Offcall Physician Spotlight: Meet Dr. Benjamin Schwartz

Offcall Team

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1. Benjamin, what's one task you've fully handed off to AI that you'd never take back? Hah, trick question! I have increasingly incorporated AI into my day-to-day workflow including research, brainstorming, creating a Virtual Personal Assistant that helps coordinate my calendar/email, etc. The tools have gotten incredibly good, but I'm not to the point that I would "fully" turn something over to AI. I'm still very much in the "human-in-the-loop" camp. One of my mentors always said "Trust, but verify." That stuck with me throughout my medical career, and I think it's especially true with AI.

2. Are you worried about deskilling — that the next generation won't develop the intuition you did because the model handled it? Absolutely. I think anyone that uses these tools on a regular basis feel the allure of using them for ... just about everything. But, especially in healthcare, intuition is incredibly important. If we outsource critical thought and our knowledge base to AI, we lose something important: the ability to see into the grey areas and the intuition you mentioned. AI gives us infinite access to knowledge, but knowledge is not the same as expertise. If I'm using a surgical robot, and something goes wrong half way through the surgery, I need to have the skills and experience to finish the job safely. In the same way, we need the skills to spot where the AI may be incorrect, and the confidence to act.

3. Will AI solve the physician shortage or quietly make it worse? I'm not sure we have much of a choice at this point. It is extremely difficult to quickly grow the physician workforce. It seems like, between retirements and physicians leaving the frontlines, the shortage will get worse before it gets better. AI is probably as good a solution as any to help address this gap. However, a lot depends on implementation, oversight, guardrails, liability, etc. There's also the unresolved question of how comfortable patients are with AI. The assumption is that AI-powered access is better than no access. But I'm not sure that's a forgone conclusion.

4. If you could redesign residency from scratch, what's the first thing you'd change? More sleep! That's a tough one. Ortho Residency was tough, and I'm glad I don't have to do it again. But, the experience taught me a lot about resilience, responsibility, when and how to push physical and mental boundaries, etc. It set the groundwork for the kind of doctor and surgeon I wanted to become. Even though it was grueling, there's a shared experience with your co-residents that is priceless. To this day, if I run into one of them at a meeting, there is an instant camaraderie and sense of fellowship, even if we haven't seen each other for years. It's been 20 years since I finished residency, so I'm sure things are different now. I don't think training should be toxic, but it should be something you love and hate at the same time.

5. Independent practice in 2026 — endangered species or quiet comeback? That's really the question. Honestly, it's easy to see it going either way. But, I'm a believer in cycles, and I think we've hit peak consolidation. It's only natural for the pendulum to swing back in the other direction as docs want more autonomy and realize that trading the safety and stability of employment for the freedom of independence is a risk worth taking. It is still a very challenging environment, and I think the definition of independence is changing. You either have to be really small (DPC, concierge, micro-practice) or really large (MSO, supergroup) to survive the current climate. Physicians are risk-averse, and may not take the leap back into independence unless there is a firm landing spot. I'm curious to see who will create it. (And, yes, AI has a role to play here too -- e.g., practice management tools).

6. What's something you used to judge other physicians for that you now completely understand? I think the term "unnecessary care" gets thrown around a lot, but it's a complex issue that too often gets labeled as "volume over value" or viewed too simplistically. There are a lot of reasons for low value care: knowledge gaps, empathy for the patient, limited consensus, lack of other options, and (unfortunately) financial motives. "The right treatment to the right patient at the right time" is the cliche, but I'd take it a step further. The key is having the experience and expertise to figure this out at the individual level while understanding the broader evidence-based practices and clinical guidelines. We often view "evidence-based medicine" too rigidly, especially when the evidence is suspect!

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

A stethoscope. 😆

8. What's something physicians are quietly worried about that the public doesn't know about yet? The rise of misinformation. I think the public kind of knows about it, but it's become so pervasive and so insidious. It's increasingly difficult to figure out what's truly cutting edge, what's pseudoscience, and what's flat out grifting. There is a very fine line between being an innovator and pushing boundaries and offering poorly studied quick fixes that may be harmful. Public frustration with the traditional healthcare system and growing distrust in all institutions has created a void that some are happy to step into, often for their own gain. For physicians, it's important to find the balance between skepticism and paternalism.

9. If you had a magic wand for one thing in medicine — not your whole career, just one thing — what would you fix tomorrow? The demand side of the equation (i.e., the societal factors that profoundly affect healthcare outcomes and utilization). Again, it sounds like cliched virtue signaling, but the reality is that we spend a lot of time fiddling with things that have a comparatively small impact. Outcomes are primarily driven by things that the healthcare system can't directly touch or change, yet these things are increasingly pushed onto the healthcare system (especially at the primary care level). All the payment reform, value-based care modeling, fancy technology, etc. will have less impact than figuring out a way for people to maintain good health in the first place.