Hard Medicine

Ilana Yurkiewicz, MD
  • 5.0 (1)
  • MEDICINE
  • UPDATED MONTHLY

A show dedicated to solving medicine's hardest problems — one big question at a time. Hosted by Dr. Ilana Yurkiewicz, Stanford physician, professor, and journalist. ilanayurkiewiczmd.substack.com

Episodes

  1. FEB 10

    What Makes a Good Life with Stage IV Cancer?

    All of life, in a way, is decision-making with a deadline — paired with deep uncertainty about that deadline. For people living with stage IV cancer, both the deadline and its uncertainty are radically heightened. Cancer is one word, but it’s not one disease. Thanks to targeted therapies and evolving treatments, some people live for years with metastatic illness. They must make ongoing choices about work, relationships, and meaning, without knowing how many days they have or what those days will look like. In this episode of Hard Medicine, Dr. Yurkiewicz sits down with Dr. Bryant Lin, a primary care physician and clinical professor who was diagnosed with stage IV lung cancer just shy of his 50th birthday. How did he decide what to continue and what to let go? How much detail about prognosis did he seek? Does time itself pass differently when you know there’s less of it? 0:06 Opening Monologue: Living with Compressed Time 1:43 Life Before Cancer 4:01 Lung Cancer in Non-Smoking Asians 8:09 First Symptoms and Getting Diagnosed 18:27 How Much Did You Want to Know About Prognosis? 22:14 Making Decisions Under Uncertainty 27:42 Finding Joy and Passing Time 38:25 Choosing Hospice or Clinical Trials 41:29 Insurance Hell 50:20 “Sunshine” — What Makes a Good Life with Stage IV Cancer? Get full access to Hard Medicine at ilanayurkiewiczmd.substack.com/subscribe

    58 min

  2. JAN 12

    Can Primary Care Be Saved?

    Despite being one of the only parts of American medicine that consistently improves outcomes, primary care is in crisis. In this episode, Dr. Yurkiewicz talks with Dr. Lisa Rotenstein, a primary care physician and health systems researcher, about why modern primary care leaves doctors both chronically overworked and functionally unavailable. They unpack the structural mismatches driving this crisis: payment for visits but not the work in between, patient practices in the thousands, and the ever-expanding burden of electronic medical records. They also explore solutions: What is the ideal team, and is AI part of it? What’s the right number of patients for one doctor to see? And is fee-for-service payment simply incompatible with primary care today? 0:06 Opening Monologue: Primary Care Is a Design Failure 2:01 The Good — Why Doctors Choose Primary Care 6:15 What’s Wrong with Primary Care? 8:47 Distorted Math: 2,500 Patients and 27-Hour Days 13:56 Electronic Medical Record Burdens 21:44 When “Part Time” is Full Time 24:43 Consequences of an Unsustainable System 27:09 Is Fee-for-Service Payment a Non-Starter? 31:00 The Ideal Team and Continuity 37:29 What AI Can and Cannot Fix 44:08 Direct Primary Care 48:34 Can Primary Care Be Saved? Get full access to Hard Medicine at ilanayurkiewiczmd.substack.com/subscribe

    51 min
  3. Trailer: Hard Medicine

    TRAILER

    Trailer: Hard Medicine

    Healthcare is one of our most important institutions. But it’s no secret it’s deeply broken. Hard Medicine is a monthly podcast tackling the hardest questions facing medicine today: Can primary care be saved? What does a good life look like with stage IV cancer? Why does it take months to see a doctor? Hosted by Ilana Yurkiewicz, MD, Stanford physician, professor, and journalist, and the author of Fragmented: A Doctor’s Quest to Piece Together American Health Care. First episode drops January 12. Get full access to Hard Medicine at ilanayurkiewiczmd.substack.com/subscribe

    2 min

Trailer

About

A show dedicated to solving medicine's hardest problems — one big question at a time. Hosted by Dr. Ilana Yurkiewicz, Stanford physician, professor, and journalist. ilanayurkiewiczmd.substack.com

Information

  • Creator
    Ilana Yurkiewicz, MD
  • Years Active
    2025 - 2026
  • Episodes
    3
  • Rating
    Clean
  • Copyright
    © Ilana Yurkiewicz, MD
  • Show Website
    Hard Medicine