It has been almost two years since the publication of the Telehealth Success book. I see some of the same discussions and challenges that I noted 12 years ago.

Ten years ago, I became a first-degree black belt. There’s a lot to say about the benefits of martial arts: the discipline, the ability to calm your mind, the camaraderie. In my case, it helped me become more self-aware and understand myself better. It helped me overcome burnout.

There is a scene from the Netflix show, Sexual Education in which two siblings are sitting in the waiting room of an emergency department (or A&E as the Brits call it). They had been called in because their mother was admitted to the hospital and they were awaiting news.

Most of what I write focuses on digital health, innovation, and systems change. But I am, and always will be, a doctor first.

There’s a line I have heard over and over in digital health: “We have to design for reimbursement.” It comes up in product meetings, hospital strategy meetings, policy roundtables, and investor pitches. And while I understand why, every time I hear it, I feel that familiar tightening in my gut.