How I Doctor with Dr. Graham Walker

Offcall
  • 4.8 (19)
  • MEDICINE
  • UPDATED WEEKLY

I built MDCalc 20 years ago because I wanted to save myself and other doctors time and make it easy for them to integrate more evidence into their medical care. Now I’ve launched Offcall to tackle something even bigger: giving doctors back our autonomy — through salary and workload transparency. These ideas shouldn’t be radical…but here we are. I still practice emergency medicine, but I’ve spent my career breaking out of the cookie cutter version of “what a doctor looks like” or “what a doctor’s supposed to do.” That’s why I started How I Doctor: a podcast about the most creative and influential physicians and how they’re rewriting the job description. Medicine wasn’t built for creativity. But I think that’s exactly what it needs. If you’re looking for new role models, different stories, or just proof that fulfillment is still possible in this era of medicine — this show’s for you. Welcome to “How I Doctor,” where we’re bringing joy back to medicine. If you enjoy the show, please hit the follow button! That will help us continue to bring you more great episodes every week. And don’t forget to sign up for Offcall. Join the growing movement! Offcall: https://www.offcall.com/ LI: https://www.linkedin.com/company/joinoffcall TikTok: https://www.tiktok.com/@offcalldotcom IG: https://www.instagram.com/offcalldotcom/

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

    6D AGO

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

    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 LearnHow predicting the next word isn’t the same as clinical reasoning and where LLMs fall short in medicine.What “world models” are and how they differ fundamentally from today’s large language models.Why 80% accuracy isn’t acceptable in healthcare and what reliability really means in clinical AI.Why medical coding may be one of the next frontiers for AI in clinical workflows.How AI assistants could amplify doctors the way a research lab amplifies a professor, by making clinicians smarter, not obsolete. 🩺 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 a href="https://www.instagram.com/ubergraham/" rel="noopener noreferrer"...

    38 min
  2. The Crisis in Primary Care No One Wants to Own with NEJM’s Lisa Rosenbaum, MD

    FEB 5

    The Crisis in Primary Care No One Wants to Own with NEJM’s Lisa Rosenbaum, MD

    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: Why is the specialty that knows patients best paid and respected the least?How did “referral culture” replace continuity?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 LearnWhy the crisis in primary care is fundamentally about respect and ownership, not technologyHow modern systems discourage physicians from fully “owning” their patientsThe hidden costs of referral culture and fragmented responsibilityWhy restoring autonomy may be essential to saving primary careWhat gives Lisa hope—and why cultural change is still possible in medicine Resources & Where to Find LisaLisa Rosenbaum, MD – National Correspondent, New England Journal of MedicineNot Otherwise Specified (NEJM Podcast) 🩺 Offcall is more than a platform — it’s a community. Join today! 📝 For a full transcript of this episode click a...

    41 min
  3. What Doctors Get Wrong About AI with Robert Wachter, MD

    JAN 29

    What Doctors Get Wrong About AI with Robert Wachter, MD

    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 LearnWhy AI can both improve clinical judgment and quietly erode core physician skills at the same time.What AI means for medical education, training, and the future of clinical reasoning.Why trust in AI systems may arrive sooner than we expect, and why that’s both rational and risky.How health systems should think about regulation, guardrails, and local accountability. 🔗 Resources & Further ReadingA Giant Leap: How AI Is Transforming Healthcare and What It Means for Our FutureRobert Wachter on SubstackRobert Wachter, MD – UCSF Faculty PagePrevious Book: The Digital Doctor 🩺 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 a href="https://offcall.beehiiv.com/subscribe" rel="noopener noreferrer"...

    38 min
  4. Fix the System, Not the Women: Shikha Jain on Why Medicine Is Failing Female Physicians

    JAN 22

    Fix the System, Not the Women: Shikha Jain on Why Medicine Is Failing Female Physicians

    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 LearnWhy physician burnout is a structural failure, not a personal oneHow RVU-based compensation undervalues real clinical and cognitive workThe hidden, uncompensated labor disproportionately carried by women physiciansPractical ways physicians and allies can drive meaningful change Learn More About Shikha & Women in MedicineDr. Shikha Jain: https://shikhajainmd.comWomen in Medicine: https://www.wimedicine.orgWomen in Medicine Summit September 24-26, 2026: https://www.wimedicine.org/summitOncology Overdrive Podcast: https://oncologyoverdrive.com 🩺 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 a href="https://www.linkedin.com/in/graham-walker-md/"...

    41 min
  5. ER Doctor Running for Congress Diagnoses How to Fix the U.S. Healthcare System, with Dr. Tim Peck

    JAN 15

    ER Doctor Running for Congress Diagnoses How to Fix the U.S. Healthcare System, with Dr. Tim Peck

    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 LearnWhy emergency medicine is one of the most effective forms of leadership trainingWhat changes when doctors see patients earlier instead of downstream in crisisHow rural healthcare deserts form—and what they look like in real timeWhy nursing homes and opioid care expose the deepest system failuresHow payment models shape clinical behavior more than most physicians realize 🩺 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

    40 min
  6. Reimagining the Future of Chronic Disease Care, With Cadence CMO Eve Cunningham, MD

    JAN 8

    Reimagining the Future of Chronic Disease Care, With Cadence CMO Eve Cunningham, MD

    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 LearnWhy episodic, visit-based medicine is structurally incapable of managing chronic diseaseWhat early remote patient monitoring efforts got wrong and what has finally made them workHow change management and incentives matter more than technology aloneWhy health systems struggle to act on data, even when the answers are obviousWhat 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 🎧 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 a...

    40 min
  7. Where AI in Medicine Is Actually Headed, with Microsoft’s CMO David Rhew

    JAN 1

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

    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 LearnWhy the biggest failure of healthcare AI isn’t the technology itself, but how it’s measured, implemented, and governedHow agentic AI with multiple models working together on discrete tasks can outperform single “super models” in complex clinical problemsWhy ambient documentation succeeded by addressing burnout and patient experience, not productivity metricsHow AI-enabled screening and risk stratification can identify high-risk patients long before symptoms appearWhat 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 🎧 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 a href="https://bsky.app/profile/drgrahamwalker.com" rel="noopener noreferrer"...

    38 min
  8. Mark Cuban: How I’d Reform Healthcare If I Were in Charge (Re-Release)

    12/25/2025 · BONUS

    Mark Cuban: How I’d Reform Healthcare If I Were in Charge (Re-Release)

    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. 🩺 Offcall is more than a platform — it’s a movement! Join today! https://www.offcall.com/ 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 👨‍⚕️Follow Dr. Graham Walker: LinkedIn https://www.linkedin.com/in/graham-walker-md/ IG https://www.instagram.com/ubergraham/ Bluesky https://bsky.app/profile/drgrahamwalker.com ✉️ Get our On/Offcall email newsletter: https://offcall.beehiiv.com/subscribe 🟧 Follow Offcall: LinkedIn a href="https://www.linkedin.com/company/joinoffcall/" rel="noopener noreferrer"...

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About

I built MDCalc 20 years ago because I wanted to save myself and other doctors time and make it easy for them to integrate more evidence into their medical care. Now I’ve launched Offcall to tackle something even bigger: giving doctors back our autonomy — through salary and workload transparency. These ideas shouldn’t be radical…but here we are. I still practice emergency medicine, but I’ve spent my career breaking out of the cookie cutter version of “what a doctor looks like” or “what a doctor’s supposed to do.” That’s why I started How I Doctor: a podcast about the most creative and influential physicians and how they’re rewriting the job description. Medicine wasn’t built for creativity. But I think that’s exactly what it needs. If you’re looking for new role models, different stories, or just proof that fulfillment is still possible in this era of medicine — this show’s for you. Welcome to “How I Doctor,” where we’re bringing joy back to medicine. If you enjoy the show, please hit the follow button! That will help us continue to bring you more great episodes every week. And don’t forget to sign up for Offcall. Join the growing movement! Offcall: https://www.offcall.com/ LI: https://www.linkedin.com/company/joinoffcall TikTok: https://www.tiktok.com/@offcalldotcom IG: https://www.instagram.com/offcalldotcom/

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