Offcall Physician Spotlight: Meet Dr. Andrew Lundquist

Offcall Team

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1. What's one task you've fully handed off to AI that you'd never take back?

I gave initial patient documentation over to AI a few years ago and I won't go back. I am engaged and alert with AI doing the "remembering" and before that I was distracted during visits. I'd avoid conversations because I was always behind. Now I just review the AI generated notes and do a few changes and sign. It takes 30 seconds to a minute instead of 10-15 minutes. The feeling of always having more work piling up can be crippling. That mostly goes away with AI. My latest effort is using AI to increase my reach on social media and platforms.

2. Are you worried about deskilling — that the next generation won't develop the intuition you did because the model handled it?

Yes and no. Those coming out of training will never do work like we did and that's Ok. We will have to build intuition training another way. One internist in my group who is "old school" says that the biggest skill for a clinician to know is knowing "sick from well." I tend to agree that being able to distill physical findings, lab and imaging data, and tiny history details then doing the right thing is the basis of "value based care." We will always need clinicians who can do $20,000 worth of care in a 99213 visit. Maybe we train that by withholding current tools until mastery of the basics is proven. This is being done in some training programs. A recent physician, a new grad hire of ours, called me in his first week of practice "Drew, Using an AI scribe feels like cheating..!" That's probably how it should feel.

3. Will AI solve the physician shortage or quietly make it worse?

I have more questions than answers here. Long term it will solve it, but short term it will be messy. Part of me thinks that people will always want to go to an excellent clinician to make sense of AI. However, Waymo has me thinking that we will need fewer physicians because we can offload complex things to technology. An AI answer often contains better information than what you get in a 10 minute clinical visit, but do you trust it? People will seek out trust. We will want all of the benefits of AI and have options to see the specialist opinion for the human element. The AI doctor should cost less, and the human cost more, but will it? I think that we will have a slice of the population who will be able to afford the AI option and the expert opinion. Watching to see who gets better outcomes will be fascinating. I feel fairly safe in my career, but, watch me be replaced next year by an Agent and a new college grad.

4. If you could redesign residency from scratch, what's the first thing you'd change?

Medical practice is so different from location to location. Most grads don't go into academia, but we are trained there. I'd create paths for different practice destinations earlier in the training programs. Example: Send a resident to the place that they want to practice and learn how to practice in that environment for the last 6 months of training.

5. Independent practice in 2026 — endangered species or quiet comeback?

Independent practice is where I have practiced for almost 20 years. I think it's both endangered and the future of excellent care. The headwinds that independent practices have are real, but there is really good data that shows that they have the same or better quality, lower cost, and better results under risk than hospital or large group practice. As the CMO at the largest independent multispecialty group in my state, I'm doing all that I can to make sure that independent practice remains an option for physicians.

6. What's something you used to judge other physicians for that you now completely understand?

Not learning new things. Many physicians have their lives set up so they can't take 3 hours to learn a new workflow that would save them 1 hour each day of their lives.They will spend a whole weekend conference to learn a clinical skill that they try to plug into a day that is already a mess because of their weak workflows. The differentiating factor in career longevity is that ability to learn a new way of doing the non-clinical part. I get that some just want to do the thing that feels safe for a whole career, but I also have seen how learning better workflows improves clinicians lives.

7. What did you spend money on early in your career that absolutely wasn't worth it?

Ties and books. I haven't worn a tie in 10 years and I read a lot, just not the books that are collecting dust on my shelves.

8. What's something physicians are quietly worried about that the public doesn't know about yet?

How good AI can be for many medical things. We go to it first also, but not everyone knows how to use it properly and monitor it. We will have to figure out the human element of that.

9. If you had a magic wand for one thing in medicine — not your whole career, just one thing — what would you fix tomorrow?

I would love to get people to understand that how they go about their days is medicine. I would like them to see how their choices, lifestyle, friendships, diet, and spiritual practices shape their health in 20-30 years. A few visits to a clinician a year can't undo things. In Europe, they have pictures of gangrenous limbs on cigarette boxes... like that, except for more culturally acceptable habits.