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Explore every episode of the podcast How I Doctor with Dr. Graham Walker

Dive into the complete episode list for How I Doctor with Dr. Graham Walker. Each episode is cataloged with detailed descriptions, making it easy to find and explore specific topics. Keep track of all episodes from your favorite podcast and never miss a moment of insightful content.

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TitlePub. DateDuration
51 of the Top 100 Healthcare Companies Had a Physician Founder: Dr. David Lortscher Explains Why23 Jul 202600:30:17

Dr. David Lortscher is a dermatologist turned founder of Curology, one of the first companies to combine telehealth, prescription skincare, and a subscription model into something patients would actually use. He's also the author of a new book making a data backed case that should unsettle every hospital administrator who's ever doubted a physician founder: Why Doctors Win.

In this episode of How I Doctor, Dr. Graham Walker sits down with David to trace his path from a dermatopathology fellowship waiting for him at UCLA to starting Curology, and then a decade later stepping back from the CEO seat. That gave him time to go looking for proof that his own success wasn't a fluke.

What he found is that 51 of the top 100 healthcare companies founded in the last 40 years had a physician founder!

Graham and David get into why the doctor plus engineer pairing keeps showing up in the biggest healthcare success stories, the blind spot that trips up even smart physician founders, and David's blunt rule for anyone gathering advice before making the leap: take the inputs, not the conclusions.

What You'll Learn

  • Why physician founded healthcare companies outperform at roughly 3x the rate you'd expect from their overall representation among founders
  • The doctor plus engineer combination that shows up in 7 of the 10 companies profiled in Why Doctors Win, and why it works
  • How an MD behind your name changes the way you sell into a hospital, from the CMO's office up to the CEO and CFO
  • The most common blind spot physician founders hit: falling for the technology itself instead of the harder question of who will actually pay for it
  • David's rule for gathering advice from as many people as possible while still keeping the final decision your own

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📝 For a full transcript of this episode click HERE

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What Does Good AI in Healthcare Look Like? CHAI CEO Brian Anderson Is Trying to Get Every Hospital in America to Agree16 Jul 202600:31:28

Dr. Brian Anderson is a pediatrician turned CEO of the Coalition for Health AI (CHAI), the organization behind the push to give every AI tool in your EHR something like a nutrition label: what it was trained on, who trained it, and where it might fail.

In this episode of How I Doctor, Dr. Graham Walker sits down with Brian to trace his path from a Mass General exam room, where a clunky EHR rollout first pushed him toward building technology instead of just using it, to running a coalition of more than 3,000 organizations trying to agree on one deceptively hard question: what does good AI in healthcare actually look like.

They also break two major pieces of news together, live on the show. OpenAI and Anthropic are donating thousands of AI licenses to public health agencies through CHAI, aimed at rebuilding trust in digital tools after decades of underinvestment. And CHAI is launching a health sector specific version of Anthropic's Project Glasswing, bringing serious cybersecurity firepower to the industry Brian calls the most attacked critical infrastructure in the country.

Graham and Brian also get into what "human in the loop" should really mean for a working physician, why model cards solve procurement but not the fifteen-minute exam room, and what CHAI is doing to finally connect AI performance to real clinical outcomes.

What You'll Learn

  • What CHAI's model cards actually tell a physician, and the gap that still exists between hospital procurement and the exam room
  • The details of CHAI's new partnership with OpenAI and Anthropic, and what it means for public health agencies gaining free access to Claude and ChatGPT
  • Why CHAI is bringing a health sector version of Anthropic's Project Glasswing to hospitals, the most attacked critical infrastructure sector in the country
  • How CHAI plans to measure whether AI tools are actually improving patient outcomes, not just getting deployed

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📝 For a full transcript of this episode click HERE

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Two Surgeons Explain Why U.S. Healthcare Is So Broken And Can't Be Reformed From Inside, from Wendy Dean's 43cc Podcast09 Jul 202600:39:02

A few weeks ago, Graham sat down with Dr. Wendy Dean, co-founder of Moral Injury in Healthcare, for one of his favorite conversations this show has ever recorded. It's the kind of episode that changes how you talk about your own job.

That's why this week, How I Doctor is doing something new: handing the feed over to Wendy's own show, 43cc, which she co-hosts with orthopedic surgeon Dr. Matt Ramsey. 43cc bills itself as informal, informative, and irreverent, and if this episode is representative, that's undersold. It's the conversation you'd have with a colleague after a brutal clinic day, if you let yourself say the quiet part out loud.

In this episode, Wendy and Matt start from a real patient encounter, a $3,100 out-of-pocket shoulder MRI on a $6,500 deductible, and use it to walk through exactly how the system got this expensive and this hard to fix from the inside. They don't stop at diagnosing the problem. They name the specific legislative mechanism (a provision buried in the Affordable Care Act) that keeps physicians from building an alternative, and the bills currently in Congress trying to undo it.

What You'll Learn in This Episode:

  • Why one patient's $3,100 out of pocket MRI charge reveals exactly how high deductible plans are designed to work against patients, not for them
  • The real difference between concierge medicine and direct primary care, and why Wendy argues only one of them actually changes the underlying cost of care
  • How Section 6001 of the Affordable Care Act froze the growth of physician owned hospitals in 2010, and why reversing it has become one of the more promising paths to real competition in healthcare
  • Why employer sponsored health plans, not federal legislation, may be the most realistic lever for forcing change in how insurers and hospitals operate

Subscribe to 43cc wherever you get your podcasts to hear more from Wendy Dean and Matt Ramsey. Full episode and show notes here: 43ccpodcast.com

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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40+ Authors, 9 Specialties, and a Book Written by the Next Generation of Doctors: Emily Leventhal and Rishma Jivan on The Physician's Guide to AI From Offcall and MD+02 Jul 202600:35:42

Emily Leventhal is a third-year MD-PhD student at the Icahn School of Medicine at Mount Sinai. Rishma Jivan is a fourth-year at Rush Medical College who spent years inside San Francisco health tech startups before going back to medical school. Together they co-led The Physician's Guide to AI, a nine-specialty e-book built with more than 40 physician authors, published in partnership with MD+.

In this episode of How I Doctor, Dr. Graham Walker sits down with Emily and Rishma to find out what medical training actually looks like from inside the AI shift. What's really happening on rotations, in the hallways, and in the conversations students are having with attendings who don't always know what to make of it.

They dig into the "hidden curriculum," the unwritten norms of medical training that AI is starting to help close for students who don't come from medical families, and why Rishma refuses to let herself trust an AI output without teaching herself to critique it first. Emily makes the case that AI won't just change how physicians practice, it will change which specialties students choose to go into at all. And both push back on the idea that relying on these tools is a shortcut, describing it instead as a discipline they're still building the rules for in real time.

This isn't about students skipping the hard parts of training. It's about a generation building the habits and guardrails the rest of medicine hasn't caught up to yet.

📖 Download The Physician's Guide to AI: https://www.amazon.com/dp/B0GY36B58Z

What You'll Learn

  • Why every medical student is already using ChatGPT to prep for cases, and why that's different from the smaller group actually building AI tools.
  • What the "hidden curriculum" is, and how AI is helping close that gap for students without a medical background in the family.
  • How to guard against automation bias: the habit of verifying an AI output against its source before trusting a clinical recommendation.
  • Why AI's impact on a specialty may become a real factor in how students choose where to train.

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

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Your Patient Trusts ChatGPT More Than You Now: The New Yorker's Dr. Dhruv Khullar on Medical Authority in the Age of AI25 Jun 202600:37:07

Dhruv Khullar is a hospitalist at New York Presbyterian, a health policy researcher at Weill Cornell, and a contributing writer to The New Yorker. That combination is rarer than it should be. Most physicians writing about medicine observe it from a remove. Dhruv rounds on patients in the morning, then sits down to report on what medicine is becoming for one of the most widely read publications in the country. What he writes carries clinical weight because he was just in the room.

Over the past several years, Dhruv has reported at length on AI and its risks for clinical training, the structural forces reshaping the profession, and what he calls the Gilded Age of American medicine: dazzling innovation on the surface, structural rot underneath. That rot has a specific anatomy. Private equity now owns roughly 500 hospitals in the United States, and in some markets a single firm controls more than half of physician practices in a given specialty. Medicare Advantage insurers have turned risk-adjusted payment into a revenue strategy, systematically capturing diagnostic codes for conditions patients may not know they have and that no physician is treating, because sicker-looking patients generate more money. The value-based care revolution that many physicians believed in, Dhruv included, has not delivered on its promise. And all of it is happening while AI is simultaneously raising the ceiling of what medicine can do and quietly lowering the floor of what training physicians are being asked to do themselves.

In this episode of How I Doctor, Graham sits down with Dhruv to get into what his reporting has actually uncovered and what it means for physicians living inside this moment. They talk about the difference between cognitive deskilling and cognitive foreclosure: the risk that medical trainees who turn to AI before doing the hard thinking themselves may never build the reasoning infrastructure that clinical judgment depends on. Dhruv describes watching an AI model called Cabot go head to head with one of the best diagnosticians he has ever trained alongside on a New England Journal CPC case, and nearly gasping when the machine finished in minutes. They also get into what happens to medical authority when a patient in your ER trusts ChatGPT over the physician standing in front of them, how Medicare Advantage is being gamed, and whether medicine can still be a calling after the system has spent years making it feel like a job.

What You'll Learn in This Episode:

  • Why cognitive foreclosure may be a bigger threat to physician training than cognitive deskilling
  • What Dhruv witnessed when an AI went up against one of the best diagnosticians he has ever trained alongside, on one of medicine's hardest diagnostic case formats, and why it made him nearly gasp
  • How Medicare Advantage insurers have turned risk adjustment into a revenue strategy
  • Why the most successful version of physician advocacy will be built around patient needs rather than professional status
  • Whether medicine can still be a calling after the system has spent years turning it into a job

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

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IG https://www.instagram.com/ubergraham/

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How Stanford Health Care Is Rethinking What AI Should Actually Do for Clinicians with CIO Dr. Michael Pfeffer18 Jun 202600:35:03

Dr. Michael Pfeffer is Stanford Healthcare's Chief Information Officer and a practicing hospitalist, which means he builds AI tools in the morning and uses them on patients that afternoon. That combination is rarer than it should be, and it shapes everything about how he thinks.

Stanford is one of the most AI-forward health systems in the country. It runs 1,500 software applications, has put generative AI into the hands of its clinicians through ambient documentation and a plain-language chart querying tool called ChatEHR, and has published the outcomes of all of it, including the parts that did not go as expected. Mike's argument is that none of that is the point. Healthcare spends three times more on AI than any other industry, and most of that investment is going toward automating processes that were broken to begin with. Digitizing the way medicine has always been done is not transformation. The real opportunity is redesigning what the encounter itself looks like, offloading guideline-driven busywork to agents that can own it, and building toward a world where the right test is ordered the first time and the right drug is prescribed before the patient leaves the room.

In this episode of How I Doctor, Graham sits down with Mike to get into what Stanford has actually built, what the data shows, and what distinguishes a health system that deploys AI responsibly from one that just deploys it. They also get into clinical AI governance, how physicians interact with decision support versus how they should, whether the next generation of trainees is losing its curiosity or still has it, and what Mike's ideal AI-enabled hospital day actually looks like in five years.

What You'll Learn in This Episode:

  • What the difference between digitizing and transforming healthcare actually means in practice
  • Why healthcare spending more on AI than any other industry may be a sign of lag, not leadership
  • How Stanford uses the FURM framework to evaluate every AI application
  • Why the biggest mistake medicine could make with AI is buying a lot of it without understanding the value, and what responsible deployment actually requires
  • Why Mike is less worried about AI deskilling the next generation of physicians than most and what he saw on rounds last week that gave him confidence

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📝 For a full transcript of this episode click HERE

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Meet the Doctor Who Went Anonymous to Say What the Rest of Us Can't: The Story of Dr. Orange11 Jun 202600:34:09

Dr. Orange is a primary care physician, one year out of residency, practicing somewhere in the United States at a health system she can't name. She posts on TikTok as a talking orange, with her face obscured and her voice altered, because showing up as herself would cost her too much. Her employer might find out. Her patients might lose confidence in her. And after years of training and too much debt, she cannot afford either.

What she says from behind that mask is not radical. It is what physicians say to each other in workrooms, in parking lots, in group texts that will never see the light of day. That the job is not what they signed up for. That the administrative burden is crushing. That corporate medicine has turned patient care into customer service. That they feel like children being managed by a system that owns them.

She said it anyway. Thousands of people have found her.

In this episode of How I Doctor, Dr. Graham Walker sits down with Dr. Orange for the most candid conversation about the state of medicine you will hear from a physician who is still inside it. They cover the financial trap that keeps early-career doctors locked in jobs they want to leave, the expectation gap that nobody warns you about before you become an attending, what would actually have to change for her to love her job, and why the anonymous fruit salad of healthcare workers she accidentally created online is one of the most honest signals medicine has produced in years.

What You'll Learn in This Episode:

  • Why physicians who speak honestly about hating their jobs risk their patients, their employers, and their careers, and what it says about medicine that anonymity is the only safe container for that conversation
  • What the first year of attending life actually looks like when residency ends and the full weight of portal messages, non-clinical requirements, and production pressure lands all at once
  • How student loan debt and restrictive contracts function as a structural trap that keeps early-career physicians in systems that are making them miserable
  • Why autonomy, not salary, may be the variable that determines whether the next generation of physicians stays in medicine at all

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Moral Injury Is Why The Best Doctors Are Disappearing with Dr. Wendy Dean04 Jun 202600:35:54

Dr. Wendy Dean is a psychiatrist, author, and the co-founder of Moral Injury of Healthcare, a nonprofit dedicated to understanding and alleviating clinician distress. In 2018, she co-wrote a 500-word op-ed in STAT News that did something rare: it handed an entire profession the language for something most physicians had been carrying alone. The argument was simple and devastating.

Physicians aren't burning out.

That implies a personal failure of resilience. What's actually happening is moral injury, the damage that accumulates when you are repeatedly forced to act in ways that violate your own moral code.

That piece started an international conversation that Wendy has been leading ever since, through her book "If I Betray These Words," her podcast 43cc, and her ongoing research and consulting work with health systems around the world.

In this episode of How I Doctor, Dr. Graham Walker sits down with Wendy to go deep on what moral injury actually is, why getting the language right matters so much, and what a healthcare system that takes clinician distress seriously would actually need to look like. They cover AI's entry into an already fractured system, the EMR as a cautionary tale the profession is at risk of repeating, and the grief that comes with watching a profession you love get slowly hollowed out.

What You'll Learn in This Episode:

  • Why burnout and moral injury are distinct problems that require fundamentally different solutions, and why naming it correctly changes where responsibility sits
  • What it actually feels like to be morally injured, and why the absence of a bid to repair a betrayal is often where the real damage sets in
  • How physicians are trained to be independent thinkers and then placed in systems that give them no authority, no agency, and all of the responsibility
  • Why Wendy believes AI is walking into the same trap as the EMR, and what the liability question nobody in health law has answered yet tells us about where this is heading
  • What gives Wendy genuine hope that medicine gets to the other side, and why the grief physicians are carrying right now is also a signal that the fight is not over

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

It's all coming together

Abridge is hosting its first-ever Keynote, live from New York City and streaming globally for the Offcall community. Join Abridge CEO and Founder, Dr. Shiv Rao, for a presentation on the future of AI in healthcare. Register at https://events.abridge.com/keynote

Now Is Not the Time for Silence. Dr. John Whyte on the AMA, AI, and the Stakes for Physicians Right Now28 May 202600:31:36

Dr. John Whyte is a board-certified internist who has spent his career at the intersection of medicine, policy, media, and technology. He served at the FDA, built a reputation as one of medicine's most trusted public communicators at WebMD, and 10 months ago became CEO and Executive Vice President of the American Medical Association, the oldest and largest physician organization in the United States.

Whyte came into the role with a candid assessment: the AMA had lost some of its relevance and impact, and needed to become a real force for physicians and patients in Washington again. He's now leading that effort at a moment when the profession is navigating burnout, prior authorization, scope creep, a rapidly shifting AI landscape, and a payment system that fails to make the case for what physicians actually contribute to patient safety and access.

In this episode of How I Doctor, Dr. Graham Walker sits down with John to cover what the AMA is focused on right now and why, how AI is already reshaping the way physicians practice whether they're ready or not, and what it means that the efficiency gains from AI tools are largely flowing to health systems rather than back to physicians or patients. They also get into the harder question underneath all of it: who speaks for physicians when the stakes are this high, and what happens to the profession if physicians stay on the sidelines.

What You'll Learn in This Episode:

  • Why physician burnout remains at 40% across the profession and above 50% in emergency medicine and OB-GYN, and why the AMA believes it has to be solved at the systems level
  • How AI adoption among physicians jumped from 38% to 81% in three years, and why that speed of uptake hasn't translated into more time with patients
  • Why the real argument for physician payment is not compensation but patient safety and how the public narrative gets this wrong
  • What the AMA is doing on prior authorization and scope creep, and why those are the two issues where physicians are most aligned across specialties

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Dr. Rana Awdish Almost Died as a Fellow. Now She's Teaching Doctors How to Heal.21 May 202600:36:39

Dr. Rana Awdish is a pulmonologist, critical care physician, and Medical Director of Care Experience at Henry Ford Health in Detroit. She is also the author of In Shock, a book that has changed the way countless physicians walk into a patient's room, and her new book After Shock, which picks up where that story left off.

Rana nearly died as a fellow from a catastrophic illness that left her hospitalized in the very system she had trained inside. What she heard, experienced, and absorbed from the other side of the bed became the foundation for a decade of research into how medical language shapes patient outcomes.

In this episode of How I Doctor, Dr. Graham Walker sits down with Rana to explore what it actually means to heal, both for patients and for the physicians caring for them. They dig into Rana's Never Words research, published in Mayo Clinic Proceedings, which identifies specific phrases physicians use that strip power from patients and offers concrete alternatives. And they get into the harder questions: how do you build trust with patients, why the data shows compassionate care actually makes clinical visits more efficient, and what it means that medicine has spent decades rewarding physicians for ignoring their own bodies.

What You'll Learn in This Episode:

  • The specific words and phrases from Rana's Never Words list that physicians should stop using, and what to say instead
  • Why redistributing power through language is not just ethical but changes clinical outcomes including adherence and return visits
  • Why medicine rewards disembodiment in physicians and what the cost of that has been for trainees, patients, and the profession
  • What curiosity can do when every other communication tool has run out
  • Why the culture of medicine is not fixed, and what physicians can actually do to reshape it from within

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

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Physician VC Dr. John Dayton on What It Takes to Actually Build a Winning Healthcare Startup14 May 202600:38:03

Dr. John Dayton is an emergency physician, Stanford innovation fellow, and co-founder of Wildfire Partners, a new healthcare seed fund built around a simple but data-backed conviction: physicians make better health tech founders than the industry has ever given them credit for.

The data is hard to ignore: more than a quarter of billion-dollar healthcare companies built in the last decade had at least one clinician co-founder. John did not just write that paper. He built a fund around it.

In this episode of How I Doctor, Dr. Graham Walker sits down with John to dig into what it actually takes to build a health tech company worth funding. They walk through John's Seven Ps framework for evaluating startups, what makes a pitch compelling versus an instant red flag, and why the barrier to entry for physician-founders has never been lower thanks to AI.

What You'll Learn in This Episode:

  • The Seven Ps framework John uses to evaluate every health tech company he considers funding
  • What kills a pitch immediately and what signals a founder has actually done their homework
  • Why AI has dramatically lowered the barrier to entry for physician-founders and what that changes about building a company today
  • How to think about the principal-agent problem when selling into health systems
  • Why ambient AI tools matter more for physician burnout than the time savings data alone suggests
  • What John learned about scalable, practical problem solving from practicing in resource-poor clinical environments
  • What winning actually looks like and why it is about more than financial

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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IG https://www.instagram.com/ubergraham/

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Going Independent Doesn't Mean Going It Alone. Dr. Basil Kahwash on Fixing Referrals and Building Physician Networks07 May 202600:42:12

Most physicians have had a referral disappear. Many have spent days tracking down a colleague just to coordinate care for a single patient.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Basil Kahwash, an allergist and immunologist in Columbus, Ohio, to talk about one of the most universal and underappreciated problems in medicine: the referral system is broken, and independent physicians are paying the highest price.

Basil didn't set out to become an advocate for fixing referrals. He trained at Vanderbilt, where reaching a collaborating physician was as simple as sending an Epic message or jumping on a 20-minute Zoom call with three specialists at once. Then he went into independent practice in Columbus and discovered that none of that infrastructure existed. No shared records. No easy way to reach a referring physician. No directory of local specialists. Just a fax machine, a stack of paper charts, and a phone number he hoped was still current.

The referral black hole isn't just a physician frustration. It's a patient safety problem. Basil shares the story of a pregnant patient with a rare drug allergy whose referring OB-GYN he couldn't reach for three to four days. These aren't edge cases. They're a typical Tuesday.

Graham and Basil co-authored the referral manifesto at offcall.com/manifesto, making the case that independent practice doesn't have to mean isolated practice. This episode is the conversation behind that letter: what's actually broken, what it costs physicians and patients, and what a connected network of independent physicians could change.

What You'll Learn

  • How patients have become the de facto middlemen in a system that has no better option
  • Why most referrals arrive as little more than a diagnosis code, and what even a small amount of added context would change
  • How the fax machine became the rate-limiting step for physician collaboration and why EHRs haven't solved the problem
  • Why hyperlocal physician networks exist within specialties online but not across specialties within cities, and what filling that gap could look like
  • What winning looks like if the referral problem gets solved: coordination fades into the background and physicians get back to patient care

Resources and Where to Find Basil and Offcall


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Restoring Physician Mental Health and Honoring the Legacy of Dr. Lorna Breen, With Dr. Stefanie Simmons30 Apr 202600:38:21

Most physicians know a colleague who has struggled. Many know one who didn't make it.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Stefanie Simmons, Chief Medical Officer of the Dr. Lorna Breen Heroes' Foundation and practicing emergency physician in Ann Arbor, Michigan, for one of the most important conversations in medicine right now.

Physician mental health isn't an abstract policy issue.

It's the licensing form that places a mental health history question directly after "are you a pedophile." It's the peripartum depression Stefanie developed during her own residency that she never treated because a formal diagnosis felt like a career risk. It's Dr. Lorna Breen, chair of emergency medicine at New York Presbyterian, working 18-hour days through the first COVID wave in Manhattan, who received mental health care and told her family she was terrified it would cost her her license.

Stefanie didn't know Lorna before her death. But like every emergency physician in the country, she was one degree of separation from her. And when Lorna's family started hearing from hundreds, then thousands, of healthcare workers who said "she wasn't alone," Stefanie was one of the people who called.

Stefanie makes the case that physician mental health is a systems failure, not a personal one, and that the fix is structural. The foundation has already changed the credentialing language at more than 2,000 hospitals and across 70 state licensing boards, covering more than 3 million health workers. The Lorna Breen Healthcare Provider Protection Act was reauthorized in February 2026. The calculus is shifting. But the work is far from complete.

This episode is an honest conversation about why physicians won't seek mental health care, what it costs when they don't, and how one foundation is rebuilding the system from the inside out.

What You'll Learn

  • How the Dr. Lorna Breen Healthcare Provider Protection Act works, what it funds, and why its reauthorization matters for every physician
  • How a single question on a licensing application has kept generations of physicians from getting help, and what the foundation is replacing it with
  • Why physicians massively overestimate how much their colleagues will judge them for seeking mental health care, and what the data actually shows
  • What Stefanie's own experience with peripartum depression during residency taught her about the cost of not getting help
  • Why burnout is an occupational syndrome, not a personal failing
  • What a struggling physician can do right now, and where to find support

If You or a Colleague Need Help

  • 988 Suicide and Crisis Lifeline: call or text 988 / 988lifeline.org
  • Physician Support Line: free, confidential, anonymous, staffed by psychiatrists / 1 (888) 409-0141 / physiciansupportline.com
  • Emotional PPE Project: free anonymous mental health care for clinicians / emotionalppe.com
  • All For Mental Health resource hub: drlornabreen.org/all-for-mental-health

Resources and Where to Find Stefanie and the Foundation


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Why The Pitt Is the Show Every Doctor Needs Right Now, with Dr. Jeremy Faust23 Apr 202600:45:07

The Pitt just wrapped its most talked-about season yet - and two ER doctors who lived the real version have thoughts.

In this episode of How I Doctor, Dr. Graham Walker sits down with Dr. Jeremy Faust, emergency physician at Brigham and Women's Hospital and Editor-in-Chief of MedPage Today, to have an honest, insider conversation about what The Pitt actually gets right, what it's doing to the culture around medicine, and why it's hitting clinicians so differently than everyone else.

This isn't a review. It's a reckoning. Graham and Jeremy explore physician grief, the mythology of burnout, the generational trauma baked into medical training, and why every ER doctor they know secretly identifies with Santos. Along the way, they explore what it means that a TV show is doing more to help Americans understand social determinants of health, end-of-life care, and the emotional weight of this job than almost anything the healthcare system has produced on its own.

For doctors who have felt seen by this show, and for those who can't bring themselves to watch it yet, this is the conversation worth having.

What You'll Learn

  • Why the most accurate thing about The Pitt isn't the medicine, it's the ethos.
  • What the show is actually changing about how patients approach end-of-life conversations.
  • Why ER doctors defend Santos when nobody else will, and what that reveals about the profession.
  • How medical training perpetuates cycles of trauma
  • Why the term "burnout" may be the wrong frame entirely for what's happening to emergency physicians right now.

🔗 Resources & Further Reading


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Using AI to Accurately Code and Measure Physician Outcomes, With Solventum’s Dr. Travis Bias16 Apr 202600:35:48

Most physicians understand that documentation is important. Very few understand the systems that determine what that documentation actually means for how they're paid, measured, and judged.

Dr. Travis Bias does because he's spent years operating on both sides of that divide.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Travis Bias, Deputy Chief Medical Officer of Health Information Systems at Solventum, and one of the few clinicians who has led AI strategy for a company whose tools are already inside 80% of U.S. hospitals. The conversation covers the hidden infrastructure behind hospital quality scores, risk adjustment, and clinical documentation. And what most physicians don't realize about how those systems are shaping their professional reputation every day.

Travis also brings a perspective most health tech voices lack: two years teaching medicine in Kenya and Uganda, where finite resources and physical exam skills are the standard of care. It's a vantage point that sharpens his thinking on everything from clinical judgment to what U.S. medicine consistently gets wrong.

What You'll Learn

  • Why ambient AI documentation tools are capturing clinical complexity that physicians never had time to write down, and what that means for how patients are coded and how doctors get paid
  • How hospital quality scores, mortality rankings, and US News ratings are all downstream of documentation completeness and what physicians can do about it
  • Why the regulatory framework for healthcare AI is already behind the technology, and what happens if it doesn't catch up
  • How his time teaching medicine in East Africa changed the way he thinks about resource stewardship, clinical judgment, and the U.S. healthcare system's relationship with overtesting
  • What tech companies consistently get wrong about physicians and what physicians consistently get wrong about tech
  • Why Travis sees his role as a translator between medicine and technology, and how clinical training makes you better at both

Resources & Where to Find Travis

Solventum.com

Travel Health Consult:

LinkedIn

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The AI Conversations Every Physician Should Hear: Highlights from Yann LeCun, Dr. Bob Wachter, and Dr. David Rhew09 Apr 202600:28:07

AI is everywhere right now. In your inbox, your EHR, your hospital's strategic plan, and probably your last three CME credits. But most of what physicians hear about AI is either hype or fear. We think you deserve something better.

In this special Best of AI episode, Dr. Graham Walker revisits three conversations that generated the most messages, DMs, and forwarded links from How I Doctor listeners, plus a Physician Spotlight that has nothing to do with AI and everything to do with why physicians need support right now.

These guests don't agree on everything. But together they map a path that every physician needs to understand: where AI actually works today, where it falls short, and what's coming next.

Featured Episodes & Links

Yann LeCun is the ACM Turing Award Laureate, former Chief AI Scientist at Meta, and co-founder of AMI, Advanced Machine Intelligence. Alex LeBrun is a serial entrepreneur, co-founder of NABLA, and CEO of AMI.

Listen to Move Over LLMS! AI Legends Yann LeCun and Alex LeBrun Debut AMI Labs' Bold Ambitions for World Models in Healthcare

Dr. Bob Wachter is Chair of the Department of Medicine at UCSF, author of The Digital Doctor, and author of the new book A Giant Leap: How AI Is Transforming Healthcare and What It Means for Our Future.

Listen to What Doctors Get Wrong About AI with Robert Wachter, MD

Dr. David Rhew is an infectious disease physician and Global Chief Medical Officer at Microsoft, working at the intersection of the world's largest health systems and its largest technology companies.

Listen to Where AI in Medicine Is Actually Headed, with Microsoft’s CMO David Rhew

What You'll Learn

Yann LeCun & Alex LeBrun

  • Why large language models have a fundamental ceiling and what world models are designed to do instead
  • Why 80% accuracy is considered excellent in research and completely unusable in clinical practice
  • What it actually took to build AI tools physicians trust and why every assumption they walked in with was wrong

Dr. Bob Wachter

  • Why the healthcare system is uniquely positioned to benefit from AI, and uniquely capable of wasting those gains on a faster hamster wheel
  • The deskilling death spiral: what happens when the AI becomes more reliable than the human checking its work
  • What part of medicine Bob believes we should never hand to AI, and why

Dr. David Rhew

  • Why AI in medicine isn't one thing, it's a portfolio of tools, and conflating them leads physicians to trust the wrong ones
  • How retinal screening AI is finding advanced diabetic disease in people who were told everything was fine months earlier
  • Why the most important physician skill in 2030 will have nothing to do with clinical knowledge

Dr. Stefanie Simmons

  • The spheres of control, influence, and acceptance and why physicians chronically misestimate which is which
  • Why 43 state medical boards have now removed stigmatizing mental health questions, and how to check if yours is one of them

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The Pay Gap in Medicine Is Real. Dr. Pamela Buchanan Is Done Being Quiet About It02 Apr 202600:37:54

Dr. Pamela Buchanan is an emergency physician, author, founder of Melanated Medicine, and one of the most candid voices in medicine on the things doctors aren't supposed to talk about.

In this episode of How I Doctor, Dr. Graham Walker sits down with Pamela to have the conversation most physicians have been trained their entire careers to avoid.

What does it actually cost to stay silent about pay?

What happens when a colleague throws a stethoscope on the ground and tells you that you're worth more than you're making? What does it feel like to be called the N-word by a patient you treat anyway?

Pamela doesn't flinch. She talks about the $100,000 pay gap Black women physicians face even when matched for the same role. She walks through the moment a friend told her to rip up a signed contract — and the $75,000 sign-on bonus that landed in her bank account 48 hours later. She speaks openly about burnout, depression, and the mental health crisis medicine refuses to name. And she makes the case that the silence around all of it isn't accidental.

This isn't a conversation about victimhood. It's a diagnosis of a broken system and a blueprint for every physician who's ever stayed quiet too long.

What You'll Learn

  • Why pay transparency in medicine isn't just taboo, and why Pamela believes the silence is intentional
  • How two candid conversations with colleagues changed her financial trajectory permanently
  • What to say, what to ask, and what to refuse when you're sitting across from someone offering you a contract
  • How racism shows up on shift — not occasionally, but every single day — and what it costs to absorb it alone
  • What Melanated Medicine is, why Pamela built it, and what happens when Black women physicians finally find each other
  • Why asking for help — professional, domestic, emotional — is not weakness but math

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Virtual Neurology at Scale: Raj Narula and Melanie Winningham on How Sevaro Is Transforming Rural Stroke Care26 Mar 202600:37:37

Dr. Raj Narula is a vascular neurologist who walked away from a neurointerventional radiology fellowship to build something that could reach thousands of patients instead of one at a time.

Dr. Melanie Winningham is a vascular neurologist, medical director of a comprehensive stroke center in Virginia, and VP of Clinical Strategy at Sevaro- someone who has lived the neurology access gap from both sides of it.

In this episode of How I Doctor, Dr. Graham Walker sits down with Raj and Melanie to explore one of the most urgent and most invisible crises in American healthcare.

What happens when a stroke patient lands in a rural ER at 2 AM and the nearest neurologist is a hundred miles away?

For too long, geography has been the single biggest predictor of whether that patient walks out of the hospital. Sevaro was built to change that. This episode gets into what telestroke actually looks like when it's done right. They explain how Sevaro's AI-enabled platform — built by neurologists, for neurologists — puts a board-certified specialist on screen in 45 seconds, eliminates the call center entirely, and follows patients from the acute encounter all the way through rehab and outpatient care.

This isn't a pitch for virtual care. It's a clinician's diagnosis of a workforce crisis that isn't getting better and a concrete look at what it takes to build technology that works the way physicians actually practice.

If stroke outcomes are going to improve in rural America, it won't be through more neurologists. It will be through smarter infrastructure that makes the ones we have go further.

What You'll Learn

  • Why geography remains the single biggest predictor of stroke outcomes and what it actually takes to close that gap at scale.
  • How Sevaro eliminated the call center entirely and why that single design decision changes everything about the speed and quality of a telestroke consult.
  • What AI is doing inside an acute stroke encounter and where Raj and Melanie draw a hard line between decision support and decision making.
  • Why the neurology workforce crisis is structural and worsening, and how virtual neurology is reshaping who enters the field and why.
  • How keeping patients in their own communities creates a trust loop that improves outcomes over time.
  • Why state licensing requirements are the single regulatory change that would do the most to expand virtual specialty access in rural America.

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How Medical Misinformation Took Over — and What Doctors Can Do to Take It Back w/ Dr. Geeta Nayyar19 Mar 202600:33:03

Medical misinformation isn't a new problem. But somewhere along the way, it stopped being background noise and became the loudest voice in the room.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Geeta Nayyar a rheumatologist, former Chief Medical Officer at both Salesforce and AT&T, and bestselling author of Dead Wrong. Together they diagnose how medical misinformation went from the fringes of the bell curve to the halls of power, and what physicians can actually do about it.

Geeta doesn't come to this conversation as a distant observer. She's spent her career at the intersection of clinical medicine and health tech, advising organizations from the AMA to Fortune 500 companies on how to navigate a healthcare information landscape that has fundamentally broken down.

Her perspective is grounded in something personal too. She saved her own mother's life during fellowship by doing what the system failed to do: gathering all the data, laying it out on the floor, and refusing to accept a diagnosis that didn't add up. That experience drove her into rheumatology and eventually into health tech, motivated by a simple question she still hasn't stopped asking: what does the average patient do when they don't have a doctor in the family?

That question has never been more urgent. When patients can't get an appointment for six to nine months, they don't wait. They go to TikTok. They follow influencers who are confident, simple, and wrong. And while wellness gurus monetize confusion, hospitals are still telling their physicians they can't mention their institution on social media. Medicine left a vacuum, and the wrong people filled it.

This episode is a call to action for every physician who has watched that happen and felt powerless to stop it. Graham and Dr. G make the case that physicians aren't just allowed to take the microphone. They are obligated to! And that the hospitals and health systems who figure that out first won't just be doing the right thing. They'll be winning.

What You'll Learn

  1. Why medical misinformation has moved from the fringes to the mainstream and what changed to make it this dangerous
  2. How hospitals' culture of social media silence created the exact vacuum that wellness influencers now own
  3. What the business case for physician content actually looks like and why Cleveland Clinic and Kaiser figured it out before everyone else
  4. Why confidence is not accuracy, and how to help patients tell the difference
  5. The practical playbook for physicians who want to build a public presence with their hospital's support, not in spite of it

Resources & Where to Find Dr. Geeta Nayyar

Website

Dead Wrong

LinkedIn

Instagram

Inside the First Autonomous AI Prescription Program in America w/ Doctronic CMO Dr. Byron Crowe12 Mar 202600:36:46

Most physicians see AI as something happening to medicine. Dr. Byron Crowe is one of the few who decided to make it happen himself.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Byron Crowe — internal medicine physician, former Harvard Medical School faculty, and Chief Medical Officer of Doctronic — to discuss the most provocative development in healthcare AI yet: the nation's first state-approved program allowing AI to autonomously renew prescriptions, currently live in Utah.

This episode doesn't traffic in hypotheticals. The program is running right now. And the questions it raises are ones every physician is going to have to answer eventually — whether they're ready or not. Who's responsible when AI gets a prescription wrong? Is the current system it's replacing actually any better? And if AI can handle the routine work, what does that mean for the physicians who've been doing it? Byron has thought harder about these questions than almost anyone in medicine. He's the first author on the Society for General Internal Medicine's position statement on generative AI. He's published peer-reviewed research in JAMA on AI's diagnostic capabilities. And now he's running clinical strategy for a company that calls itself your personal AI doctor — and means it.

Byron doesn't come to this conversation to sell the technology. He comes to make the case that the status quo — millions of prescription refills processed via portal clicks with minimal physician review — is already broken, and that AI done right, with graduated autonomy, genuine accountability, and clinicians at the center, is an improvement worth taking seriously. It's a conversation that will challenge what you think you know about where medicine is headed and who gets to decide.

What You'll Learn

  1. What "AI-native care" actually means and why Byron argues it's a fundamentally new care model — not just a faster version of telehealth
  2. How Doctronic's graduated autonomy model works in Utah, from full physician review of every refill to eventual full autonomy with retrospective oversight
  3. Why Byron believes not a single doctor will lose their job to AI — and what "doctor reassignment" actually looks like in practice
  4. What "careworthiness" means as a moral standard, and why Byron thinks it matters more than any technical benchmark
  5. Why most health AI companies make the same fatal mistake when entering clinical medicine — and how Doctronic is trying to avoid it
  6. Where Byron draws the hard line on AI autonomy — and the one place he says AI should never act alone

Resources & Where to Find Byron

Byron's LinkedIn

Byron's Substack: Always On Call

Doctronic

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99 Ways to Avoid Death: Lessons from Author and ER Physician Dr. Ashely Alker05 Mar 202600:32:59

Most people spend their entire lives trying not to think about death. Emergency physicians don't have that option.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Ashely Alker an emergency physician, founder of Meaningful Media, and author of 99 Ways to Die and How to Avoid Them.

This episode goes somewhere most medical conversations don't. And that's the point.

Because death isn't an abstract concept in the emergency department. It's the patient who never documented their wishes and ended up on a ventilator they never wanted. It's the 19-year-old with undiagnosed Marfan syndrome you catch while suturing a hand. It's the lost patients you carry with you forever.

Ashely has been thinking about death since her twenties, when she lost her mother and became the de facto medical translator for a family with no one else to turn to. That personal history, combined with years on the front lines of emergency medicine, is what eventually became a book she wrote for the patients who need it most.

This episode is an honest conversation about what emergency medicine teaches you about dying and how that changes the way you live.

What You'll Learn

  1. Why ER physicians remember their lost patients more vividly than their greatest saves — and what that means for how we process the emotional weight of the work
  2. How Ashlely thinks about the gap between helping people live longer versus helping them live better, and why the ER is the hardest place to close it
  3. Why storytelling is a clinical skill, and how physicians who don't engage with public communication cede the conversation to people with no training
  4. What writing a book about death taught Ashely about being a better doctor and a more intentional human being

Resources & Where to Find Ashely

99 Ways to Die and How to Avoid Them — available at Amazon, Barnes & Noble, and independent bookstores everywhere

Ashely's Website

Instagram

LinkedIn

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What Will It Take to Actually Build a Quality Healthcare System? NCQA's New CEO Dr. Vivek Garg Has a Plan26 Feb 202600:35:12

Every quality metric shaping your career, your bonus, and your reputation traces back to one nonprofit most physicians have never thought twice about.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Vivek Garg, the new President and CEO of NCQA - the National Committee for Quality Assurance - and only the second leader in the organization's 36-year history.

This episode is unabashedly nerdy. And that's the point.

Because the measures you're chasing, the scores you're being judged on, and the bonuses tied to your performance don't come from nowhere. They come from a deliberate two-year long process of evidence review, statistical validation, and independent clinical committee sign-off. It’s a process most physicians have never seen and don't know they can influence.

Vivek doesn't come to this conversation to defend the status quo. He's blunt that the current system produces incomplete data, punishes independent practices for lacking the infrastructure of large health systems, and has overused financial incentives as a lever for change. He calls value-based care underappreciated and AI overhyped, and then spends the rest of the conversation explaining exactly where both could actually move the needle.

This episode is an honest reckoning with whether we're measuring what actually matters and what it would take to build a system that clinicians trust and patients actually feel.

What You'll Learn

  1. Where your HEDIS scores actually come from and the two-year pipeline behind every measure that lands in your workflow
  2. Why the data feeding your quality scores is often incomplete, lagged, and missing critical parts of your patient's clinical picture
  3. How Goodhart's Law plays out in real clinical practice — and why even well-designed measures can distort the behavior they're trying to assess
  4. Why independent and small practices carry the same reporting burden as large health systems with entire quality departments

OB-GYN Influencer: How Doctors Can Find Their Social Media Voice and Fight Wellness Misinformation w/ Dr. Fran19 Feb 202600:36:55

Physicians are making more correcting medical misinformation online than delivering babies.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Fran Haydanek, better known to millions as Paging Dr. Fran, for an unfiltered conversation about medicine in the algorithm era.

Fran is a board-certified OB-GYN, residency faculty member, hospital medical director and a physician creator with more than one million followers across TikTok and Instagram. What began as a simple video correcting breastfeeding misinformation during maternity leave has evolved into a full-scale media operation. One that now generates more income than her clinical practice.

But this episode isn’t about clicks. It’s about trust.

Together, Graham and Fran examine why patients increasingly turn to influencers instead of physicians and why the medical system itself helped create that vacuum. Fran argues that physicians don’t just compete in this digital ecosystem and that they have an obligation to show up in it.

This episode isn’t a defense of influencer culture.

It’s a reckoning with where patients actually learn about their health and whether physicians are willing to meet them there.


What You’ll Learn
  1. Why patients are turning to TikTok for medical advice and how 15-minute visits contribute to the problem

  2. What it means for medicine when a practicing OB-GYN earns more correcting misinformation than delivering babies

  3. How religion and politics uniquely fuel misinformation in women’s health

  4. Practical ways any physician can participate in the digital information ecosystem




Resources & Where to Find Dr. Fran

Website: https://www.pagingdrfran.com/

TikTok: https://www.tiktok.com/@pagingdrfran

Instagram: https://www.instagram.com/pagingdrfran


Move Over LLMS! AI Legends Yann LeCun and Alex LeBrun Debut AMI Labs' Bold Ambitions for World Models in Healthcare12 Feb 202600:38:14

Yann LeCun is one of the most influential figures in artificial intelligence. Alex LeBrun is the founder of Nabla and newly announced CEO of AMI Labs, a new AI research company he and Yann are building around a bold idea: large language models aren’t enough for medicine.

In this special episode of How I Doctor, Dr. Graham Walker sits down in-person with Alex and Yann to explore the next frontier of AI in healthcare - world models. While today’s AI systems excel at predicting the next word, Yann argues that real clinical intelligence requires something deeper: models that can imagine, simulate, and plan.

From the limitations of LLMs in high-stakes environments to the concept of building a “patient model” that can predict the consequences of treatment decisions, this episode dives into what it would actually take to build AI that reasons more like a physician. They discuss why documentation was the first breakthrough use case, how 80% accuracy fails in clinical settings, and why reliability, and not hype, will determine who wins in healthcare AI.

This isn’t about replacing doctors. It’s about amplifying them.

If AI is going to meaningfully change medicine, it won’t be through better chatbots. It will be through systems that understand the world.

Watch or Listen

🎥 Watch the full video conversation now — exclusively on https://www.offcall.com/learn/podcast/ai-world-models-medicine-yann-lecun-alex-lebrun

🔊 Or stream the audio version on your favorite podcast platform.

What You’ll Learn
  1. How predicting the next word isn’t the same as clinical reasoning and where LLMs fall short in medicine.
  2. What “world models” are and how they differ fundamentally from today’s large language models.
  3. Why 80% accuracy isn’t acceptable in healthcare and what reliability really means in clinical AI.
  4. Why medical coding may be one of the next frontiers for AI in clinical workflows.
  5. How AI assistants could amplify doctors the way a research lab amplifies a professor, by making clinicians smarter, not obsolete.

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📝 For a full transcript of this episode click HERE

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The Crisis in Primary Care No One Wants to Own with NEJM’s Lisa Rosenbaum, MD05 Feb 202600:40:48

Primary care sits at the center of medicine and yet no one seems willing to truly own it.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Lisa Rosenbaum, cardiologist and national correspondent for the New England Journal of Medicine, for a wide-ranging conversation about why primary care remains both indispensable and persistently undervalued.

🎧 Before you go any further: If this conversation resonates, make sure you also listen to Lisa’s excellent NEJM podcast, Not Otherwise Specified. It’s one of the most honest, intellectually rigorous explorations of modern medicine and this past season focuses deeply on primary care.

Lisa has spent the past year reporting on primary care across the country, and what she uncovers isn’t a story about technology gaps or workforce shortages. It’s a story about culture. About respect. About responsibility. Together, Graham and Lisa explore how modern incentives have quietly shifted medicine away from ownership - of patients, of decisions, and of outcomes - and why primary care has absorbed the consequences more than any other specialty.

They dig into uncomfortable but essential questions:

  1. Why is the specialty that knows patients best paid and respected the least?
  2. How did “referral culture” replace continuity?
  3. And what happens to trust between doctors, and between doctors and patients when no one is clearly responsible anymore?

Lisa argues that the crisis in primary care is not inevitable, and not intractable but only if medicine is willing to confront its own values.

This episode isn’t about nostalgia.

It’s about deciding what kind of profession medicine wants to be.

What You’ll Learn
  1. Why the crisis in primary care is fundamentally about respect and ownership, not technology
  2. How modern systems discourage physicians from fully “owning” their patients
  3. The hidden costs of referral culture and fragmented responsibility
  4. Why restoring autonomy may be essential to saving primary care
  5. What gives Lisa hope—and why cultural change is still possible in medicine

Resources & Where to Find Lisa
  1. Lisa Rosenbaum, MD – National Correspondent, New England Journal of Medicine
  2. Not Otherwise Specified (NEJM Podcast)

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What Doctors Get Wrong About AI with Robert Wachter, MD29 Jan 202600:38:02

AI has arrived in medicine faster than anyone expected, but speed doesn’t guarantee wisdom.

In this episode of How I Doctor, Dr. Graham Walker sits down with Dr. Robert Wachter, chair of medicine at UCSF and one of healthcare’s most trusted voices on technology, to unpack what physicians are getting wrong about AI.

Drawing from his new book A Giant Leap, Bob offers a rare, grounded perspective: neither hype nor fear, but informed optimism. Graham and Bob explore de-skilling, trust, medical education, workflow realities, regulation, and the very human question of what happens when clinicians start relying on machines that may eventually outperform them.

This is a conversation for doctors who are already using AI, and those who are uneasy about what comes next. Not a manifesto, but a clear-eyed guide to thinking better about AI before it reshapes medicine for us.

What You’ll Learn
  1. Why AI can both improve clinical judgment and quietly erode core physician skills at the same time.
  2. What AI means for medical education, training, and the future of clinical reasoning.
  3. Why trust in AI systems may arrive sooner than we expect, and why that’s both rational and risky.
  4. How health systems should think about regulation, guardrails, and local accountability.

🔗 Resources & Further Reading
  1. A Giant Leap: How AI Is Transforming Healthcare and What It Means for Our Future
  2. Robert Wachter on Substack
  3. Robert Wachter, MD – UCSF Faculty Page
  4. Previous Book: The Digital Doctor

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Fix the System, Not the Women: Shikha Jain on Why Medicine Is Failing Female Physicians22 Jan 202600:41:09

Medicine is full of people doing the right thing inside systems that reward the wrong work.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Shikha Jain, a hematologist-oncologist, professor, and founder of Women in Medicine, to discuss why some of the most essential work in medicine happens after hours, off the clock, and without recognition - especially for women physicians.

Shikha makes a clear case for why physician distress isn’t a resilience problem, a time-management issue, or a pipeline failure. It’s a systems problem. From RVU-based compensation models that ignore invisible labor, to unpaid committee work that never counts toward promotion, to insurance barriers that put doctors in the crosshairs while profits flow elsewhere, she explains how modern healthcare quietly extracts more from physicians while valuing them less.

Together, Graham and Shikha explore how gender expectations shape leadership, why women physicians are “voluntold” into uncompensated work, and how stereotypes around empathy and agreeableness create double standards that follow doctors from the clinic to the boardroom.

The conversation closes with practical guidance for change: how physicians can set boundaries without guilt, how institutions can measure the work that actually matters, and how male allies can show up in ways that help rather than harm.

This episode isn’t about blaming individuals. It’s about fixing the system so doctors can keep doing the work that brought them to medicine in the first place.

What You’ll Learn
  1. Why physician burnout is a structural failure, not a personal one
  2. How RVU-based compensation undervalues real clinical and cognitive work
  3. The hidden, uncompensated labor disproportionately carried by women physicians
  4. Practical ways physicians and allies can drive meaningful change

Learn More About Shikha & Women in Medicine
  1. Dr. Shikha Jain: https://shikhajainmd.com
  2. Women in Medicine: https://www.wimedicine.org
  3. Women in Medicine Summit September 24-26, 2026: https://www.wimedicine.org/summit
  4. Oncology Overdrive Podcast: https://oncologyoverdrive.com

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ER Doctor Running for Congress Diagnoses How to Fix the U.S. Healthcare System, with Dr. Tim Peck15 Jan 202600:39:45

Tim Peck has spent his career practicing medicine where the system is most fragile. A Harvard-trained emergency physician, healthcare entrepreneur, and frontline clinician in rural America, Tim has worked inside nursing homes, healthcare deserts, and communities shaped by the opioid crisis—places where delays, payment failures, and policy decisions have immediate consequences.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Tim to explore what emergency medicine teaches about leadership, systems failure, and responsibility beyond the bedside. Tim shares why ER doctors are uniquely trained to lead in chaos, how seeing patients too late distorts outcomes, and what he learned by embedding himself in the environments that generate avoidable hospitalizations.

The conversation moves beyond ideology into the mechanics of why U.S. healthcare breaks down—from fee-for-service incentives and uninsured rural populations to ambulance shortages and hospital closures that happen quietly, then all at once.

This is not a political debate or a campaign pitch. It’s a clinician’s diagnosis of a system under strain—and a candid discussion of what it would take to fix it.

What You’ll Learn
  1. Why emergency medicine is one of the most effective forms of leadership training
  2. What changes when doctors see patients earlier instead of downstream in crisis
  3. How rural healthcare deserts form—and what they look like in real time
  4. Why nursing homes and opioid care expose the deepest system failures
  5. How payment models shape clinical behavior more than most physicians realize

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📝 For a full transcript of this episode click HERE

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Reimagining the Future of Chronic Disease Care, With Cadence CMO Eve Cunningham, MD08 Jan 202600:39:55

Eve Cunningham has spent her career navigating the hard edges of modern medicine from delivering babies and performing gynecologic surgery to leading large health system initiatives and now serving as Chief Medical Officer at Cadence. Along the way, she’s seen firsthand why chronic disease care continues to fail patients despite more data, more technology, and more dashboards than ever before.

In this episode of How I Doctor, Graham Walker sits down with Eve to unpack why clinic-based, episodic care is fundamentally mismatched to conditions like heart failure, diabetes, and hypertension. She explains why early efforts at remote patient monitoring fell flat, how change management and not technology has always been the real barrier, and why most health systems struggle to turn insight into action.

The conversation moves from the realities of governance-heavy decision-making and physician burnout to what it actually takes to manage patients upstream before they land back in the ICU. Eve also shares the deeply personal connection that drives her work, including how her father’s experience with chronic illness shaped her view of what patients truly need.

This is not a tech demo or a sales pitch. It’s a candid discussion about redesigning chronic disease care in a way that works for patients, clinicians, and the realities of modern medicine.

What You’ll Learn
  1. Why episodic, visit-based medicine is structurally incapable of managing chronic disease
  2. What early remote patient monitoring efforts got wrong and what has finally made them work
  3. How change management and incentives matter more than technology alone
  4. Why health systems struggle to act on data, even when the answers are obvious
  5. What proactive, upstream care looks like when someone is actually accountable

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Where AI in Medicine Is Actually Headed, with Microsoft’s CMO David Rhew01 Jan 202600:38:25

David Rhew has spent his career at the intersection of frontline medicine and cutting-edge technology. An infectious disease physician by training and now Global Chief Medical Officer at Microsoft, David brings a rare perspective shaped by decades of clinical work, health system leadership, and early research on AI in healthcare.

In this episode of How I Doctor, Graham Walker sits down with David to unpack where AI in medicine is actually headed and why so many clinicians feel frustrated despite using these tools every day. David explains why physicians aren’t afraid of AI itself, but of poorly designed systems that remove judgment, overload workflows, and fail to reflect how medicine really works.

From agentic AI and ambient documentation to population screening, risk stratification, and resource allocation, the conversation moves beyond buzzwords into the real mechanics of how AI can support better care.

David makes the case that AI’s true promise is helping clinicians practice at the top of their license, identify disease earlier, and redesign care around human decision-making rather than administrative burden.

This is not a futurist thought experiment or a vendor pitch. It’s a grounded, systems-level look at how AI could meaningfully improve medicine.

Explore the Data

📊 Want to see how your peers are actually using AI today? Download Offcall’s 2025 Physicians AI Report, featuring insights from over 1,000 physicians on daily AI use, adoption gaps, and what doctors really want from these tools:

👉 https://2025-physicians-ai-report.offcall.com/

What You’ll Learn
  1. Why the biggest failure of healthcare AI isn’t the technology itself, but how it’s measured, implemented, and governed
  2. How agentic AI with multiple models working together on discrete tasks can outperform single “super models” in complex clinical problems
  3. Why ambient documentation succeeded by addressing burnout and patient experience, not productivity metrics
  4. How AI-enabled screening and risk stratification can identify high-risk patients long before symptoms appear
  5. What skills physicians will need in the next decade to apply AI responsibly without losing clinical judgment

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Mark Cuban: How I’d Reform Healthcare If I Were in Charge (Re-Release)25 Dec 202501:03:29

Merry Christmas! Today we are re-releasing one of our favorite episode of the year. We'll be back next week with a brand new interview to kickoff 2026.

Mark Cuban is a business mogul, the “Shark” every entrepreneur wants to make a deal with, the former owner of the Dallas Mavericks, and, most recently, an online pharmacy CEO. In 2022, Mark co-founded Cost Plus Drugs with the goal of lowering prescription drug prices. The direct-to-consumer company makes generic drugs affordable by cutting pharmacy benefit managers out of the distribution chain. But, once Mark starts talking about tackling the pharmaceutical market, you get the sense he has his sights set on an even bigger goal: reforming the healthcare system at large.

Offcall co-founder Graham Walker recently got the chance to interview Mark on How I Doctor, a podcast that explores the lives and careers of physicians who are practicing medicine differently. Mark, of course, is not a physician. But, as Graham notes, “I'm talking to him because I think he actually gives a damn about healthcare, and more importantly, he's doing something about it.”

Mark pulls no punches in this episode, and frames American healthcare as a David- and Goliath-style fight between good and bad actors.

Physicians are on the good team: “I happen to be a fan of people who save lives and make other people feel better, you know? Call me crazy.”

Who’s on the bad team? Anyone trying to game the system and extract money from it for their own benefit — insurance companies, hospitals, private equity firms, and others. “In healthcare, that $4.9 trillion wherever anybody can arbitrage whatever they can out of the system, that's exactly what they are going to do.”

With clarity of conviction and a hard-charging spirit, Mark shares his vision for how to fix healthcare.

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For a full transcript of this episode click HERE

https://www.offcall.com/learn/podcast/mark-cuban-interview-how-shark-tank-star-and-cost-plus-drugs-ceo-would-fix-healthcare

Find all episodes of How I Doctor at offcall.com/podcast or subscribe on your favorite podcast player at https://episodes.fm/1767429315.

In this episode, Graham and Mark discuss:

04:26 Expanding Medical School Enrollment

09:33 Insurance Plan Designs

16:27 Insurance Company Tactics

20:45 Negotiation Loopholes and Legal Tangles

28:04 Healthcare Spending

34:53 Transparency and Trust Drive Growth

43:37 Unfair Broker Fees

49:53 Profitability in Specialized Medical Services

55:08 Future of AI-Assisted Healthcare

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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

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Eric Topol on Why Doctors Shouldn’t Fear AI — And How It Could Finally Fix Our Broken System18 Dec 202500:43:40

Dr. Eric Topol is one of the most influential voices in modern medicine. Founder of the Scripps Research Translational Institute and author of Deep Medicine and Super Agers, Eric has spent decades interrogating medical dogma, calling out hype, and pushing the profession toward evidence, prevention, and humanity.

Dr. Graham Walker sits down with Eric for a candid conversation about why physicians shouldn’t fear AI and why when used correctly, it may be one of the most powerful tools we’ve ever had to reduce errors, restore trust, and shift medicine from late-stage treatment to true prevention. 

From diagnostic error and physician burnout to immune aging, GLP-1s, personalized risk prediction, and the limits of randomized trials, this episode is both a reality check and a roadmap. Eric makes the case that AI’s greatest promise isn’t automation, but rather it’s the ability to see what humans never could, identify risk earlier, and finally decouple aging from chronic disease.

This isn’t a hype cycle conversation. It’s a grounded, evidence-based look at how AI could help fix what’s broken in medicine if physicians lead the way.

Explore the Data

📊 Want to see how your peers are actually using AI today? Download Offcall’s 2025 Physicians AI Report, featuring insights from over 1,000 physicians on daily AI use, adoption gaps, and what doctors really want from these tools:

👉 https://2025-physicians-ai-report.offcall.com/

What You’ll Learn

  • Why Eric Topol believes doctors shouldn’t fear AI and why holding it to an impossible standard may be harming patients
  • How AI could dramatically reduce diagnostic error and support better clinical judgment
  • Why prevention has failed historically and how AI finally makes it possible at scale
  • The difference between AI hype and evidence-backed breakthroughs physicians should actually care about
  • How personalized, data-rich medicine may reshape trials, training, and the future role of the physician

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📝 For a full transcript of this episode click HERE


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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

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What Doctors Really Think About AI: Here Are the Surprising Findings From Offcall’s 2025 Physicians AI Report11 Dec 202500:44:16

AI is already shaping how physicians practice. And for the release of The 2025 Physicians AI Report, Graham is taking a different kind of episode: a deep-dive mailbag where he answers the questions doctors are actually asking about AI, grounded in one of the largest physician surveys of its kind.

More than 1,000 physicians were polled in this project, and their answers paint a far more nuanced picture than the headlines suggest. 

📊 Yes, two-thirds of physicians already use AI every day. 

✅ Yes, the majority believe AI can meaningfully reduce administrative burden. 

⚠️ And yes, 81% are frustrated with how their organizations are deploying it. 

In this episode, Graham walks through those realities one by one.

He breaks down why doctors trust AI for documentation but hesitate when it comes to decision support. Why the #1 fear isn’t “AI will replace me,” but rather who will control it. How payers, administrators, and mixed incentives shape the way AI enters clinical workflows. And why physicians may quietly be years ahead of their institutions in actually using the technology day-to-day.

He also shares the moments from the report that surprised him most and the “dream tools” physicians wish someone would build already. And he offers a roadmap for healthcare leaders, AI companies, and clinicians about how to prevent AI from becoming the next EHR rollout: deployed to doctors instead of with them.

👉 If you want to go deeper, you can download the full dataset and insights in The 2025 Physicians AI Report at https://2025-physicians-ai-report.offcall.com/

Whether you’re experimenting with AI every shift or still cautiously watching from the sidelines, this episode offers clarity on where physicians actually stand  and where medicine is headed next.

What You’ll Learn
  • What doctors are really doing with AI right now Two-thirds of physicians already use AI daily, but what exactly are they using it for, and how are they integrating it into their clinical workflows?
  • Why organizational deployment is failing physicians From restrictive policies to unclear guidelines, Graham explains why 81% of doctors are frustrated and what leaders must fix to avoid repeating the mistakes of the EHR era.
  • The #1 fear doctors have about AI and it’s not job loss Physicians overwhelmingly worry about AI falling under payer and administrative control. Graham breaks down the incentives behind that fear.
  • What physicians want from AI companies A clear message to builders: specialty matters. Physicians don’t want “AI for doctors”; they want tools that understand their specific workflows.
  • Why AI adoption is happening with or without institutions Graham explains how grassroots physician use is outpacing formal hospital adoption and what that means for the future of medical practice.
  • Access all findings from The 2025 Physicians AI Report Download the full report, charts, and analysis at  https://2025-physicians-ai-report.offcall.com/

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📝 For a full transcript of this episode click HERE


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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

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The Future of Primary Care Is Independent: How Aledade Helps Doctors Break Free From Employed Medicine with Dr. Umar Bowers and Dan Bowles04 Dec 202500:41:23

Independent primary care isn’t a relic of the past — it’s becoming the future of American medicine.

In this episode of How I Doctor, Dr. Graham Walker talks with two leaders helping drive that shift: Dr. Umar Bowers, an internist who left a major health system to build the practice he always envisioned, and Dan Bowles, General Manager of Practice Health at Aledade , the physician-led company enabling thousands of doctors to stay independent, financially stable, and clinically autonomous.

Umar shares his personal journey from rising frustration inside a large employed medical group to opening Dawson Medical Group with the support of Aledade. He explains what independence really means, why he had zero fear stepping out of the system, and how value-based care became the engine that allowed his practice to thrive. You can read more of his story in Aledade’s physician success profile or connect with him directly on LinkedIn.

Dan offers a rare inside look at why so many doctors feel trapped in employment, what’s driving the national shift back toward physician-led care, and how Aledade’s data, contracting expertise, and ready-made community of independent clinicians help doctors cross the bridge to autonomy instead of trying to swim it alone.

This isn’t another story about burnout or bureaucracy, it’s a roadmap for physicians who want their careers, their schedules, and their practices back. Whether you’re considering independent practice or simply want to understand the movement reshaping primary care, this episode shows how doctors are taking back control of the profession, one practice at a time.

What You’ll Learn
  • Why independent primary care is resurging and how value-based care is creating new financial stability for small practices.
  • How Dr. Umar Bowers built his own practice from scratch and why he had zero fear leaving a major health system.
  • What Aledade’s turnkey model actually provides, from startup capital and contracting support to data, workflows, and a nationwide physician community.
  • How doctors can reclaim autonomy, flexibility, and clinical decision-making power without sacrificing income, infrastructure, or patient care.


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📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

Thank You, Doctors! A Thanksgiving Highlight Reel from Mark Cuban, Shiv Rao, Danielle Ofri and More27 Nov 202500:34:54

This Thanksgiving, we’re pressing pause on the chaos of clinical life to honor the physicians, nurses, and healthcare workers who keep showing up tired, hopeful, frustrated,and inspired. 

In this special “Best Of” episode, Dr. Graham Walker revisits five conversations that have sparked the most messages, DMs, forwarded links, and late-night reflection from our listeners. These clips come from leaders who’ve helped all of us re-examine the work, the system, and ourselves:

Featured Episodes & Links

Dr. Shiv Rao is a cardiologist, entrepreneur, and the CEO and co-founder of Abridge, the physician-founded AI company transforming how clinical conversations become care.

Listen to The Physician AI Conversation: How Doctors Can Drive the AI Era in Medicine Forward with Abridge CEO Dr. Shiv Rao

Dr. Danielle Ofri is an internist at Bellevue Hospital, clinical professor at NYU, and one of the most widely read physician-writers of our time. 

Listen to Medicine’s Broken Promises: Dr. Danielle Ofri on Greed, Trust, and Why the System Survives on Exploiting Clinicians

Mark Cuban is a business mogul, the “Shark” every entrepreneur wants to make a deal with, the former owner of the Dallas Mavericks, and, most recently, an online pharmacy CEO.

Listen to Mark Cuban: How I’d Reform Healthcare If I Were in Charge

Dr. Vineet Arora is the Dean for Medical Education at the University of Chicago and one of the nation’s leading voices on equity, leadership, and physician well-being.

Listen to Why Women Physicians Still Earn Less — and What We Can Do About It With Dr. Vineet Arora

Dr. Ali Chaudhary is an emergency physician, entrepreneur, and one of the leading voices helping doctors reclaim control over their careers.

Listen to Breaking Free from W-2 Medicine: The Physician’s Guide to Locum Tenens with Dr. Ali Chaudhary

What You’ll LearnDr. Shiv Rao
  • Why AI adoption is accelerating inside health systems faster than anyone expected and how clinicians can shape the guardrails, not get steamrolled by them.

Dr. Danielle Ofri
  • The “unbroken chain” of clinicians and why modern healthcare quietly relies on exploiting professionalism to keep the system from collapsing.

Mark Cuban
  • How insurance design, pre-auth delays, and underpayment schemes shift financial risk onto physicians while confusing patients — and why it’s not your fault.

Dr. Vineet Arora
  • How women residents fall three months behind in milestone advancement by graduation — and the narrative biases in feedback that fuel the promotion gap.

Dr. Ali Chaudhary
  • Why the traditional W-2 model is structurally unstable — and how locums work can restore autonomy, income stability, and control over your life.


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Building Decision Support AI That Doctors Truly Love and Trust, with Evidently's Dr. Kalie Dove-Maguire20 Nov 202500:37:56

Dr. Kalie Dove-Maguire is an emergency physician, health-tech leader, and the President and Chief Product Officer at Evidently — a physician-founded company building clinical decision support tools designed to earn trust, not replace judgment. After years on the frontlines, Kalie saw firsthand how critical information gets lost in the noise, how clinicians compensate for broken workflows, and how better tools could prevent avoidable harm. That realization ultimately pushed her from the ER to the product world, where she now designs AI systems that surface the right data, cite their sources, and respect the mental work only clinicians can do.

In this episode of How I Doctor host Dr. Graham Walker sits down with Kalie to talk about about why AI must be transparent, why judgment can’t be automated, and what it really takes to create decision support clinicians actually want in their workflow. From the emotional weight of missed findings in residency to shipping software with guardrails, Kalie explains how Evidently approaches trust, verification, and workflow design in a way that empowers physicians.

This isn’t just a conversation about AI. It’s a look at how doctors can shape the tools that guide their practice, protect clinical judgment, and help build the next generation of decision support that clinicians rely on.

What You’ll Learn
  • Why clinical decision support fails when it ignores physician judgment — and how Evidently builds tools that do the opposite.
  • How Kalie’s ER experience shaped her approach to product design, safety, and transparency.
  • The difference between predictive models, LLMs, and workflow-level AI — and why lumping them together creates misconceptions.
  • How Evidently “shows its work” by surfacing evidence, matching data to action, and earning clinician trust over time.
  • Practical lessons for physicians considering a transition into tech, entrepreneurship, or product roles.
  • Why the future of AI in medicine is augmentation, not automation — and why the “AI resident” metaphor matters.

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📝 For a full transcript of this episode click HERE


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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

The Physician AI Conversation: How Doctors Can Drive the AI Era in Medicine Forward with Abridge CEO Dr. Shiv Rao13 Nov 202500:50:54

Dr. Shiv Rao is a cardiologist, entrepreneur, and the CEO and co-founder of Abridge, the physician-founded AI company transforming how clinical conversations become care. Built on the belief that healthcare is about people, not paperwork, Abridge is now embedded in more than 200 major health systems, processing millions of encounters each week and helping doctors reconnect with the meaning of their work.

In this special in-person episode, How I Doctor host Dr. Graham Walker sits down with Shiv for an unfiltered, wide-ranging conversation about the rise of AI in medicine, the moral crisis facing clinicians, and what it truly takes to build technology that serves the physician instead of replacing them.

From Abridge’s early days of being dismissed as a “party trick” to its current role in reshaping clinical workflows nationwide, Shiv shares how the company scaled, why it never called itself an “AI scribe,” and how every patient conversation can now fuel better care, fewer clicks, and more connection.

This isn’t just another startup story — it’s a blueprint for how doctors can lead the AI movement from the inside.

🎥 Watch the full video conversation now — exclusively on offcall.com/learn/podcast/physician-ai-conversation-shiv-rao-abridge


What You’ll Learn
  • How healthcare AI grew from a party trick to becoming an integral part of healthcare infrastructure.
  • How Abridge turns physician-patient conversations into structured clinical data.
  • Shiv’s vision for the future and where the company will go next from a product standpoint.
  • Why Shiv believes physicians must lead the AI movement and not watch from the sidelines.

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📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

A Rare Look Inside Epic's Vision for Physicians' Future With CMO Dr. Jackie Gerhart06 Nov 202500:46:41

Dr. Jackie Gerhart is a family physician, clinical informaticist, and Chief Medical Officer at Epic — the company whose software powers much of American healthcare. From ambient documentation and AI scribes to patient-facing AI assistants like Emmy, Epic is now redefining how data, technology, and the human touch coexist in clinical care. 

Few physicians have seen this evolution from the inside and even fewer have helped shape it.

In this episode of How I Doctor, host Dr. Graham Walker talks with Jackie about Epic’s internal culture, its push to make the EHR invisible, and the company’s next wave of physician-centric innovation. Jackie also opens up about Epic’s development philosophy, the company’s obsessive customer-focus, and why she believes we’re entering the most exciting era in modern medicine, but only if physicians can stay engaged in shaping what comes next.

This episode pulls back the curtain on one of healthcare’s most influential companies and offers a grounded look at how Epic envisions the future of practice for the doctors who depend on it every day.

What You’ll Learn in This Episode:

  • How Epic’s “software-factory” model enables faster innovation across healthcare.
  • Where many EHR frustrations stem from and how Epic considers what to address.
  • How Epic’s new AI tools, Art and Emmy, aim to reduce friction for both doctors and patients.
  • What “the office visit of the future” could look like – powered by ambient AI with no typing and no mouse.
  • How Epic thinks about collaboration vs. competition with startups like Abridge and partners like Microsoft.
  • Why Dr. Gerhart believes this is the most exciting time to practice medicine in decades.

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📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

We're releasing a Physicians AI Whitepaper and need your help!

Calling all MDs: Help us shape the future of what AI looks like in medicine. Participate Here! https://tally.so/r/n0pxeN

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

Should Doctors Unionize? The Story of Why Physicians at Salem Hospital Joined a Union to Take Back Power with Dr. Sean Codier30 Oct 202500:42:16

We're releasing a Physicians AI Whitepaper and need your help!

Calling all MDs: Help us shape the future of what AI looks like in medicine. Participate Here!

Dr. Sean Codier is an emergency physician at Salem Hospital within Mass General Brigham and one of the leaders behind the first successful physician unionization effort in the system’s history. What started as frustration over understaffing, overcrowding, and a lack of voice in patient-care decisions grew into a movement that’s now inspiring doctors nationwide to organize for change.

In this episode of How I Doctor, Dr. Graham Walker talks with Dr. Codier about why more physicians are turning to unions as their only legal avenue to force real dialogue with hospital leadership. They discuss how the corporatization of medicine has stripped doctors of autonomy, the myths administrators use to discourage organizing, and what it actually looks like to form and run a physician union. Dr. Codier also shares the personal risks, lessons learned, and why he believes reclaiming physicians’ collective voice is essential to protecting both the profession and the patients we serve.

This episode is a candid look at how medicine reached this crossroads and asks whether the future of physician advocacy depends on this form of collective power.

What You’ll Learn in This Episode:

  • Why more physicians are unionizing and what that process really involves.
  • The biggest myths hospitals spread about unions — and what’s actually true.
  • The personal and professional risks of organizing inside large health systems.
  • Whether unionization is a long-term solution to help physicians reclaim medicine’s moral core.

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📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

We're releasing a Physicians AI Whitepaper and need your help!

Calling all MDs: Help us shape the future of what AI looks like in medicine. Participate Here! https://tally.so/r/n0pxeN

Why Women Physicians Still Earn Less — and What We Can Do About It With Dr. Vineet Arora23 Oct 202500:41:23

Dr. Vineet Arora is the Dean for Medical Education at the University of Chicago and one of the nation’s leading voices on equity, leadership, and physician well-being. Her groundbreaking research has exposed how gender bias and pay inequity continue to shape medicine—from how residents are evaluated to how faculty are promoted and paid. But more importantly, she’s focused on what can be done about it.

On this episode of How I Doctor, Dr. Graham Walker talks with Dr. Arora about why women physicians still earn less than their male peers—and the systemic, cultural, and personal strategies that can finally close the gap. They discuss the hidden ways bias shows up in training and evaluations, how compounding pay inequities add up to millions over a career, and what real pay transparency should look like. Dr. Arora also shares practical advice for early-career physicians on negotiation, knowing your value, and finding professional fulfillment without burning out.

This episode will challenge how you think about pay, power, and progress in medicine—and what each of us can do to make equity the norm, not the exception.

What You’ll Learn in This Episode:

  • The real data behind the $2 million lifetime gender pay gap in medicine.
  • How bias in evaluations and promotions starts as early as residency.
  • Why pay transparency alone won’t fix inequity and what else needs to change.
  • How fair pay connects directly to feeling valued, supported, and able to keep practicing the medicine you love.


🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

Breaking Free from W-2 Medicine: The Physician’s Guide to Locum Tenens with Dr. Ali Chaudhary16 Oct 202500:39:47

Dr. Ali Chaudhary is an emergency physician, entrepreneur, and one of the leading voices helping doctors reclaim control over their careers. After leaving a traditional W-2 job, he built Locums United and LocumOS - two platforms designed to bring transparency, fairness, and autonomy to how physicians are staffed and compensated. Having lived both sides of medicine, Ali shares how locum tenens work can transform burnout into balance and turn short-term contracts into long-term career freedom.

On this episode of How I Doctor, Dr. Graham Walker talks with Ali about what really happens when doctors leave the W-2 world, how to build stability as an independent contractor, and why locums can be the key to both financial freedom and professional fulfillment. They break down the myths that scare physicians away from 1099 work, the financial strategies that make it sustainable, and the mindset shift required to think like a business owner instead of an employee.

If you’ve ever wondered whether it’s possible to make more, work less, and still love medicine again then this episode is your blueprint.

What You’ll Learn in This Episode:

  • Why the traditional W-2 model is burning out physicians and how locums flips the script.
  • How to set up your locums life for stability.
  • The real financial math behind 1099 work, and how to maximize your take-home pay.
  • How to spot red flags in locums contracts and avoid being underpaid.

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📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

The Future of Emergency Medicine: Dr. Alison Haddock on Physician Empowerment, Unionization, and Survival in the ED09 Oct 202500:29:29

Dr. Alison Haddock is an emergency physician, educator, and past president of the American College of Emergency Physicians (ACEP). She’s spent her career fighting for physician autonomy and building a sustainable future for emergency medicine. One where doctors aren’t just surviving shift to shift, but leading the systems that shape their work. A national voice on policy and workforce reform, Dr. Haddock has seen firsthand how crowding, violence, and financial pressure are pushing ER physicians to their breaking point and what it will take to bring them back.

On this episode of How I Doctor, Dr. Graham Walker sits down with Alison live at ACEP to unpack what’s really driving burnout in emergency medicine, how systemic failures fuel the crisis in the ED, and why unionization and pay transparency may be the boldest tools for reclaiming control. They dive into the politics of boarding, the hidden cost of private equity in healthcare, and the urgent need to rebuild physician power from the ground up. It’s a candid, timely conversation about survival, advocacy, and the kind of leadership emergency medicine needs right now.

If you’ve ever walked out of a shift wondering how much longer you can do this, or what it would take to make things better, this episode is for you!

What You’ll Learn in This Episode
  • Why burnout isn’t about resilience—it’s about control. How the loss of professional autonomy, not the lack of self-care, drives physicians out of the field.
  • How ED boarding exposes systemic rot. Why emergency physicians are paying the price for hospital inefficiency, and what policy changes could actually fix it.
  • The financialization of medicine explained. How profit-first strategies have warped incentives and left doctors carrying the moral and financial burden.
  • Why unionization is gaining traction among physicians. How collective action could be the next step in protecting clinicians and reshaping the balance of power in healthcare.
  • What ACEP is doing to fight back. Inside Dr. Haddock’s efforts to reform employment models, prevent physician exploitation, and push for meaningful change.

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

Escaping Physician Exploitation: Private Practice, Pay Transparency, and Entrepreneurship with Dr. Brian Dixon02 Oct 202500:41:20

Dr. Brian Dixon is a psychiatrist, entrepreneur, and one of the boldest physician voices pushing for salary transparency and fairness in medicine. He’s the founder of Simply Psych and Mindful, and he’s built his career by pulling back the curtain on contracts, compensation, and the hidden math of how health systems profit off physicians. With radical honesty, he shares not just his wins but also his mistakes—showing doctors the real trade-offs between employment, private practice, and entrepreneurship.

On this episode of How I Doctor, Dr. Graham Walker talks with Brian about why most contracts are designed to exploit physicians, how transparency builds trust, and what it really takes to scale a practice without burning out. They dig into the myths that keep doctors underpaid, the psychological traps that make us easy to exploit, and the lessons Brian had to buy - sometimes for $50,000 - that can save you from the same fate. If you’ve ever wondered how to get paid fairly and keep your autonomy intact, this is the conversation you’ve been waiting for.

If you’ve ever looked at your paycheck and wondered, “Is this really what I’m worth?”—this episode will change how you see employment, private practice, and the business of medicine.

What You’ll Learn in This Episode:
  • Why the salary you’re offered is rarely the salary you’re actually worth—and how employers frame the numbers against you.
  • How the culture of altruism in medicine gets exploited, leading doctors to accept less than they deserve.
  • The three true career paths for physicians (employee, owner, or hybrid) and how to think about risk versus autonomy.
  • Why employed physicians today may face more risk than independent ones—and how non-competes and contract language trap doctors.
  • How to scale a private practice the right way so you don’t burn out trying to do everything yourself.

Thank you to our wonderful sponsors for supporting the podcast:

Abridge - AI for clinical conversations: https://www.abridge.com/

Evidently - Leading AI-powered clinical data intelligence https://evidently.com/





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📝 For a full transcript of this episode click HERE


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Mentioned in this episode:

This Episode is Sponsored by Abridge

Abridge is the leading AI platform that drafts structured, clinically useful notes at the point of conversation

Abridge Sponsor

How Two ER Doctors Created the Top Clinical Tool for Physicians: The Origins of MDCalc with Dr. Joe Habboushe25 Sep 202500:36:30

This episode is sponsored by Abridge - the leading AI platform that drafts structured, clinically useful notes at the point of conversation.

MDCalc turns 20 this year. What began as a scrappy side project in med school grew - without outside funding - into one of the most-used, most-trusted clinical references in the world. In this episode of How I Doctor, host Dr. Graham Walker sits down with his co-founder Dr. Joe Habboushe - an emergency physician, math nerd in the best sense, and relentless advocate for evidence-based care - to unpack how MDCalc was built, why clinicians trusted it early, and what comes next in the age of AI.

They revisit the “slow and thoughtful, not move-fast-and-break-things” playbook that earned physician trust, the scrappy years when both were working full-time in the ED while growing the site score-by-score, and how partnering with tool creators and societies raised the bar for quality. From COVID’s chaotic first year to today’s AI hype cycle, Joe explains why guardrails matter, why calculators should augment (not replace) clinical judgment, and how MDCalc plans to lead responsibly.

What You’ll Learn in This Episode
  • How two ER docs grew MDCalc organically into a global, trusted clinical tool
  • The product philosophy behind MDCalc: safe, fast, trusted—and why “don’t break things” works in medicine
  • Why decision tools must partner with clinical judgment and not compete with “gestalt vs. calculator” false choices
  • How MDCalc’s contributor model and society partnerships improved evidence quality and bedside usability
  • MDCalc + AI: where responsible, physician-led guardrails can make tools powerful and safe
  • Practical advice for physician-founders: finding a complementary co-founder, building step-by-step, and choosing work that actually fits you

About Dr. Joe Habboushe

Emergency physician, co-founder of MDCalc, and long-time champion of evidence-based medicine. Joe helped design MDCalc’s contributor ecosystem, content standards, and “safe-fast-trusted” ethos that clinicians rely on at the bedside.

If you’re a clinician who uses MDCalc, this conversation is a rare behind-the-scenes on how it was built for you—and how it will stay clinician-first as AI enters the workflow.

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📝 For a full transcript of this episode click HERE


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Mentioned in this episode:

This Episode is Sponsored by Abridge

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From Hospital Insider to Physician Advocate: How Ethan Nkana Switched Sides to Champion Doctors’ Voices18 Sep 202500:40:11

Ethan Nkana spent over a decade as a hospital executive negotiating contracts on behalf of health systems. He knew the inside playbook: how administrators calculated physician value, what mantras they used behind closed doors, and the quiet ways hospitals exploited physician professionalism. Then he switched sides. 

In this episode of How I Doctor, Dr. Graham Walker sits down with Ethan to explore medicine’s hidden business realities. From the stigma of being called “greedy,” to why the squeaky wheel gets the raise, Ethan unpacks how contracts are really written and how doctors can speak up without jeopardizing their careers. He shares the three buckets every physician should focus on - life balance, practice support, and fair pay - and the practical strategies that turn an uneven negotiation into a fair one.

He calls himself the “Jerry Maguire for physicians,” and in this conversation Ethan shares what every doctor needs to know before signing or renewing a contract.

What You’ll Learn in This Episode:

  • Why “greedy” is a trap word and how to reframe fair pay as part of safe patient care
  • The 3 contract buckets that matter most: life balance, practice support, and compensation
  • What hospital executives really say behind closed doors about new physician hires
  • Why the best physicians don’t always get paid the most—and who does
  • Simple, non-adversarial scripts physicians can use to ask for what they need

Additional Resource for Physicians:

👉 Contract Negotiation Guide

 Before your next contract discussion, make sure you’ve gathered:

  • Your actual weekly workload (clinical + after-hours documentation)
  • Recent productivity metrics and patient satisfaction scores
  • Evidence of non-revenue work (committees, teaching, outreach)
  • Market data for your specialty and region
  • A clear ask for at least one improvement in each bucket: life balance, practice support, fair pay\

Find out more about Rocky Mountain Physician Agency

Follow Ethan on Instagram at https://www.instagram.com/physicianagency/?hl=en 

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315


👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/ 

IG https://www.instagram.com/ubergraham/ 

Bluesky https://bsky.app/profile/drgrahamwalker.com 


✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe 


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Medicine’s Broken Promises: Dr. Danielle Ofri on Greed, Trust, and Why the System Survives on Exploiting Clinicians11 Sep 202500:38:43

Dr. Danielle Ofri is an internist at Bellevue Hospital, clinical professor at NYU, and one of the most widely read physician-writers of our time. Through her books, essays, and New York Times op-eds, she has given voice to the emotional realities of medical work and exposed the ways the business of healthcare exploits the professionalism of doctors and nurses. Her clarity and candor have made her a trusted guide for physicians who feel the weight of a system that too often prioritizes profit over patient care.

In this episode of How I Doctor, Dr. Graham Walker sits down with Danielle to discuss medicine’s broken promises. From the erosion of trust and the exploitation of clinicians’ goodwill, to the disconnect between luxury hospitals and patient harm, they explore the hidden economy of modern healthcare and the ethical line between professionalism and exploitation. Dr. Ofri shares why nursing shortages are directly tied to patient mortality, how administrators rely on doctors “doing the right thing,” and what it will take for physicians to reclaim their voice in shaping the system.

What You’ll Learn in This Episode:

  • Why the “professionalism” of doctors and nurses has become healthcare’s most exploited resource
  • How nursing shortages directly affect patient safety and mortality rates
  • The ethical and personal toll of 20-minute visits for medically complex patients
  • The hidden disconnect between nonprofit hospital profits and patient care
  • Strategies for physicians to speak up without crossing ethical or professional lines

Subscribe to Danielle’s newsletter here

Follow her on Instagram at https://www.instagram.com/danielle_ofri/  

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315


👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/ 

IG https://www.instagram.com/ubergraham/ 

Bluesky https://bsky.app/profile/drgrahamwalker.com 


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Longevity Doctor Reveals The Truth About Supplements, Multivitamins, Biohacking, And More with Dr. Hillary Lin04 Sep 202500:36:12

Dr. Hillary Lin is a Stanford-trained internist and longevity entrepreneur who is cutting through the hype to bring evidence-based clarity to one of medicine’s buzziest frontiers. As co-founder and CEO of Carecore and host of The Longevity Show, she’s built her career at the intersection of clinical skepticism and innovation, challenging what’s real and what physicians need to know about this fast-growing space.

In this episode of How I Doctor, Dr. Graham Walker sits down with Hillary to unpack the science of longevity medicine. From the pillars that actually work to the overhyped products flooding social feeds. They explore supplements, multivitamins, full-body scans, and the influencer-driven myths that confuse patients, while offering physicians a framework for counseling patients who are curious, skeptical, or already experimenting with longevity trends.

💡 Want to Go Deeper?

We’ve created a companion resource to this episode: Longevity Medicine Resource Guide for Physicians: Separating Fact from Fiction. Inside you’ll find curated evidence, peer-to-peer insights, and practical tools to help you counsel patients to cut through wellness industry hype and stay current on what really works.

👉 Download the guide now

What You’ll Learn in This Episode:

  • The Lifestyle Pillars That Actually Extend Healthspan
  • Supplements And Multivitamins: What’s Worth It (And What’s Not)
  • The Most Overhyped Longevity Trends—Debunked
  • Why Longevity Medicine Isn’t A Real Specialty
  • The Future: Pre-Disease Screening And At-Home Testing

Subscribe to Hillary’s newsletter on evidence-based strategies for extending healthspan

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/ 

IG https://www.instagram.com/ubergraham/ 

Bluesky https://bsky.app/profile/drgrahamwalker.com 

✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe 

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Surviving Medicine’s Hidden Trauma: How Dr. Gita Pensa’s Malpractice Lawsuit Became a Blueprint for Helping Other Doctors28 Aug 202500:36:51

Dr. Gita Pensa is an emergency physician and nationally recognized advocate who knows firsthand the toll malpractice takes on doctors. After enduring a 12-year legal battle that included two jury trials, she emerged determined to break the silence around litigation and its hidden impact on physicians’ identity, mental health, and careers. Today, she uses her story to teach colleagues how to survive what she calls medicine’s “second trauma.”

In this episode of How I Doctor, Dr. Graham Walker talks with Gita about the day she was served, the years she spent fighting in court, and how that experience reshaped her mission. From defensive medicine to the isolation lawsuits create, Gita offers hard-earned insights and a blueprint for how doctors can protect themselves, find support, and come out stronger on the other side.

The Physician’s Guide to Surviving Medical Malpractice

Offcall has created a comprehensive resource guide to help physicians navigate the realities of litigation. This guide pulls together expert advice, peer support programs, and practical strategies for what to do if you’re sued. Whether you’re early in your career or decades into practice, this guide offers the tools and community you need to protect your career, care for yourself, and move forward with confidence.

👉 Read The Physician’s Guide to Surviving Medical Malpractice

What You’ll Learn in This Episode:
  • Common mistakes doctors make after being sued  - and how to avoid them
  • How litigation drives defensive medicine and impacts the way we practice
  • What every physician should know about malpractice coverage including state-by-state differences
  • Reforms that could make the system more fair for patients and doctors
  • Why finding support and breaking the silence is critical for surviving litigation
  • Watch A World of Hurt: How Medical Malpractice Fails Everyone


🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315


👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/ 

IG https://www.instagram.com/ubergraham/ 

Bluesky https://bsky.app/profile/drgrahamwalker.com 


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No Insurance Needed! Same Day Appointments! Unlimited Visits! Pay Whatever You Can! How Dr. Paulius Mui Is Reinventing Primary Care to Put Patients First21 Aug 202500:37:24

Dr. Paulius Mui is a family physician, technologist, and community builder who refuses to fit into a single box. Instead of choosing between clinic shifts and tech projects, he’s built a portfolio career that blends patient care, experimentation, and creativity. Most recently, Paulius is reimagining what primary care looks like by launching a direct primary care practice that lets patients pay what they can.

In this episode of How I Doctor, Dr. Graham Walker talks with Paulius about why full-time primary care has become nearly impossible and why he has decided to choose mission over money for the benefit of patients and his profession. Paulius’ story offers a blueprint for fellow physicians to break the rules — and build something better.

📘 Resource Guide for Primary Care Physicians

We’ve created a companion resource guide to this episode, including tools, communities, and references for anyone who is interested in learning more about direct primary care.

Whether you’re exploring direct care models, looking for innovative tech tools, or are ready to set up a direct primary care practice of your own, this guide offers concrete next steps.

👉 Download the Resource Guide here

What You’ll Learn in This Episode:
  • Why primary care has gotten so challenging
  • How Direct Primary Care offers a path forward for doctors who prioritize mission over money
  • How technology, community, and curiosity can help doctors build better systems instead of just fighting broken ones

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE


🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315


👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/ 

IG https://www.instagram.com/ubergraham/ 

Bluesky https://bsky.app/profile/drgrahamwalker.com 


✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe 


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LinkedIn https://www.linkedin.com/company/joinoffcall/ 

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TikTok https://www.tiktok.com/@offcalldotcom

What Happens When a Pediatrician Takes On Congress - Dr. Annie Andrews on Turning Clinical Advocacy into Political Action14 Aug 202500:30:43

Dr. Annie Andrews is a pediatric hospitalist, public health advocate, and U.S. Senate candidate in South Carolina taking on incumbent Lindsey Graham. Known for her unapologetic advocacy for children’s health, Annie has spent over 15 years caring for sick and injured kids, only to realize that many of their challenges stemmed from broken policies far upstream of the hospital. From gun violence prevention to protecting Medicaid, she’s made it her mission to bring a physician’s voice into the rooms where decisions are made and to speak with a candor rarely heard in politics.

In this episode of How I Doctor, Dr. Graham Walker talks with Annie about why more physicians should step into public life, how to fight misinformation without losing credibility, and the communication skills doctors already have that translate to the campaign trail. They dig into the gender inequities baked into medicine and why telling patient stories matters more than citing p-values. If you’ve ever wondered how to turn clinical advocacy into real political action, Annie’s story will make the case that there’s never been a more important time for doctors to run toward the fire.

What You’ll Learn in This Episode:

  • The skills every physician already has that translate to political leadership
  • How to fight misinformation without sounding like you’re in an ivory tower
  • Why gender inequities in medicine persist even in female-dominated specialties
  • The role of storytelling in rebuilding public trust in physicians
  • What politicians would learn if they were required to spend a day in a children’s hospital

Find out more about Annie here and connect with her on Instagram at https://www.instagram.com/annieandrewsmd/


Watch her campaign launch video at https://www.youtube.com/watch?v=J8wMNLaSNW4 


🩺 Offcall is more than a platform — it’s a community. Join today!


📝 For a full transcript of this episode click HERE


🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315


👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/ 

IG https://www.instagram.com/ubergraham/ 

Bluesky https://bsky.app/profile/drgrahamwalker.com 


✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe 


🟧 Follow Offcall on 

LinkedIn https://www.linkedin.com/company/joinoffcall/ 

IG https://www.instagram.com/offcalldotcom/ 

TikTok https://www.tiktok.com/@offcalldotcom

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