What Physicians Say About Practicing Differently
Most physicians who have made the shift to a different practice model describe a version of the same experience: a moment when they realized the gap between the medicine they were practicing and the medicine they had always intended to practice had become too wide to ignore.
They weren’t looking for an easier career. They were looking for a way to practice the one they had chosen.
What follows are the perspectives of four physicians who have made that shift, in their own words, about what their practice looked like before, what finally moved them to change, and what practicing medicine looks like now.
“I Felt Like I Was Spread Too Thin With Every Single Patient”
Dr. Carmen Teague practiced internal medicine for 24 years, serving as Director of Internal Medicine for 14 of them. By any external measure, she was at the top of her field. By her own account, she was barely holding on.
Carmen Teague, MD, MC | Internist, Charlotte, NC | MDVIP-affiliated since 2024
“A run-of-the-mill day felt like catching water out of a fire hose. I was seeing about 28 patients a day. Patients would walk in and I would have no idea what their history was. I always felt like I was chasing my tail. It felt frantic, it felt overwhelming, and I felt like I was just doing a terrible job with every single patient.”
— Carmen Teague, MD, MC
The toll wasn’t just professional. In a five-and-a-half-month period, she lost 30 pounds and cried every day. Her family staged an intervention.
“My four children and my husband sat me down and said, mom, we don’t even know who you are anymore. You need to figure this out.”
— Carmen Teague, MD, MC
What she describes is something that doesn’t appear in burnout surveys but that many physicians recognize immediately: moral injury, the experience of being required, day after day, to provide care that falls short of what your patients deserve.
“I was required to see 28 patients a day, often many new, with no time to prepare, no time to build relationships, and no time to practice the kind of medicine I believe patients deserve. I felt like a gerbil on a wheel, constantly behind, unable to catch up, and never able to care for people the way I knew was right.”
— Carmen Teague, MD, MC
“We Practice Medicine Now Like My Grandfather Used To”
Dr. Karl Dannehl came from a high-volume internal medicine practice in Atlanta carrying a panel of 3,000 to 3,500 patients. The thing he describes most vividly about practicing differently isn’t a clinical outcome or a financial metric — it’s time.
Karl Dannehl, MD, FACP | Internist, Atlanta, GA | MDVIP-affiliated
“We practice medicine now like my grandfather used to. We can sit down and talk to our patients for 15 minutes, ask about the family. You can usually make a diagnosis 75% of the time if you just let the patients tell you their story.”
— Karl Dannehl, MD, FACP
He also describes something many high-volume physicians will recognize — the chest pain disclosed at the end of an appointment when time was already up.
“They would come in and then they’d say, you know, I didn’t mention this before, but I’ve been having these chest pains lately — when time was up. And it was like, oh my gosh, that’s important. You would spend another 30 minutes and you would be 30 minutes behind.”
— Karl Dannehl, MD, FACP
The change wasn’t just clinical. Dannehl found himself getting home two hours earlier than before — eating dinner with his family, walking his dog. Disorienting at first, and then simply good.
“I Didn’t Know There Was Another Way”
Dr. Keisha Ellis describes the path into volume-driven medicine as less of a choice and more of a current, something physicians are swept into before they fully understand what they’re agreeing to.
Keisha Ellis, MD | Internist and endocrinologist, Alpharetta, GA | MDVIP-affiliated
“A lot of times what we as doctors experience when you leave the field of training and go into actual practice is you’re kind of funneled into the corporate healthcare system and you don’t really see outside. It’s sort of given like a boogeyman vibe to be your own solo practitioner.”
— Keisha Ellis, MD
What changed for her was a persistent friend — someone willing to keep raising the question until Ellis was ready to hear it.
“Once someone shares another thought, you sit back and you have to first get over the fear and then second, realize — like in my case — that it’s exactly what I needed.”
— Keisha Ellis, MD
Looking back, her message to physicians who are asking the same questions she once avoided is direct:
“If I can speak to my past self, I would have said: it’s fine, go ahead. I would have told her to do it sooner. Listen to that first phone call, not the third phone call.”
— Keisha Ellis, MD
“I Knew I Couldn’t Go Back to a High-Volume Practice”
Dr. David Johnson’s framing is simpler than most — and for that reason, perhaps the most clarifying.
David Johnson, MD | Family medicine, Carson City, NV | MDVIP-affiliated
“I have a very clear idea of what practicing medicine is supposed to be like, because I have a very clear idea of what practicing medicine is supposed to be like, because I have practiced in different settings. And when I was faced with the possibility that we were going back to a high-volume practice, I knew I couldn’t.”
— David Johnson, MD
The MDVIP model, he says, isn’t just a return to something familiar. It’s more consistent with what he always believed patients deserve.
What Practicing Differently Actually Looks Like
For Dr. Teague, the change shows up most clearly in a single question she now asks at the start of every appointment — one she never had time to ask before.
“I sit in the room. I say, how was your day? What was your weekend like? Tell me about those grandkids. Because I have time to ask those questions. And then when I do get into the actual part of the visit, I get to ask a patient, what’s on your agenda today? We have time to talk about all of that today.”
— Carmen Teague, MD, MC
She named her practice Teague Internal Medicine and Enrichment — the acronym is TIME — because that is exactly what the model gave her back. Her message to colleagues who are where she was is not complicated:
“Life is too short to be miserable. Don’t think that just because the situation you’re in seems miserable, there’s no other way to do it. That is not true. There is always hope. There is always a way to find joy in what you’re doing.”
— Carmen Teague, MD, MC