It's a cliche to say health care is broken. However, the extent to which it is unnecessarily convoluted, inefficient, and fragmented frustrates even the most experienced clinicians each time they are forced to deal with its consequences. Medical records disappear when a patient switches doctors. Critical details of life-saving treatment plans are buried deep within thousands of pages worth of electronic charts.  In this episode, Stanford oncologist and journalist Ilana Yurkiewicz, MD explores all the ways that modern medicine is riddled with gaps and the incredible strain this puts on providers, patients, and caregivers alike. She is the author of the 2023 book Fragmented: A Doctor's Quest to Piece Together American Health Care. In the first half of our conversation, Dr. Yurkiewicz shares how she connects with patients and helps them through the worst moments of their lives—often taking place after a cancer has been treated. In the second half, we discuss why electronic medical records are failing doctors and patients, how clinicians can strive to retain a sense of autonomy, and how she manages the uncertainty that this broken system frequently imposes upon her. In this episode, you’ll hear about:  2:53 - Dr. Yurkiewicz’s day job as a primary care physician specializing in cancer patients and survivors 5:49 - The benefits that cancer patients and survivors receive in seeing a primary care provider with additional training in oncology 10:34 - What initially drew Dr. Yurkiewicz to oncology  15:00 - Why helping people through times of suffering is meaningful to Dr. Yurkiewicz 18:30 - How Dr. Yurkiewicz became adept at dealing with the diverse emotional psychosocial of cancer survivors  22:45 - What “fragmentation of the healthcare system” means to Dr. Yurkiewicz  24:24 - How patients expect the medical system to work versus how it actually works  34:30 - The challenges physicians face in piecing together a patient’s story through medical charts 39:12 - The consequences of fragmented medical records 46:26 - How electronic medical records can be improved 50:44 - How Dr. Yurkiewicz retains a sense of autonomy amid a fragmented system  58:11 - Dr. Yurkiewicz’s approach to having difficult and high-stakes conversations with patients  Dr. Ilana Yurkiewicz is the author of Fragmented: A Doctor's Quest to Piece Together American Health Care (2023). Dr. Yurkiewicz can be found on Instagram at @iyurkiewiczmd. In this episode, we discuss Danielle Ofri’s 2019 New York Times Op Ed The Business of Healthcare is Built on Exploiting Healthcare Workers. Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes. If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to [email protected]. Copyright The Doctor’s Art Podcast 2024