How I Doctor with Dr. Graham Walker

Offcall
  • 4.8 (14)
  • MEDICINE
  • UPDATED WEEKLY
How I Doctor with Dr. Graham Walker

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. The RVU Trap: How Hospitals Use Productivity Metrics to Keep Physicians in the Dark, with Contract Attorney Dennis Hursh

    8H AGO

    The RVU Trap: How Hospitals Use Productivity Metrics to Keep Physicians in the Dark, with Contract Attorney Dennis Hursh

    Attorney Dennis Hursh has reviewed more than 3,500 physician contracts and has seen the same patterns again and again - doctors being underpaid, overworked, and legally trapped by language they didn’t know to question.  In this episode, Dr. Graham Walker talks with Dennis about how RVUs and non-competes are often used against physicians, and how to push back. They dive into the structural imbalance between hospitals and physicians, the myths of “standard contracts,” and the silent clauses that could cost you tens of thousands of dollars. From shocking stories of RVU misreporting to seven-figure locums arbitrage, this episode unpacks how the business of medicine quietly undermines doctors’ financial stability and career flexibility. Dennis brings clarity and tactical advice for any doctor negotiating a contract. Whether you’re fresh out of residency, or already practicing and unsure if you’re getting a fair deal, there’s something in this episode for everyone. If you’ve ever felt like your compensation didn’t reflect your work. Or if you’ve been told “this is just how it’s done”. This episode will show you how to reclaim your leverage and ask the right questions before you sign. Dennis wanted to make his decades worth of knowledge available to all Offcall physicians. So he’s compiled a Contract Negotiation Guide featuring helpful negotiation resources, key questions to ask during a negotiation, and practical pointers. This is a one-of-a-kind resource and it’s free and available exclusively for Offcall physicians. Create an Offcall account (or log-in if you’ve already done so) in order to access the guide at https://www.offcall.com/learn/podcast/the-rvu-trap-physician-contract-red-flags-rvu-pitfalls-and-negotiation-tips-with-dennis-hursh What You’ll Learn in This Episode:Why “standard contracts” are a trap — and how to spot the clauses that limit your freedom or earningsHow malpractice tail coverage can destroy your savings if you’re not carefulThe truth about RVU compensation and why most physicians never get the full pictureHow locums companies profit on your labor — and how to negotiate like a free agentThe Stark Law loopholes and myths that employers use to shut down fair pay discussions We’re excited to announce that Dennis is offering a special 10% discount for his legal services for all Offcall physicians. You can book a free consultation here, and be sure to mention “Offcall” during your appointment to claim your 10% discount! 🩺 Offcall is more than a platform — it’s a community. Join today! 🎧 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"...

    44 min
  2. Innovation and AI-Driven Healthcare, with MD Entrepreneur Dr. Jay Parkinson

    JUL 10

    Innovation and AI-Driven Healthcare, with MD Entrepreneur Dr. Jay Parkinson

    Dr. Jay Parkinson is a pediatrician and founder who’s been reinventing healthcare from the outside in for nearly two decades. From launching one of the first tech-enabled house call services in Brooklyn to pioneering virtual primary care with Sherpaa, Jay has always believed that doctors can design better systems. Now he’s back with Automate Clinic, a new venture training physicians to fine-tune clinical AI models with real-world judgment and insight. In this episode of How I Doctor, Dr. Graham Walker talks with Jay about bucking the traditional medical career path, designing more human-centered systems, and what most startups (and health systems) still don’t get about primary care. They also dive into Jay’s new work building AI you can actually trust, and why the doctors best positioned to shape its future are the ones curious enough to break stuff and ask better questions. If you’ve ever wanted more freedom, more creativity, or more control in medicine then this one’s for you. What You’ll Learn in This Episode: Why Jay bet on the iPhone, and not the EMR, as the future of medicineWhat healthcare can learn from previous startups like Uber and GoogleWhy most doctor visits don’t need to happen in person and how to rethink the “front door” of careHow AI can surface consensus, not just “the right answer” and why that’s so powerful in medicineWhy design is a form of protest, and every patient deserves a more beautiful experience 🩺 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

    43 min
  3. FTEs, RVUs, PSLF...WTF? Everything You Were Never Taught to Become a Successful Doctor with Dr. Ami DeWaters

    JUL 3

    FTEs, RVUs, PSLF...WTF? Everything You Were Never Taught to Become a Successful Doctor with Dr. Ami DeWaters

    Dr. Ami DeWaters is a hospitalist, medical educator, and one of the leading voices reimagining how we prepare residents for the realities of modern medicine. She’s an associate professor at Penn State College of Medicine that’s known for her sharp insights and deep commitment to building physicians who are not just clinically excellent, but also financially, professionally, and systemically fluent. In this episode of How I Doctor, Dr. Graham Walker talks with Ami about the disconnect between what doctors are taught and what they actually need to succeed. From FTEs and RVUs to PSLF and prior auths, they unpack the hidden curriculum of becoming a practicing physician - and why not understanding how the system works is no longer an option. If you’ve ever felt like medicine handed you the keys without teaching you to drive, this episode will tell you how to take back control. What You’ll Learn in This Episode: Why understanding FTEs is essential for your contract, your income, and your loan forgivenessHow to negotiate your first job like a pro and the surprising reason your desk might be the first red flagThe hidden power of residents to drive change and how one radiology resident helped redesign their entire overnight workflowWhy every doctor needs to speak the language of RVUs, billing, and insurance regulation if they want to lead and not just surviveThe one lesson every intern should learn by the end of their first year 🩺 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  Article Display Title (Social)

    45 min
  4. Young Doctors Need to Be Willing to Make the Ultimate Sacrifice with Congressman Greg Murphy

    JUN 26

    Young Doctors Need to Be Willing to Make the Ultimate Sacrifice with Congressman Greg Murphy

    Dr. Greg Murphy is a practicing urologist and four-term Republican Congressman representing North Carolina’s third district—and the only physician in Congress who still actively sees patients, entirely pro bono. Before entering politics, he served as an affiliate professor, urology group president, and chief of staff at a Level 1 trauma center in Greenville, NC. These days, he’s sounding the alarm about what he sees as a crisis in the medical profession: a generation of young doctors who, in his view, are losing their sense of calling. In this episode of How I Doctor, Dr. Graham Walker talks with Congressman Murphy about the tweet that sparked backlash from younger physicians and the deeper frustrations behind it. Together, they explore the erosion of autonomy, the death of private practice, and what Murphy calls “the ultimate sacrifice” that medicine requires. It’s a fiery, honest, and civil conversation that cuts across generations, full of tough questions, uncomfortable truths, and a shared commitment to fighting for the future of patient care. What You’ll Learn in This Episode: Why Congressman Murphy believes too many doctors are using the system as an excuse to stop doing what’s right for the patient.What he means when he says medicine is “a field of sacrifice”—and why he thinks too many young physicians are prioritizing lifestyle over service.His critique of how medical schools admit, train, and prepare students—and what needs to change now.Why he thinks physicians need to give more than just their time to advocacy—and why money matters in politics.How doctors can get more engaged, whether it’s through policy, protest, or running for office themselves. If you’re a doctor questioning the future of medicine or just looking for a straight-talking take on what it means to stay in the fight this episode’s for you. 🩺 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

    44 min
  5. Why Medical Education Is Broken, And How We Can Fix It with Dr. Paul Tran

    JUN 19

    Why Medical Education Is Broken, And How We Can Fix It with Dr. Paul Tran

    Dr. Paul Tran is a pediatric gastroenterologist, award-winning medical educator, and the creator behind Alimentary School — an online platform using storytelling, mentorship, and dad jokes to make medicine more human. He’s on a mission to break down outdated hierarchies and rebuild medical education around trust, real-time feedback, and genuine connection. In this episode of How I Doctor, Dr. Graham Walker talks with Paul about what’s broken in medical training and how we can actually fix it. With warmth and wit, Paul explains why seeing students as “just students” undermines patient care, how virtual interviews and pass/fail boards have reshaped the residency match, and why the way we give feedback needs to change yesterday. He also shares the killer interview question every applicant should ask, and how social media can help bridge gaps traditional training leaves wide open. If you’ve ever wondered what it would look like to blow up med ed and start fresh, this is the conversation for you. What You’ll Learn in This Episode: Why medical training still relies on outdated hierarchies — and how that hurts future doctors and patients alike.How the move to pass/fail Step 1 and virtual interviews is reshaping residency applications (and adding new pressures).The big flaws with “Feedback Fridays” — and Paul’s practical advice for giving and getting better feedback every day.The exact two-part question every med student should ask to uncover a residency program’s real culture.How Paul uses humor and short-form videos to make medical education more accessible, honest, and fun. 🩺 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

    39 min
  6. We're Sharing AI Secrets for Clinicians

    JUN 12

    We're Sharing AI Secrets for Clinicians

    The world of medicine is entering a new era. One where AI isn’t just a buzzword, but a daily presence in the lives of physicians. That’s why Offcall recently hosted a live webinar We're Sharing AI Secrets for Clinicians, featuring Dr. Graham Walker, ER physician and co-founder of Offcall, and Dr. Sarah Gebauer, anesthesiologist and founder of Valara Health. Longtime friends and Stanford med classmates. Their goal? Demystify AI for busy clinicians and provide practical tools to navigate this moment of transformation. Not in five years, but right now. Throughout the session, Graham and Sarah unpacked the real-world impact of AI in clinical practice, offering a blend of foundational education, cautionary guidance, and hands-on tips.  You can watch the full video presentation at https://www.linkedin.com/events/7331694686937530368/about/ Physicians, visit Offcall.com/AIGuide to download Graham & Sarah’s AI Guide. For everyone else who doesn’t have an NPI number you can download that guide at https://docsend.com/v/3t6h4/offcallwebinar What You’ll Learn in This Episode: AI Is Already Here—You Just Might Not Know ItKnow Your AI Types: Generative vs. DeterministicUse Cases Are Expanding RapidlyAsk the Hard Questions Before You AdoptBias and Hallucinations Are Real RisksOverreliance Can Weaken Clinical JudgmentLegal and Ethical Guardrails Are Still Being BuiltClinicians Need to Lead the Conversation 🩺 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

    37 min
  7. Nurses Know How to Fix Healthcare, So Why Are They Left Out of the Room? with Shawna Butler, RN

    JUN 5

    Nurses Know How to Fix Healthcare, So Why Are They Left Out of the Room? with Shawna Butler, RN

    Shawna Butler is a nurse, economist, and creator of the EntrepreNURSE movement — but above all, she’s a force for rethinking how healthcare systems are built and who gets a say. In this episode of How I Doctor, Dr. Graham Walker talks with Shawna about what we lose when we treat nurses like costs instead of collaborators. They unpack the deep roots of burnout and moral injury, explore why innovation often fails without frontline input, and ask a radical but overdue question: what if nurse wellbeing were a quality metric? It’s a bold conversation about power, trust, and how healthcare can only heal when the people delivering it are heard, valued, and supported. What You’ll Learn in This Episode: The Real Reason Nurses Burn Out - It’s not just stress. Nurses are seen as expenses, not expertsm and that perception shapes everything from policy to paychecks.Why Burnout Isn’t Just Exhaustion — It’s Moral Injury - Healthcare workers know what their patients need and are powerless to provide it. That’s not just frustrating, it’s ethically devastating.How Innovation Can Actually Keep Nurses at the Bedside - Nurses aren’t afraid of change, they’re afraid of being left out of it. When nurses lead innovation, they stay longer and solve more.The Untapped Power of Team-Based Care - Doctors and nurses are on the same team, but the system wasn’t built to reward teamwork. Fixing that is key to fixing care. 🩺 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

    34 min
  8. This 2x Founder Did Something Radical: He Listened to Doctors Before Building Anything With Aniq Rahman

    MAY 29

    This 2x Founder Did Something Radical: He Listened to Doctors Before Building Anything With Aniq Rahman

    Aniq Rahman is a two-time tech founder, but when he turned his attention to healthcare he did something most disruptors don’t - he shut up and listened. Aniq embedded himself in hospitals, shadowed physicians, and absorbed the daily frustrations that don’t show up in EMR logs or admin dashboards. In this episode of How I Doctor, Dr. Graham Walker talks with Aniq about what he learned by watching before building, and how that humility shaped his approach to transforming healthcare with Fabric. They dig into what’s broken in the current system, why software often makes doctors’ lives harder, and how a product-first mindset can fail in a field where people - not features - are the real complexity. It’s a rare conversation that bridges tech optimism with physician realism and makes a compelling case for designing with doctors, not just for them. What You’ll Learn in This Episode: Why Tech Usually Gets Healthcare Wrong - The classic startup playbook fails when applied to medicine.What Happens When You Listen First - How a year of shadowing and silence led to insights most founders never hear.Fixing the Wrong Problems - Why too many platforms are optimized for metrics instead of meaning and how Fabric is different.Doctors Aren’t the Problem, The System Is - A candid look at how current tools make good physicians feel ineffective, and what needs to change.The Case for Physician-Led Innovation - Why tech needs more co-design, less command-and-control and what healthcare can learn from infrastructure. ❓What's the biggest question you have about AI and healthcare? ❓ We’re throwing our first live event, and you’re invited! Graham Walker, MD and Sarah Gebauer, MD are two of the country's leading MD experts about AI and they'll be answering your questions in an urgent live webinar on June 3rd. Register at https://www.linkedin.com/events/we-resharingaisecretsforclinici7331694686937530368/theater/ 🩺 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 a href="https://www.linkedin.com/company/joinoffcall/" rel="noopener noreferrer"...

    40 min
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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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