On/Offcall: A Rare Look Inside Epic With Dr. Jackie Gerhart in Conversation With Dr. Graham Walker

Welcome back to On/Offcall!

She’s one of the single most influential physicians in medicine…Whose decisions touch the lives of millions of clinicians and patients…And she’s our next How I Doctor guest!

This week, Offcall was honored to welcome Epic CMO Jackie Gerhart for a rare sit down interview with our co-founder Dr. Graham Walker to reveal what really goes on inside one of the most powerful (and misunderstood) companies in healthcare.

No matter how you feel about the company, one thing is crystal clear: Where Epic goes, so goes the rest of medicine, which makes this a MUST-WATCH conversation for every single clinician who wants to understand where AI will take healthcare and what our role will be in that future. They unpack:

🔍 How a tiny team of just 14 physicians makes decisions that show up across all of Epic📢 How Jackie responds to (and invites!) unfiltered feedback she gets from Epic’s harshest physician critics
📄 Inside the company’s bright red paper system to track complaints and determine which improvements get implemented across the EHR
🤖 How Epic’s AI tools — “Art” for clinicians, “Emmy” for patients — could redefine the way clinicians practice medicine
🤝 How Epic thinks about working partnerships with others in the healthcare ecosystem🤔 What the “doctor’s office visit” of the future might look like if Epic’s AI vision takes hold

The episode has already sparked a huge conversation and we’re eager to hear more from each and every reader of this newsletter! Tell us: What surprises you most hearing about how Epic makes decisions? If you could share one thing with Jackie about what you’re hoping for as Epic implements AI, what would it be?

♻️ Reply directly with your reaction or post it in the comments. And don’t forget to share this episode to spread the word!

Watch the episode here

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Physician Builder Spotlight: Dom Pimenta

We’re shining light on MD-entrepreneurs! Each week, we feature an entrepreneurial doctor who’s building a cool product, company, or working on a big idea that you definitely want to know about. This week, meet Dr. Dom Pimenta, CEO and Co-Founder at TORTUS, a London-based start-up that is building AI assistants for clinicians. You can connect further with Dom on LinkedIn.

1. Dom, what inspired you to become a physician entrepreneur? During Covid, I was redeployed to Covid ITU from cardiology and I co-founded a charity to build sustainable PPE for colleagues across the UK. We raised £3.2m and delivered 500,000 items in the end, with the charity becoming a mental health and well-being support service for healthcare workers afterwards. It really showed me what happens when you find a difficult problem and try to solve it, and the impact that can be had when you bring together the right people around it. 

Becoming a founder was something I had always been looking for but never really knew what it was. Founding TORTUS, I went through an accelerator called Entrepreneur First in the UK which is quite big now and in the U.S. too. That gave me the skills and network to then get into founding a startup.

2. Tell us what your company does and what problem you're trying to solve. TORTUS builds AI assistants for clinicians. Our initial problem to solve is the 60% of time clinicians spend on computer tasks – finding information, documenting new information, ordering, billing, scheduling etc. Compressing that to <15% time will double clinical capacity everywhere. Just imagine what we could do with twice as many doctors on shift.

3. What's your advice to anyone who's thinking about a nontraditional career in medicine? Do it. If it’s not for you, you’ll soon realise it. And if it is, you’ve just made the best decision of your life. To be an entrepreneur is to try and fail as fast as possible. You won’t know it’s not for you until you act. “Action is information” – I think that’s a Paul Graham quote.

4. How can a physician overcome their biggest fear to start a company/organization? You just have to start and ship something to somebody – these days you can vibe code a solution to a problem and test it in the real world (within governance reason) in hours. So why haven’t you yet? As good as your idea is, ideas are increasingly cheaper and cheaper. It’s your ability to execute that really matters. Most physicians have never tried to execute a product vision so need to be humble about being bad at it, start practicing, and get better. Some of the maxims of medicine – “see one, do one, teach one” apply here. I met with many founders who had successfully founded startups and that gave me the boost to think I could too.

5. What's the #1 lesson you've learned since building your company that wasn't obvious to you before? Companies are just people fundamentally. Everything else is window dressing unless you have great people. The idea will change, the strategy evolves all the time, but the people that build the company ARE the company. Everything about great people is 10x harder than you think, and it’s where most of the leverage in building actually comes from. So investing in people, understanding what amazing talent actually looks like, these are the most critical skills, especially if you’re coming from a non technical background like physicians.

6. Name the top resources you found most helpful to get going as an entrepreneur. Other entrepreneurs have been very useful. There are various Slack and WhatsApp groups as well that have communities of folks. For me, the accelerator Entrepreneur First was literally life-changing. And lean into being a novice by reading expert advice and absorbing books. For me, High Output Management, Measure What Matters and The Hard Thing About Hard Things, plus anything by Paul Graham, are essential reading. Avoid advice from anyone who has never built something before. The world is full of pretenders in this space too.

7. How can other physicians support you? Open to all! Send me things at dom@tortus.ai

Read Dom’s answers and sign up for Offcall here. Know someone else who should be featured? Reply or tag them and their company in the comments!

Physicians, How Do You Really Feel About AI?

We’re gearing up to release a definitive physician AI whitepaper in a few weeks that will cover how physicians really feel about AI tools and their impact. You can expect that we’ll cover topics like: How AI could actually improve physician job satisfaction, which AI tools save us time vs. just add more admin, and how employers could get us excited to adopt new AI tools. Please answer the short questions below (takes 2 mins!), and repost to spread the word! Thank you in advance!

How do you really feel about AI?

Highlights From Our Community

Each week, we celebrate career milestones, launches, & other goings-on in the physician community. Have something to promote? Reply and we’ll feature you.

🤔 Think he’s right? Varun Verma
Dr. Varun Verma shared an honest reflection after 13 years practicing medicine about why the only sustainable path left for generalist physicians is independence: owning your practice and working for patients, not payers. Think he’s right? Dr. Corinne Rao certainly does. Join the discussion and let him know your own thoughts here.

🙏 Thanks for your work, Jessica Peterson
Dr. Jessica Peterson summarized the key points in the 2026 Medicare physician fee schedule final rule. Check them out here. Also see some reflections on the same topic from Dr. Benjamin Schwartz here.

🎧 Give it a listen, Scott McCusker
Dr. Scott McCusker was featured on the BackTable ENT Podcast alongside hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss the impact of nasal airway obstruction on obstructive sleep apnea. Listen more here!

👌 Well done, Sarah Nasir
Dr. Sarah Nasir spoke at a virtual summit about the important topic of academic bullying in medicine alongside Dr. Aleobe Eruemulor, Dr. Amna Shabbir, Kim Downey, Dr. Ravi Yarid, Dr. Nondumiso Makhunga-Stevenson, Dr. Jennifer Fraser, Dr Grabrielle Horne, Dr. Gloria Esoimeme, Dr. Dominic Corrigan, and Dr. Raji Akileh. See the lineup and learn more here.

👏 Bravo, Michael Chen
Dr. Michael Chen received the Putting People First award from his Clinical Insights Engine team at CVS to advance AI work in healthcare. Congratulate him here.

🌟 Go go go, Alae Kawam
Dr. Alae Kawam was honored by The Pathologist as one of 50 voices selected to this year’s Pathologist Power List 2025: Leading Voices Edition. Check out the other honorees and learn more here.

🌟 Way to go, Madan Kandula
Dr. Madan Kandula experienced the 21-year anniversary of opening his own independent private practice ADVENT to help people live better with in-office sinus and snoring solutions and shared reflections on social media about what that means to him. Read them here.

🤔 Thought provoking, Bhargav Patel
Dr. Bhargav Patel shared a thought-provoking discussion about how we made a critical mistake with EMRs by not engaging clinicians in the design process, and about how we’re now repeating the same mistakes with AI. Do you agree? Read his post and join the discussion here.

🎉 Congratulations, Kameron Matthews
Dr. Kameron Matthews announced that she is stepping away from her job at Cityblock Health after four years as Chief Health Officer. Celebrate her great work and accomplishments here.

✅ So very true, Sachin Jain
Dr. Sachin Jain offered up his inspiring advice to young people today about why it’s important to take some big chances in life and stretch your own boundaries. Read it here.

Be Sure to Sign Up for Offcall!

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