Why continuity of care feels broken in medicine

Today a family told me, “We’d love for you to be our child’s primary doctor.”
I said yes—and then had to explain the reality of access.

If they want to see me specifically, they may need to ask for me by name and be willing to wait longer. If they just want the fastest appointment, they’ll likely see whoever is available.

That’s not a personal failure by patients or physicians. It’s how the system is designed.

Access has become king—get an appointment, get off the phone, move on. But that often comes at the cost of continuity, relationship, and a doctor truly knowing the patient.

Patients feel the fragmentation.
Doctors feel it too.

Some of these systems solve real problems. Others create new ones—especially around trust, follow-up, and sustainable care.

If we want something different, we have to name it and advocate for systems that work for patients, clinicians, and the long-term health of medicine—not business metrics alone.

If this resonates, you’re not alone.
Follow along as I share practical ways to build more sustainable, humane systems in medicine.

I’m Dr. Ryan, and I’m here to help you thrive in medicine.

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