Cut & Tell

Hippocratic Collective
  • 5.0 (19)
  • Medicine

Cut & Tell is a real-time account of becoming a surgeon—at the exact moment the training wheels come off. Hosted by plastic surgery chief resident Elizabeth Malphrus, this show follows the transition from residency to “year one”: the first, most disorienting, and most defining stretch of a surgical career. It’s where the identity you’ve spent a decade building is suddenly tested—clinically, professionally, and personally. This is not a retrospective. It’s happening now. Through solo episodes, unfiltered conversations, and stories from inside the operating room and beyond, Cut & Tell explores what it actually takes to become a surgeon: the structure of training, the emotional cost, the invisible curriculum, and the tension between perfection and reality in a high-stakes field. It also asks harder questions—about trust in medicine, the role of physicians in a changing cultural landscape, and what it means to step into authority when you’re not sure you’re ready.

  1. 23h ago

    Coaching, panic, and the arrival fallacy: a surgery chat with Mel Thacker, MD

    What happens when you become the surgeon, pay off the loans, and still feel empty? On Cut & Tell’s first guest episode, Dr. Mel Thacker (ENT, surgeon coach, and host of Surgeons with Purpose) joins me to talk about her new memoir, Scrubbing In. It covers her path from childhood neglect to surgery, the arrival fallacy, and the panic attacks in the OR that finally forced her to face it all. We also get into how insurance incentives quietly shape clinical decisions, why Mel walked away from private practice, why residency needs coaching, and how she built a part-time locums career on her own terms. 📚 Referenced: Scrubbing In: A Surgeon’s Journey from Self-Doubt to Wholeness by Dr. Mel Thacker; “When Incentives Become Instinct” (Hippocratic Collective); The Infinite Game by Simon Sinek Enjoyed this episode? Rate, review, and subscribe, and find more shows at hippocratic-collective.com. Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  2. Oct 1

    Financialization of Healthcare: How Money Became the Mission

    Administrative bloat, skyrocketing CEO pay, hospital mergers, rural closures. These aren't separate problems. They're symptoms of one syndrome: financialization. In this episode, Liz breaks down how hospitals and practices went from places that care for people to assets that exist to generate returns, and why nonprofit hospitals now behave almost exactly like for-profits. We cover the vocabulary that gets thrown around in boardrooms (marketization, corporatization, privatization), the administrator arms race between hospitals and insurers, what hospital CEOs are actually paid to optimize for, and how consolidation drives up prices without improving quality. Then we get to what doctors can do about it, from unionization to clinician leadership requirements to cutting out the insurance middleman. It's Goodhart's Law on a massive scale: when growth and revenue are the targets, healthcare stops being the point. 📚 Referenced: Bruch, Roy & Grogan, "The Financialization of Health in the United States," New England Journal of Medicine (2024)Blumenthal & Galvin, "The Vocabulary of Our Discontent," JAMA"Money has become the mission," The Lancet (2025) ⏱️ Timestamps 00:00 Welcome to Cut & Tell 00:19 From the administrator boom to a bigger problem 02:22 Financialization as a syndrome 04:56 Defining financialization 07:30 Marketization: the 1980s shift 12:52 Corporatization and consolidation 14:14 Why nonprofits act like for-profits 15:15 Privatization and Medicare Advantage 16:38 Money has become the mission 21:02 The administrator boom, by the numbers 24:45 The US vs. Canada and the VA 27:51 The hospital–insurer arms race 29:59 Executive pay 33:20 CEO-to-employee pay ratios 36:05 What CEOs are actually paid for 39:08 Mergers, prices, and hospital closures 44:30 The administrative accountability gap 46:30 Recap 48:00 What doctors can do about it If you enjoyed this episode, please subscribe, rate us five stars, and leave a review. Better yet, send it to someone who should be outraged, or at least better informed. Check out more shows and content at hippocratic-collective.com. #HealthPolicy #Healthcare #HospitalCEO #Financialization #PhysicianLife #MedicalPodcast #CutAndTell #DoctorsOfInstagram Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  3. Sep 24

    Healthcare's Obsession with Metrics, and Why it keeps Backfiring

    What happens when a well-intentioned healthcare metric gets turned into a target? Nothing good — and Liz has the receipts. Before medical school, she spent two and a half years as study director for a major National Academies report on healthcare measurement. Then she went to residency, and everything she believed fell apart. This episode walks through the VA wait-time scandal, MIPS, and the Hospital Readmission Reduction Program — three cautionary tales about what happens when you attach incentives to healthcare data, and why Goodhart's Law keeps winning. 📚 Referenced: Vital Signs: Core Metrics for Health and Healthcare Progress (National Academies of Sciences, Engineering, and Medicine) Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  4. Sep 17

    Private equity is eating healthcare alive

    Would you send someone you love to a hospital owned by private equity? Dr. Liz Malphrus breaks down exactly how private equity works, why it's poured billions into healthcare since 2018, and what the data says about the cost, safety, and physician burnout that follow. Plus: the exact questions to ask before taking a private-equity-backed job. Referenced: BMJ systematic review on PE and healthcare quality/cost; JAMA analysis of Medicare claims on PE hospital acquisitions and patient safety; physician satisfaction and autonomy survey data.Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  5. Sep 10

    Prior auths, step therapy, and AI: how doctors lose their professional sovreignty

    Every week, doctors spend 13 hours fighting insurance companies just for permission to treat their patients — and now, under a new Medicare pilot, some of those decisions are being handed to AI. In this episode, Liz digs into prior authorization: where it came from, how it quietly stripped doctors of their professional sovereignty, and why the newest version of this system might be the most alarming yet. 📚 Referenced: The Social Transformation of American Medicine by Paul Starr Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  6. Sep 3

    CPT codes in the news: everything you need to know

    CMS is proposing a rule that could cut your pay in half just for treating more than one problem per visit — and the comment period closes September 14th. Liz breaks down the proposed change to the 25 modifier, why the "help primary care" logic doesn't hold up, and why the AMA is being sued — again — over its copyright on the CPT codes every doctor has to use. Plus: why physician Medicare pay is down 33% since 2001 while the AMA's revenue keeps climbing. 🔗 Referenced: CMS 2027 Physician Fee Schedule public comment page — [link] (open through 9/14) Enjoyed this episode? Rate us five stars, leave a review, and send it to someone who should be outraged or better informed. More shows at HippocraticCollective.com. Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  7. Aug 27

    How Do Doctors ACTUALLY Get Paid? What Doctors and Residents Need to Know

    How does a doctor's visit actually turn into a paycheck? It's more convoluted than how a bill becomes a law — and almost nobody, including most doctors, understands it. In this episode of Cut and Tell, Dr. Liz Malphrus (plastic surgeon, Philadelphia) breaks down the claims-based payment system that runs American healthcare: the five data points that determine every dollar a doctor is paid, why a "clearinghouse" still charges $1 per claim in 2026, and how a shadowy 32-person AMA committee called the RUC quietly decides what your appendectomy is worth. We also go back to 1929 to trace how we ended up with employer-based health insurance in the first place — starting with a Baylor University hospital administrator, a group of Dallas schoolteachers, an FDR-era wage freeze, and a 1954 tax law that changed everything. WHAT WE COVER • What's actually in a medical claim (just 5 data points — no clinical detail) • ICD-10 vs. CPT codes, explained simply • Why 10–20% of claims get denied on the first pass • The clearinghouse "middleman" nobody can explain the value of • The AMA's CPT copyright and why it's worth $285M/year to them • RVUs: the fixed "pie" that pits specialties against each other • The RUC — the committee that sets what doctors get paid, and who's on it • The real history: the 1929 Baylor Plan, Blue Cross/Blue Shield, the 1942 wage freeze, and the 1954 tax exemption that built employer-based insurance • Why Medicare (1965) inherited this system rather than designing a new one CHAPTERS 00:00 Intro — why this episode matters 00:00 What is a "claim," really? 00:00 The 5 codes that determine your pay: ICD-10, CPT, place of service, provider, payer 00:00 How a claim moves: coder → clearinghouse → payer → remittance 00:00 The clearinghouse problem 00:00 Claim denials and the appeals process 00:00 A brief history of American health insurance: the 1929 Baylor Plan 00:00 Blue Cross, Blue Shield, and the birth of fee-for-service 00:00 WWII wage freezes and the accident of employer-based insurance 00:00 1954 tax law and 1965 Medicare 00:00 The AMA and the CPT code copyright 00:00 RVUs and the fixed "pie" 00:00 The RUC: who really sets your pay 00:00 Recap and why this matters for doctors and patients [Insert real timestamps after final edit] If this made you mad, good — that's the point. Subscribe, rate us 5 stars, and leave a review; it's the best way to help other clinicians find this show. Share it with a resident, an attending who won't stop complaining about RVUs, or anyone who thinks healthcare billing makes sense. Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

  8. Aug 20

    A Noble Profession Tries to Get Paid: The Historical Roots of a Modern Healthcare Crisis

    This is Episode 2 of our series on health policy and economics for doctors! This episode is about laying the historical groundwork for the rest of this season, because so many of our modern healthcare problems can be traced back to decisions made WAY in the past that set us on this course. In this episode, Dr. Liz Malphrus digs into the 19th-century roots of American medicine — from home-based house calls and bartered payments to the founding of the American Medical Association in 1847 — to explain how doctors chose to model their profession after clergy instead of lawyers, and why that choice still shapes healthcare's biggest problems today. Drawing on Paul Starr's The Social Transformation of American Medicine, this episode lays the historical foundation for everything Cut & Tell will cover this season: why healthcare is so complicated, why doctors are uncomfortable charging for care, and why patients are too. Referenced: The Social Transformation of American Medicine by Paul Starr Host: Liz Malphrus, MD Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md IG: @dr.malphrus Produced By: The Hippocratic Collective Subscribe to @hippocraticcollective on Youtube for all of the other shows and content the Hippocratic Collective has to offer.

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5
out of 5
19 Ratings

About

Cut & Tell is a real-time account of becoming a surgeon—at the exact moment the training wheels come off. Hosted by plastic surgery chief resident Elizabeth Malphrus, this show follows the transition from residency to “year one”: the first, most disorienting, and most defining stretch of a surgical career. It’s where the identity you’ve spent a decade building is suddenly tested—clinically, professionally, and personally. This is not a retrospective. It’s happening now. Through solo episodes, unfiltered conversations, and stories from inside the operating room and beyond, Cut & Tell explores what it actually takes to become a surgeon: the structure of training, the emotional cost, the invisible curriculum, and the tension between perfection and reality in a high-stakes field. It also asks harder questions—about trust in medicine, the role of physicians in a changing cultural landscape, and what it means to step into authority when you’re not sure you’re ready.

Information

  • Creator
    Hippocratic Collective
  • Years Active
    2026
  • Episodes
    23
  • Rating
    Explicit
  • Copyright
    © Copyright 2026 Hippocratic Collective
  • Show Website
    Cut & Tell

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