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. Using AI to Accurately Code and Measure Physician Outcomes, With Solventum’s Dr. Travis Bias

    6D AGO

    Using AI to Accurately Code and Measure Physician Outcomes, With Solventum’s Dr. Travis Bias

    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 paidHow hospital quality scores, mortality rankings, and US News ratings are all downstream of documentation completeness and what physicians can do about itWhy the regulatory framework for healthcare AI is already behind the technology, and what happens if it doesn't catch upHow 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 overtestingWhat tech companies consistently get wrong about physicians and what physicians consistently get wrong about techWhy 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 🩺 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

    36 min

  2. APR 9

    The AI Conversations Every Physician Should Hear: Highlights from Yann LeCun, Dr. Bob Wachter, and Dr. David Rhew

    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 insteadWhy 80% accuracy is considered excellent in research and completely unusable in clinical practiceWhat 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 wheelThe deskilling death spiral: what happens when the AI becomes more reliable than the human checking its workWhat 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 onesHow retinal screening AI is finding advanced diabetic disease in people who were told everything was fine months earlierWhy 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 whichWhy 43 state medical boards have now removed stigmatizing mental health questions, and how to check if yours is one of them 🩺 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 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

    28 min
  3. The Pay Gap in Medicine Is Real. Dr. Pamela Buchanan Is Done Being Quiet About It

    APR 2

    The Pay Gap in Medicine Is Real. Dr. Pamela Buchanan Is Done Being Quiet About It

    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 intentionalHow two candid conversations with colleagues changed her financial trajectory permanentlyWhat to say, what to ask, and what to refuse when you're sitting across from someone offering you a contractHow racism shows up on shift — not occasionally, but every single day — and what it costs to absorb it aloneWhat Melanated Medicine is, why Pamela built it, and what happens when Black women physicians finally find each otherWhy asking for help — professional, domestic, emotional — is not weakness but math 🩺 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

    38 min
  4. Virtual Neurology at Scale: Raj Narula and Melanie Winningham on How Sevaro Is Transforming Rural Stroke Care

    MAR 26

    Virtual Neurology at Scale: Raj Narula and Melanie Winningham on How Sevaro Is Transforming Rural Stroke Care

    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. 🩺 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

    38 min
  5. How Medical Misinformation Took Over — and What Doctors Can Do to Take It Back w/ Dr. Geeta Nayyar

    MAR 19

    How Medical Misinformation Took Over — and What Doctors Can Do to Take It Back w/ Dr. Geeta Nayyar

    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 Why medical misinformation has moved from the fringes to the mainstream and what changed to make it this dangerousHow hospitals' culture of social media silence created the exact vacuum that wellness influencers now ownWhat the business case for physician content actually looks like and why Cleveland Clinic and Kaiser figured it out before everyone elseWhy confidence is not accuracy, and how to help patients tell the differenceThe 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

    33 min
  6. Inside the First Autonomous AI Prescription Program in America w/ Doctronic CMO Dr. Byron Crowe

    MAR 12

    Inside the First Autonomous AI Prescription Program in America w/ Doctronic CMO Dr. Byron Crowe

    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 What "AI-native care" actually means and why Byron argues it's a fundamentally new care model — not just a faster version of telehealthHow Doctronic's graduated autonomy model works in Utah, from full physician review of every refill to eventual full autonomy with retrospective oversightWhy Byron believes not a single doctor will lose their job to AI — and what "doctor reassignment" actually looks like in practiceWhat "careworthiness" means as a moral standard, and why Byron thinks it matters more than any technical benchmarkWhy most health AI companies make the same fatal mistake when entering clinical medicine — and how Doctronic is trying to avoid itWhere 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 🩺 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. 99 Ways to Avoid Death: Lessons from Author and ER Physician Dr. Ashely Alker

    MAR 5

    99 Ways to Avoid Death: Lessons from Author and ER Physician Dr. Ashely Alker

    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 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 workHow 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 itWhy storytelling is a clinical skill, and how physicians who don't engage with public communication cede the conversation to people with no trainingWhat 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 🩺 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

    33 min
  8. What Will It Take to Actually Build a Quality Healthcare System? NCQA's New CEO Dr. Vivek Garg Has a Plan

    FEB 26

    What Will It Take to Actually Build a Quality Healthcare System? NCQA's New CEO Dr. Vivek Garg Has a Plan

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

    35 min
See All (77)

Trailer

4.8
out of 5
19 Ratings

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/

Information

You Might Also Like