Leadership, Caregiving, and Health: Can You Have It All?

Direct primary care, no-insurance medicine & why physicians are leaving the system, explained by a board-certified internist | Midlife women's health, the self-care blind spot, functional fitness & why waiting until 65 for a bone scan is too late. Dr. Nadia Sirdar, MD, MPH is a board-certified internal medicine physician trained at Yale, Northwestern, and UT Southwestern who spent nearly a decade as a hospitalist at Johns Hopkins' Sibley Memorial Hospital before walking away from the employed-physician model entirely. In January 2026 she opened Bethesda Modern Primary Care, a membership-based direct primary care practice serving adults in the DC, Maryland, and Virginia area with a focus on perimenopause, menopause, prevention, and healthy aging. In this conversation with Dr. Amy Loden Tiffany, you'll learn why a doctor with 3,000 patients and 15 minutes per visit can't actually know you, who really decides how physicians practice medicine, why "provider" and "physician" aren't the same word, the single blind spot that keeps high-achieving women from getting basic preventive care, and why being strong enough to carry your groceries up a hill at 75 matters more than any number on a scale. ⏱️ CHAPTERS 00:00 – Welcome to The Authentic Physician 01:01 – Who is Dr. Nadia Sirdar? 02:40 – Who are you without your credentials? 04:18 – The podcast that changed her mindset 05:11 – Why she left her infectious disease fellowship 07:12 – How a neighbor's nest egg started a practice 09:12 – "Why doesn't my doctor talk to me like you do?" 10:53 – Who's really deciding how doctors practice? 13:04 – Is insurance actually good business? 14:26 – Why direct primary care is exploding 15:37 – What is direct primary care? 16:54 – The hidden cost of referrals 17:48 – Why doctors stopped touching patients 19:27 – Is your insurance actually insurance? 21:57 – How do we fix it? 24:34 – Physician vs. provider: why the word matters 28:20 – Why old habits stop working in midlife 29:30 – What she refuses to compromise on in women's health 30:28 – The biggest blind spot for high-achieving women 33:16 – The 25-pound baby that fixed a patient's sleep 35:59 – Sex, aging, and vaginal estrogen 38:26 – Menopause minutes 40:06 – Why bone density screening at 65 is too late 41:31 – Strong enough for the hill at 75 42:56 – If you live to 89, what does 88 look like? 44:47 – "Break me out of here" 45:29 – Why some physicians got mad 47:23 – Find a partner, not a paternalist 48:03 – Where to find Dr. Sirdar Direct primary care is a membership-based model in which physicians do not bill insurance, keep smaller patient panels, and handle most care in-office. Employed physicians in the insurance system commonly carry 3,000 or more patients with roughly 15 minutes per visit. Vaginal estrogen for postmenopausal women reduces urinary tract infections and makes intercourse comfortable. Standard guidelines do not recommend bone density screening until age 65, though the average age of menopause is 51. 🎙️ ABOUT YOUR HOST Dr. Amy Loden Tiffany, MD, MBA, FACP is a triple board-certified physician (Internal Medicine, Lifestyle Medicine, Obesity Medicine) and founder of Vitality Medical and Wellness Consulting, a physician-led concierge practice in St. Louis helping women navigate postpartum, perimenopause, menopause, and midlife health. 🌐 https://vitalitymwc.org/?utm_source=y... 👩‍⚕️ CONNECT WITH DR. SIRDAR 🌐 https://bethesdadoctor.com 📸 Instagram: @drnadiasirdar 📘 Facebook: Dr. Nadia Sirdar ▶️ YouTube: @drnadiasirdar 📍 5272 River Road, Suite 300, Bethesda, MD