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. Meet the Doctor Who Went Anonymous to Say What the Rest of Us Can't: The Story of Dr. Orange

    2d ago

    Meet the Doctor Who Went Anonymous to Say What the Rest of Us Can't: The Story of Dr. Orange

    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 conversationWhat 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 onceHow student loan debt and restrictive contracts function as a structural trap that keeps early-career physicians in systems that are making them miserableWhy 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 🎧 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
  2. Moral Injury Is Why The Best Doctors Are Disappearing with Dr. Wendy Dean

    Jun 4

    Moral Injury Is Why The Best Doctors Are Disappearing with Dr. Wendy Dean

    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 sitsWhat 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 inHow physicians are trained to be independent thinkers and then placed in systems that give them no authority, no agency, and all of the responsibilityWhy 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 headingWhat 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 🎧 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 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

    36 min
  3. Now Is Not the Time for Silence. Dr. John Whyte on the AMA, AI, and the Stakes for Physicians Right Now

    May 28

    Now Is Not the Time for Silence. Dr. John Whyte on the AMA, AI, and the Stakes for Physicians Right Now

    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 levelHow 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 patientsWhy the real argument for physician payment is not compensation but patient safety and how the public narrative gets this wrongWhat 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 🎧 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

    32 min
  4. Dr. Rana Awdish Almost Died as a Fellow. Now She's Teaching Doctors How to Heal.

    May 21

    Dr. Rana Awdish Almost Died as a Fellow. Now She's Teaching Doctors How to Heal.

    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 insteadWhy redistributing power through language is not just ethical but changes clinical outcomes including adherence and return visitsWhy medicine rewards disembodiment in physicians and what the cost of that has been for trainees, patients, and the professionWhat curiosity can do when every other communication tool has run outWhy 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 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
  5. Physician VC Dr. John Dayton on What It Takes to Actually Build a Winning Healthcare Startup

    May 14

    Physician VC Dr. John Dayton on What It Takes to Actually Build a Winning Healthcare Startup

    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 fundingWhat kills a pitch immediately and what signals a founder has actually done their homeworkWhy AI has dramatically lowered the barrier to entry for physician-founders and what that changes about building a company todayHow to think about the principal-agent problem when selling into health systemsWhy ambient AI tools matter more for physician burnout than the time savings data alone suggestsWhat John learned about scalable, practical problem solving from practicing in resource-poor clinical environmentsWhat 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 🎧 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
  6. Going Independent Doesn't Mean Going It Alone. Dr. Basil Kahwash on Fixing Referrals and Building Physician Networks

    May 7

    Going Independent Doesn't Mean Going It Alone. Dr. Basil Kahwash on Fixing Referrals and Building Physician Networks

    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 optionWhy most referrals arrive as little more than a diagnosis code, and what even a small amount of added context would changeHow the fax machine became the rate-limiting step for physician collaboration and why EHRs haven't solved the problemWhy hyperlocal physician networks exist within specialties online but not across specialties within cities, and what filling that gap could look likeWhat 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 Read the Referral Manifesto: offcall.com/manifestoLearn about the Offcall Referral Product: offcall.com/referralsFind Basil on LinkedIn: linkedin.com/in/basil-kahwash-mdFind Graham on LinkedIn: linkedin.com/in/graham-walker-md 🩺 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

    42 min
  7. Restoring Physician Mental Health and Honoring the Legacy of Dr. Lorna Breen, With Dr. Stefanie Simmons

    Apr 30

    Restoring Physician Mental Health and Honoring the Legacy of Dr. Lorna Breen, With Dr. Stefanie Simmons

    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 physicianHow a single question on a licensing application has kept generations of physicians from getting help, and what the foundation is replacing it withWhy physicians massively overestimate how much their colleagues will judge them for seeking mental health care, and what the data actually showsWhat Stefanie's own experience with peripartum depression during residency taught her about the cost of not getting helpWhy burnout is an occupational syndrome, not a personal failingWhat 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.orgPhysician Support Line: free, confidential, anonymous, staffed by psychiatrists / 1 (888) 409-0141 / physiciansupportline.comEmotional PPE Project: free anonymous mental health care for clinicians / emotionalppe.comAll For Mental Health resource hub: drlornabreen.org/all-for-mental-health Resources and Where to Find Stefanie and the Foundation Dr. Lorna Breen Heroes' Foundation: drlornabreen.org Take Action: drlornabreen.org/take-action All In Wellbeing First for Healthcare Coalition: drlornabreen.org/all-inFind Stefanie on LinkedIn: https://www.linkedin.com/in/stefsimmons/ Follow the Foundation on Instagram: https://www.instagram.com/drlornabreenheroesfoundation/ 🩺 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
  8. Why The Pitt Is the Show Every Doctor Needs Right Now, with Dr. Jeremy Faust

    Apr 23

    Why The Pitt Is the Show Every Doctor Needs Right Now, with Dr. Jeremy Faust

    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 traumaWhy the term "burnout" may be the wrong frame entirely for what's happening to emergency physicians right now. 🔗 Resources & Further Reading Jeremy Faust, MD — Inside Medicine Substack: https://insidemedicine.substack.comJeremy Faust on MedPage Today: https://www.medpagetoday.com/people/jf6550/jeremy-faustJeremy Faust on Instagram: https://www.instagram.com/jeremysamuelfaust/Jeremy Faust on Threads: https://www.threads.com/@jeremysamuelfaustThe Pitt on Max: https://www.max.com/shows/the-pitt 🩺 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

    45 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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