liver disease. She describes how she approaches patients who arrive guarded or resistant and how digging into the fear that drives their behavior helps her build trust with them. The conversation touches on the time she invests in nurturing those relationships and how that closeness often includes patients’ families, especially when she is helping them through difficult moments. Later in the discussion she reflects on the loss of a patient and the emotional weight of that experience, especially given the bonds she forms with both patients and their families.

Dr. Adam Cifu talks with pediatric dermatologist Dr. Sarah Stein about the tricky triangle between doctor, teen, and parent. She reflects on finding the right balance between a young patient’s growing independence and a parent’s need to stay involved, and how empathy, trust, and experience shape those interactions. Together they explore what genuine communication looks like when everyone in the room has a different perspective.

Dr. Julie Oyler talks about the art of balancing social and medical care for older patients. She reflects on how her approach has evolved, from the early days of handwritten notes to today’s tech-assisted visits, and how she’s learned to keep the focus on the person behind the chart. She shares the tug-of-war between efficiency and empathy, the challenge of managing family dynamics in the exam room, and the rewards of long-term relationships that span decades of care. Thoughtful, humble, and a little funny, this one feels close to home for every clinician.