Dr. Leila is sad.
That’s the social media handle Dr. Leila Javidi chose to represent how she felt about the state of health care and a profession that often works against patients’ interests and leads to inflicting moral injury on countless physicians. The emotional toll of high-volume, low-agency environments (plus a relative lack of understanding that puts many patients at odds with their doctors—as if they had voluntarily chosen to disempower themselves) pushes practitioners to the brink. That toxic environment has led far too many professionals to stop practicing medicine altogether, and for some—far more tragically—it has even led to suicide.
That’s no mere talking point. Despite the fact that male suicide rates in the general public heavily outnumber women (accounting for nearly 80% of all national suicide deaths), female physicians die by suicide at rates comparable to their male counterparts, which is already notably higher than the general population.
This makes the suicide rate among female doctors roughly 150% to 250% higher than among women in the general population. That is a staggering statistic.
Dr. Javidi decided that she had had enough. She began to speak candidly about the myriad problems plaguing health care, and primary care in particular, on social media. For many viewers, it was the first time they had heard a doctor speak with such a level of candor. She developed a large and loyal following that appreciated her honesty, authenticity, and ability to make complex arguments and issues accessible to a wide range of viewers both inside and outside of medicine.
Eventually, through social media, she discovered the direct primary care (DPC) model. And although she had her reservations at first, she held fast to this vision for a better way to practice and committed to founding her own firm: Rebel & Thrive DPC.
Now, as a DPC doctor running a successful practice, Dr. Leila doesn’t deal with insurers and the glacial pace of reimbursements. She doesn’t have over 2,000 patients in her panel to which she cannot possibly provide the level of care she would like. She doesn’t have to give patients the runaround and shorten their visits to 10 minutes apiece. She doesn’t have to spend the bulk of her day on coding and clerical work to appease insurance companies.
She controls the size of her panel, how long she will spend with each patient, how to structure pricing models, who and when to hire, and everything about her practice right down to the light fixtures. Radically, she controls how she practices medicine.
Now, Dr. Leila is glad.
But of course, she’s still keenly aware that the system remains broken and too many physicians feel lost and hopeless. For that reason, she’s in this fight for the long haul.
I was tremendously grateful to get a chance to speak with Dr. Javidi for over an hour about the experiences that shaped her and how the insight she has now can help medical students and/or those in the early years of their careers, often characterized by great anxiety and uncertainty. We covered a lot of ground, including:
How has health care changed in the last 20 years, and how has that contributed to physician disempowerment and burnout?
Do young professionals need to have a negative experience in a large clinic system to see the value in a model like direct primary care, or can they pursue this path early in their career?
What are the biggest logistical challenges involved with getting a DPC firm off the ground?
How important are aesthetics and the physical environment to the care you provide and to creating a space where your community feels comfortable and welcome?
With all that said, I sincerely hope that you will enjoy listening to the brilliant Dr. Leila Javidi!
—Brian
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