Listening First: How Dr. James Powell Redefines Primary Care
“Everything starts with connection. When I walk into a room, or appear on screen, my first question is always, ‘How can I help you today?’ Then I listen. Uninterrupted. For at least a minute.”
That uninterrupted minute may not seem revolutionary, but for Dr. Powell, CEO of DocGo’s Clinical Practice Group and a board-certified internist, it is the foundation of effective care. His approach centers on one principle: learn from the patient. Observe what they say, how they say it, and what they might not be able to articulate. For Dr. Powell, the patient’s story is a primary diagnostic tool.
Earlier in his career, Dr. Powell worked extensively with adults with intellectual/developmental disabilities. “It taught me patience. Sometimes I had to diagnose conditions that the patient couldn’t clearly describe. I had to listen differently, think differently,” he said.
That experience still informs his approach. Whether in person or virtual, Dr. Powell leans on observation, empathy, and collaboration to guide clinical decision-making.
A 12-Month Cycle of Wellness
Primary care, Dr. Powell believes, must be proactive. “Being a PCP isn’t about just treating what’s in front of you today. It’s about helping someone reach a better tomorrow,” he said. That’s why he builds care plans around a 12-month cycle of wellness.
Annual wellness visits are an anchor in this model. They are more than just checkups; they’re opportunities to take stock of historical information, review any chronic conditions, and assess emerging risks. From there, Dr. Powell collaborates with patients to create a roadmap, including immunizations, diagnostics, and lifestyle goals.
He encourages patients to be specific in creating SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) goals. “Saying, ‘I want to exercise more’ doesn’t help anyone. But saying, ‘I’m going to walk 7,000 steps a day’; that’s something we can measure. That’s something we can track together.”
The Power of Shared Decision-Making
A cornerstone of Dr. Powell’s philosophy is partnership. He outlines choices, shares medical context, and empowers the patient to weigh in instead of presenting prescriptions as ultimatums.
Take a case of high blood pressure. “Maybe they want to try lifestyle changes first. If they’re stable, I say okay. But we agree: in the next few weeks, if it hasn’t improved, we add a medication. That kind of shared accountability goes a long way.”
Dr. Powell doesn’t believe in compromise for compromise’s sake. For him, it’s about fostering trust. Patients who feel heard are more likely to engage. And trust, once earned, makes future clinical decisions easier and more effective.
Team-Based Care as a Modern Model
Dr. Powell believes that the model of providers being involved in in each point of the decision-making process has been outdated for years, and is in need of change; “All the information around a patient doesn’t have to flow through me. We tie in care coordinators, nurses, support staff — each playing a role in delivering quality touchpoints.”
In this workflow, Dr. Powell can focus on clinical implications and long-term strategies, while other team members handle logistics and education. “I am delivering the greatest value when I can share advice that helps patients overcome their day-to-day obstacles, make healthier choices, and live a more balanced life.”
Medicine as Storytelling
He recalled inheriting patients from a retiring physician, each with just a few index cards of notes. “That doctor knew everything in his head. But today, medical records are read by everyone on the care team. I need to tell the patient’s story clearly enough that the next clinician knows what the next chapter should be.”
Technology as an Enabler
Dr. Powell is a vocal supporter of using technology to reinforce, not replace, meaningful care. Ambient AI tools, for example, can lift the administrative burden.
“The best part of taking care of people is taking care of people. Not the clicks, the typing, the acknowledgments. AI can help by capturing conversations and generating clinical notes. That gives me more time to teach, to listen, to build trust.”
He sees virtual-first models and AI-enhanced documentation as tools to bring clinicians closer to the patient. They allow providers to listen and engage with patients while an AI scribe is taking notes behind the scenes.
“To me, AI is about freeing up time so that clinicians can maximize their personal connections with patients. It’s about creating space for shared decision-making. That’s the secret sauce of medicine.”
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