This week marks my 24th year in private practice. Wow, how things have changed. I still remember seeing many kids with chickenpox in the office, as the varicella vaccine had only been recommended for a few years at that point.¹ Beta-blockers in heart failure were just beginning to move from the contraindicated list to standard of care.² Warfarin was the only choice for outpatient anticoagulation since direct oral anticoagulants were not available until 2010, when dabigatran hit the market.³ The Institute of Medicine’s “Crossing the Quality Chasm” report had just been published,⁴ and the groundbreaking “Future of Family Medicine” report was still three years away.⁵

Professionally, I’ve gone from being part of a small, independent family medicine practice with anywhere from two to four doctors to being part of a larger primary care practice with more than 60 doctors spread across 20 locations. I’ve witnessed stacks and stacks of paper charts (we originally had one computer in the office that we’d use for billing) to now my daily joy — the electronic health record. And, of course, let’s not forget that by 2001 only four “Star Wars” movies had been released! These past 24 years have given me some gray hair, but hopefully some wisdom too.