Storied Medicine// Dispatch No 2

The Space Between the Notes

"I love ya even if I don’t know ya," Jon Batiste often says. It’s a beautiful sentiment in the world, but in a medical clinic, it’s more; it’s a rebellion. Modern medicine isn’t built for love or connection; it is built around the S.O.A.P. note. If you’ve never seen a medical chart, it follows a rigid architecture: Subjective, Objective, Assessment, and Plan. It’s a tidy way to turn a breathing human into a billable document. We are trained to be efficient; to focus on no more than two problems; to click the right boxes so the insurance company is satisfied; and to usher you out the door so the next person can occupy the still-warm crinkle of paper on the exam table.

The Missing Variable

The S.O.A.P. note loses the person in the acronym. It starts with the wreckage: surgical scars, pharmacy lists, the chronology of malfunctioning parts. But you are not a collection of side effects from pills prescribed by a stranger years ago.

When we start with the clinical, we treat a ghost. We throw ourselves off track before the conversation even begins. 

Bridging the Gap

So, where is the beginning? It begins with human aspiration. Your community and friends, and how often you actually see them. The fears that keep you awake at 3:00 AM. 

The tragedy is that these questions require Time, and time has been systematically stolen. It has been stripped away by executives and specialists hungry for a larger slice of the economic pie. In the process, the primary care physician—the one who understands the entire, interconnected symphony of the body—is treated as the lowliest ticket collector. Primary care providers suffer "moral injury" because we are forced to treat the condition while ignoring the person standing in front of us.

The New Architecture: S.O.H.A.P.

I am stepping out of the assembly line. I am moving into Direct Primary Care, where the clock belongs to us again. I am adding a letter to the sterile acronym: H for Holistic. S.O.H.A.P. Subjective, Objective, Holistic, Assessment, Plan. The "H" is the bridge. It is the recognition that your story is not a distraction from your health—it is your health.

A Slower, Kinder Medicine

By reclaiming time, we reclaim the possibility of discovery. A shared detail, a new stressor, a quiet confession—these are the keys that unlock the cause of pain.

I am building a clinic where we treat the person, not just the pathology. It is time to move toward a medicine that is healthier, stronger, and—finally—wiser. I want to meet you where you are. I want to be the kind of doctor who listens first and clicks boxes later (or not at all).

Because Batiste is right: You deserve to be cared about, loved even—and especially—by your doctor.

~ Owen TM Kendall, MD, MPH