I am no longer new. Of course, I’ve known this for a long time, but there are flashes when the realization arrives anew. Such as when I attended my 35th medical school reunion in 2012. When the slide shows of our young selves went up on the screen at the gala dinner, some of us had clearly changed outwardly. And when I talked to my classmates, some had become discouraged by what has happened to the practice of medicine in this country; this was especially true for those in primary care, who bemoaned the lack of time for each patient.