The Doctor–Patient Relationship in Mid-Career Primary Care

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.

In this episode, we speak with Dr. Jennifer Brokaw about her varied and impressive career in medicine. Dr. Brokaw shares how she transitioned from emergency medicine into founding a private practice focused on advanced illness management and end-of-life care, driven by a desire to tackle complex societal challenges she witnessed in the ER. She discusses the unique value she was able to provide as an independent advocate for patients and families, as well as the challenges of building a sustainable business model around these services. Dr. Brokaw's insights offer a fascinating look at alternative paths for doctors beyond traditional clinical roles. This conversation provides an engaging glimpse into one physician's remarkable career journey.

In this installment of our series talking with medical trainees, we're joined by Dr. Ava Ferguson Bryan, a general surgery resident at the University of Chicago. Dr. Ferguson Bryan shares her winding path to medicine, from initially pursuing English and art history, to discovering a passion for surgery during her clinical rotations.She provides an honest look at the challenges and sacrifices of surgical training, including the lengthy 7-8 year commitment and the impact on work-life balance, especially as a woman having children during residency. Dr. Ferguson Bryan also discusses the evolving landscape of surgical education, including competency-based assessments that may allow for more flexibility in training duration.This episode offers valuable insights for aspiring physicians navigating the realities of surgical specialties and the broader effort to diversify the field. Dr. Ferguson Bryan's personal experience provides a nuanced perspective on the progress made, as well as the work still needed to support the next generation of surgeon-trainees.

Gaining an inside look at the realities of medical training, this episode features a conversation with Layne Keating, a chief medical resident at the University of Chicago. Layne shares her experiences navigating the transition from medical school at the Frank H. Netter MD School of Medicine at Quinnipiac University to residency, highlighting the importance of being given autonomy and the ability to make real clinical decisions.She explains how this hands-on responsibility, even with the support of her team, has been critical for developing the confidence and problem-solving skills needed to be an effective physician. Layne contrasts this with concerns that overprotecting trainees from having to make tough choices during their education can make the leap to independent practice much more difficult.The conversation also touches on the use of letters of recommendation in the residency application process. Layne and Dr. Adam Cifu discuss how more holistic, thoughtful approaches may be needed to evaluate the suitability of medical trainees.This transparent discussion provides a unique perspective on the highs and lows of the clinical training journey, as well as insights into improving medical education to better prepare the next generation of physicians.To read more:https://medicine.qu.edu/https://www.sensible-med.com/p/letters-of-recommendation-should-fb0

In this episode, we continue our series exploring the experiences of medical trainees. Dr. Adam Cifu is joined by Arman Shahriar, MD, a third-year internal medicine resident at the University of Chicago. Arman shares his nontraditional path to medicine, including teaching in Ecuador and working in the medical device industry. He provides a candid look at residency life, from the grueling schedules to the unexpected challenges and the camaraderie forged during training.Arman is also the author of two compelling articles: On One-Liners and Doing No Harm, which explores the power of language in patient care, and The Wrong Fight—Prior Authorization, a personal account of navigating systemic barriers.To read Dr. Shahriar's above-mentioned articles, check them out here:• On One-Liners and Doing No Harm: https://journals.lww.com/academicmedicine/fulltext/2023/10000/on_one_liners_and_doing_no_harm.24.aspx• The Wrong Fight—Prior Authorization: https://jamanetwork.com/journals/jamaoncology/article-abstract/2813580