33 Comments
Mar 14, 2023Liked by Adam Cifu, MD

I too spent my childhood at the met with my mom, what wonderful memories this essay stirred up.

Expand full comment
Mar 4, 2023Liked by Adam Cifu, MD

What a perfect description of our work. Beautiful piece, Adam.

Expand full comment
Mar 4, 2023Liked by Adam Cifu, MD

Beautiful piece. A great lesson on the importance of continuity of care.

Expand full comment
Mar 4, 2023Liked by Adam Cifu, MD

Wonderful reflection, thank you for sharing this. The resident who caught me when I was born went on to become my family doctor, and then my son’s. It’s impossible to even measure the value of a familiar and trusted doctor, something I learned the hard way when I moved to a different country. As an aside, your footnotes are the best!

Expand full comment

I enjoyed this article. My own health took me out of the twilight of my career, which in reflection has been a wonderful gift. I can take care of those who want what I offer pro bono, on my time - and bc each patient is an N=1 I can help them customize their plan so they can fire me (chronic non cancer pain and addiction).

Nobody teaches us how to slow down and enjoy life after an intense career in healthcare. My body did it for me. What I have learned is that it’s doubtful that anybody said, “I wish I had worked more” on their deathbeds. I know I won’t. We need more Dr. Cifu’s as well as good descendants of his methods!

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

As a senior year resident who certainly has nowhere near the amount of training Dr. Cifu is talking about, his description of the level of uncertainty upon starting independent practice is not reassuring!

(Fortunately I'm going into fellowship).

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

Lovely reflection, Dr Cifu. Thanks for letting your professional 'armor' down a bit, with your candor. Would also note the ongoing joys (beyond the early mentorship period) of working in an academic group practice, with the constant cross-pollination of ideas, attitudes, and thought-provoking cases from trainees and specialist colleagues.

Expand full comment
Mar 3, 2023·edited Mar 3, 2023Liked by Adam Cifu, MD

This is a beautiful recollection of your practice history. I grieve as I read because my own PCP with whom I bonded for decades collapsed under the ever growing demands of his field. EMR. Coding. Nights on-call. Cash flow. He ended up working with another MD to help share the load (so to speak). That was helpful for only a short while. Finally has ended up in a "concierge" type system. Where I was once Linda, I became #_____, DOB____. But I fondly remember the years I was treated as an entire entity because he knew my family, my history, the joys and heartaches I dealt with. Thank you for being who you are.

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

I always enjoy your Friday reflections.

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

No patient is a routine

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

wow this sums up my practice also...what a beautiful reflection...we are lucky to be able to reflect on years of primary care practice in an environment that allows us to practice our way. i so admire you and your writing and anyway.. any friend of vinay's is a friend of mine!!

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

You seem a vintage mix of sensitivity and humor. Wish i could find a “you” close by!

Thanks for serving well.

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

My career path sounds very similar to you. I also did a primary care internal medicine residency at Northwestern. I do believe it gave us an advantage in managing our patients when we started our careers. I feel as though many of my patients who have remained with me for 35 years, are truly friends. Incidentally, my Internist is retiring, could you be my doctor?

Expand full comment

Like wine (and some physicians--Dr. Cifu being one, thank goodness), most art museums age spectacularcularly well. Here's an opinion piece about one that may not have: shttps://www.city-journal.org/metropolitan-museum-of-art-has-redefined-itself-as-an-antiracist-agent-of-change

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

Started seeing my physician in early '79, when I was 28, and a new mother. At the time, he must have been barely out of his residency, as he was only (by the date of his college diploma) about 3-4 years older than I. He retired ~ 4-5 years ago. Nothing like the consistent care of an interested-in-you doctor. He knew my husband, he knew all my children whom he had cared for from birth; he knew the 'vibe' of the family. When we started to get slipped "down" to the younger members of his practice, things were not so good. My 18 yr-old was conned--by a young, female physician who did not know the girl--into taking Gardasil. I ask you, does a virgin need that?

Expand full comment
Mar 3, 2023Liked by Adam Cifu, MD

A gem of an essay- thank you. I have an 18 yo cardiology-EP practice. Not the same, but I have come to appreciate the rewards of a long-standing patient relationship.

Expand full comment