How Modern Genetic Medicine Interacts with the Patient-Doctor Relationship

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.

Dr. Jason Alexander joins Dr. Adam Cifu to discuss how the doctor–patient relationship evolves once you’re no longer a new physician. He reflects on the confidence that comes with experience, knowing when to listen and when to step in, and how caring for colleagues and families adds both complexity and meaning. He also shares how embracing uncertainty and being genuine help build trust.

Join us for a conversation with hematologist–oncologist and geneticist Dr. Michael Drazer for a wide-ranging discussion on caring for people with hereditary blood and cancer syndromes, including patients with leukemia. He talks about how watching mentors with very different bedside styles influenced how his approach to the doctor–patient relationship has evolved throughout his career. We also discuss how Dr. Drazer’s clinical work guides his team’s research, shifting the focus from ‘blue sky’ science to studies grounded in his patients’ real-world challenges.

This episode dives into the real-life evolution of the doctor–patient relationship through the eyes of a senior physician. Dr. Alex Lickerman shares how decades in medicine have shaped his approach to balancing authority and empathy while moving toward more relaxed, genuine conversations. He also explains why building trust with patients matters more now than ever, especially in the face of widespread patient misinformation. He reflects on moments where taking the lead, sometimes what might feel paternalistic, can help families make difficult, life-and-death decisions with clarity and compassion. The talk touches on the unique skills needed to care for patients at the end of life. Along the way, you will hear honest takes on the quirks and frustrations that come with the job.

In this season finale episode, Dr. Adam Cifu sits down with transplant nephrologist Dr. Michelle Josephson to explore the unique challenges and opportunities that arise in the later stages of an academic medical career. Dr. Josephson openly discusses the struggle to maintain a sense of relevance, the need to redefine one's priorities and goals, and the bittersweet experience of losing colleagues to retirement and passing. However, she also highlights the freedom and excitement that can come with this transitional phase, allowing her to pursue new global initiatives in areas like green nephrology. This provides an insightful look at navigating the "third phase" of a distinguished career.