Offcall Physician Spotlight: Meet Dr. Sylvie Stacy

Offcall Team

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1. Stacy, do you think AI will solve the physician shortage or quietly make it worse? I don’t think it’s going to solve it or make it worse. It might help the situation, but that depends heavily on how well our healthcare system can adapt to AI’s capabilities. A lot of aspects need to adapt: clinical guidelines and protocols, EHRs, insurance coverage policies, state licensing bodies, etc.

2. If you could redesign residency from scratch, what's the first thing you'd change? When I was in training, one frustration I had was watching attendings run on fumes all the time. Some were so buried in work and had such a high patient volume that it was hard for them to dedicate time to teaching interns and residents. I felt bad sometimes for asking a simple question…like I was just putting another burden on them. A resident shouldn’t feel like an inconvenience just for trying to learn.

3. Independent practice in 2026 — endangered species or quiet comeback? Private practice as we knew it during its golden age in the 1980s may be an endangered species. But what’s taking its place, to some extent, seems to be reimagined private practices – especially those that strive to remove any sort of ‘middleman.’ Like micro-practices, direct primary care, and certain telemedicine models allow physicians to really focus on treating patients, and less on administrative and operational issues.

4. What's something you used to judge other physicians for that you now completely understand? I remember I used to get frustrated with my own doctors when they didn’t remember what their plan for me was at my prior visit. Now I totally understand that’s nearly impossible with a large panel of patients. I definitely have memorable patients whose details I remember from visit to visit. For most, though, I rely heavily on my notes and try to take a couple minutes before the visit to refresh my memory.

5. What did you spend money on early in your career that absolutely wasn't worth it? Getting a lawyer to review my employment contract. He focused on minutiae that didn’t actually matter. And he missed a couple things that, in retrospect, I would have changed if I’d taken the time to fully review and understand the contract myself. So I figured out early on that I wanted to be familiar enough with employment contracts and contractor agreements to be able to digest and negotiate them myself. Also, if you’re like me and do side work and consulting on top of regular employment, you’ll come across a lot of these contracts, so it’s a good skill to have.

6. What's something physicians are quietly worried about that the public doesn't know about yet? Rules and regulations getting in the way of physicians' ability to use their actual clinical judgment. One example in addiction medicine is a mandatory minimum number of urine drug screens every year for patients on certain controlled medications, in certain settings or jurisdictions. This is sometimes regardless of how long they’ve been stable in recovery. It’s costly and paternalistic, and it’s another hoop that both doctors and patients have to jump through.

Other rules and regs may not impact clinical judgment, but they take up a ton of our time unnecessarily. For instance, we spend countless hours sitting through redundant corporate compliance modules (workplace safety, cultural difference, sexual harassment, how to use a fire extinguisher, etc). Similarly, there are burdensome state-specific CME requirements in many states that are required to maintain your licenses. They are often on very specific topics like HIV care or bioterrorism. Sometimes the topics have very little relevance to many doctors’ actual daily scope of practice. This stuff is time-consuming and frustrating. It's less time we're able to spend helping patients.