Primary Care Is Broken — Dr. Sukhjit Takhar on Rebuilding Medicine from Scratch
Primary care is broken. Physicians are squeezed into 15-minute slots, billing drives documentation more than patient outcomes, and people who want to stay healthy are left navigating a system that wasn't built for them. Dr. Sukhjit Takhar spent 25 years inside that system before deciding to rebuild it from scratch.
From the ER to a different model
Dr. Takhar's career spans academic medicine, busy emergency departments, and infection control during COVID. What kept pulling him forward wasn't the science alone — it was the people. Traditional practice made real relationships nearly impossible. The concierge format opened a path he didn't know existed: smaller panels, two-hour initial visits, and the space to actually know patients as humans.
The Z71.1 problem
One of the most striking moments in the conversation is the explanation of diagnostic code Z71.1 — the worried well. A patient comes in, nothing pathological is found, and the visit is billed under a code that essentially means: this person was fine. You cannot bill meaningfully for reassurance, education, or time spent listening. When patients feel unheard, they end up in internet rabbit holes ordering their own labs and full-body MRIs with no one to interpret results.
What PrimaryMD actually does differently
The model is straightforward: a yearly membership, a small patient panel, and a team that removes friction. Labs are drawn at home before the first visit. Records are reviewed in advance. The initial consultation runs about two hours — not spent on clipboard intake but on understanding what the patient actually wants. Asked which element he would cut if forced to choose, Dr. Takhar says the extensive lab panels. The coaching and physician time are non-negotiable.
Skepticism as a clinical skill
His infectious disease training shaped how he evaluates the longevity hype cycle. During early COVID he watched hospitals adopt interventions on the basis of plausible mechanisms and mouse data, and was skeptical from day one. That same lens applies to the supplement and peptide trends now flooding social media. A molecule working in a mouse with a metabolism roughly 300 times faster than a human's does not translate the way influencers suggest.
Mixed medical arts
Dr. Takhar introduces a concept he calls Mixed Medical Arts, modelled after how MMA evolved from pitting individual styles against each other into an integrated discipline. He wants to take the best from functional medicine, sports physiology, chiropractic, acupuncture, and nutrition and fold it into evidence-based primary care — not uncritically, but with humility.
The Return on Health question
Asked what one thing he would change in the current healthcare system, Dr. Takhar's answer is simple: give patients more time with their primary care doctor. Not more data, not more referrals. Time.
Key takeaways
Primary care must shift from reactive 15-minute visits to relationship-driven, longevity-oriented care. The concierge model — smaller panels, longer visits, dedicated coaching — enables prevention over procedure. Scientific skepticism is essential when evaluating longevity trends. The single highest-leverage change in healthcare: more time with your doctor.
Questions this episode answers
Why is primary care broken?
Because the format makes real relationships nearly impossible. Short visits and billing rules leave no room for reassurance, education or time spent listening, which is the part of the work that actually helps most patients.
What is diagnostic code Z71.1, and why does it matter?
It is the code for the worried well: a patient comes in, nothing pathological is found, and the visit is billed under a code that essentially means this person was fine. You cannot bill meaningfully for reassurance or education, so patients who feel unheard end up ordering their own labs and full-body MRIs with nobody to interpret the results.
What does concierge primary care do differently?
A yearly membership, a small patient panel and a team that removes friction. Labs are drawn at home before the first visit, records are reviewed in advance, and the initial consultation runs about two hours spent on what the patient actually wants rather than on intake paperwork.
Which part of that model matters most?
Asked what he would cut if forced to choose, Dr. Takhar names the extensive lab panels. The coaching and the physician time are the parts he treats as non-negotiable.
Why is he skeptical of peptides and longevity supplements?
His infectious disease training shaped it. During early COVID he watched hospitals adopt interventions on the basis of plausible mechanisms and mouse data. A molecule working in a mouse with a metabolism roughly 300 times faster than a human's does not translate the way social media suggests.
What is Mixed Medical Arts?
His term for integrating the best of functional medicine, sports physiology, chiropractic, acupuncture and nutrition into evidence-based primary care, modelled on how MMA evolved from pitting individual styles against each other into one discipline. Not uncritically, but with humility.
What one thing would he change about healthcare?
Give patients more time with their primary care doctor. Not more data, not more referrals. Time.