On/Offcall: Come to Offcall's HLTH Event (We Have a Surprise Planned!)

Welcome back to On/Offcall!

If you want to feel inspired about the future of medicine, just go to ACEP, the annual emergency medicine conference which took place this past week in Salt Lake City and marked Offcall’s first-ever medical conference!

The gathering brings together the who’s who of emergency medicine, but most of all, represents a snapshot of some of the most innovative and hard-working physicians who are doing their part to improve the profession. We are excited to have been able to host a buzzing party with Abridge, sit down with innovators like Dr. John Dayton, and connect with countless MD entrepreneurs who are starting companies or leading advocacy efforts (see Dr. Graham Walker’s recap post here!).

Healthcare may indeed be broken, but events like this gives us hope that the best days are ahead. We wanted to especially shout-out Dr. Zaid Altawil and Dr. Nicholas Stark, who lead the Emergency Medicine Innovation Collaborative and put together an impressive Shark Tank-style competition for physician entrepreneurs, and Dr. Elizabeth Clayborne, who won the Innovator of the Year award for her company NasaClip.

Speaking of events, our next gathering will be at HLTH in Las Vegas on Oct 19-22 and we’ve got something truly special planned :) Are you planning to attend? Reply directly or tag yourself (and also a colleague who’s going!) in the comments so we can be sure to invite you. See you there!

Know someone who would benefit from joining us? Help us grow our tent by forwarding this newsletter to your physician colleagues and subscribing here.

Why the Healthcare System Survives on Exploiting Clinicians w/ Dr. Danielle Ofri

This week’s How I Doctor guest is the incredible Dr. Danielle Ofri, a primary care internist at Bellevue Hospital, clinical professor of medicine at NYU, and editor-in-chief of the Bellevue Literary Review. Back in 2019, Dr. Ofri wrote a seminal New York Times column entitled, “The Business of Health Care Depends on Exploiting Doctors and Nurses,” and she’s one of the most insightful voices who regularly calls out the systemic issues that silently erode our profession – from the unchecked power of nonprofit hospitals to the burnout driven by a system that puts profit over patients.

In the episode, Dr. Ofri and Graham discuss the insidious ways that our system exploits physicians, and what it’ll take for us to speak up and fight back. They discuss:

👉 How nonprofit hospitals profit off clinicians and patients
👉 What makes nurses essential to the future of care
👉 Why physicians must speak up instead of staying silent
👉 The arms race of monopolies and billing tricks
👉 What trust looks like between doctors and patients and how to rebuild it

Listen to the episode here

Most Talked About On Offcall

Dear Burned Out Healthcare Workers: Don't Leave!
New op-ed from Dr. Rachel Johns: We simply can’t afford to keep losing good people. So what do we do?

Which States Are Women Physicians Most Satisfied?
See the chart, and weigh in on social media here.

Independent Physician Spotlight: Susan Gunduz
Meet this inspiring independent pediatrician who’s also the Founder of SoundWise4Kids.

Physician Builder Spotlight: Chaitanya Mamillapalli

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 Chaitanya Mamillapalli, CEO of CareHealth (more on the company’s mission below!). You can connect further with Chaitanya on LinkedIn.

1. Chaitanya, what inspired you to become a physician entrepreneur? As a practicing endocrinologist, I experienced firsthand the administrative burnout plaguing our profession. While EHRs handle about 90% of general tasks reasonably well, they're monolithic systems that fail at specialty-specific workflows where we spend most of our time. When customization is possible, it can cost hundreds of thousands of dollars and take months to implement. What frustrated me most was discovering that health tech companies often build solutions without meaningful input from physicians. By the time products reach us, they are often "fully baked," making them difficult to modify and lacking critical workflow nuances that only practicing clinicians understand. My passion for solving complex problems through healthcare technology motivated me to found CareHealth, where I can collaborate with cross-functional teams to build solutions from the ground up, ensuring they work in real clinical environments rather than just conference room demos.

2. Tell us what your company does and what problem you're trying to solve. CareHealth creates EHR-embedded specialty modules that target the critical 10% gaps where existing EHRs fall short: the specialty-specific, complex clinical tasks where physicians spend most of their time. We start by identifying specific workflow problems that practicing physicians face daily, then build customized solutions using the Smart on FHIR framework that work directly within existing EHR marketplaces, much like apps on your smartphone. Our suite includes AI-assisted clinical workflow improvement (EHR-integrated AI scribe with patient context + ultra-customizable workflows for providers), ChemoFlow for comprehensive oncology workflow management, specialty-specific flowsheets for complex medical conditions, and cross-EHR communication tools. These communication solutions include Microsoft Teams embedded apps that connect different hospital systems and Cisco contact center embedded apps that reduce the time call center staff spend accessing patient information. The core problem we're solving is that EHRs lack comprehensive specialty modules, forcing providers to implement expensive workarounds, manual processes, or costly customizations that can cost over $1 million and take months to complete. Meanwhile, communication silos between different EHR platforms create dangerous care gaps when patients transfer between health systems.

CareHealth has been successfully deployed at Springfield Clinic, a large Midwest healthcare system with 650+ physicians serving over half a million patients. We achieved this implementation through bootstrapping, proving that physician-led innovation can scale effectively without massive venture funding.

3. What's your advice to anyone thinking about entrepreneurship or a nontraditional career in medicine? Start by solving problems you experience daily in your practice. In the current era of AI, taking a granular, six-levels-deep approach to understanding the problem has become equally important as the solution itself.

• Embrace AI as your ideation partner. Utilize tools like Claude, ChatGPT, and Perplexity to generate ideas and brainstorm solutions. If the current market doesn't offer a comparable product, you've found a potential starting point. This creative problem-solving process can be an antidote to physician burnout.
• Finding the right cofounder is critical. Prioritize curiosity, dedication, and passion over credentials. Look for someone who combines genuine excitement about solving healthcare problems with demonstrated technical talent and willingness to get their hands dirty with coding and system architecture.
• Start before you're ready. Accept that you won't know all the answers - you'll find them as you go along. Focus on specific, underserved needs where you can deliver measurable value rather than trying to build the next big EHR.
• Stay adaptable. Be willing to pivot and evolve your ideas based on what you learn. Use AI as a communication bridge with technical cofounders to translate clinical concepts into technical requirements and vice versa.

4. How can a physician overcome the "start" problem and their biggest fear? AI has democratized innovation, wisdom, intelligence, and opportunities, making this an exceptional time to start an entrepreneurial journey. The barriers that once prevented physicians from building technology solutions have largely disappeared. Your curiosity and passion for solving problems are now more valuable than ever, and AI can help you tie up the loose ends where you lack technical expertise. I was inspired by the simple truth that "even a 10,000-mile journey starts with a single step." The idea you start with will evolve - it doesn't need to be perfect from day one. It shouldn't be. The market will teach you what matters, and your initial concept will morph based on real user feedback. Begin with small pilots in your practice or with trusted colleagues. This gives you real-world validation and immediate feedback. This approach eliminates the intimidation factor of selling to strangers and provides a safe environment for iteration and improvement.

Remember, you don't need to quit your day job immediately. Start small, validate your concept, and let the results guide your next steps. The biggest fear most physicians have is failure, but the biggest risk is not trying at all while watching non-clinicians build suboptimal solutions to problems that we understand better than anyone.

5. What's the #1 lesson you've learned that wasn't obvious before? Your biggest competition isn't other startups - it's the status quo. I spent months analyzing competitors, but the real battle was convincing physicians to adopt new, automated processes. Even broken workflows become comfortable habits. We had to prove our solution was dramatically better, not just incrementally better.

6. What are some top resources for physician entrepreneurs?

• Microsoft for Startups: Provided critical early validation and $150K+ in cloud credits. Great mentors.
• AWS for Startups
• Gust Launch: For incorporation and agreements.
• EHR Marketplace partnerships:
  • Athena Health
  • EPIC
• Mass Challenge accelerator program
• Clearwater Security partnership: Essential for HIPAA/SOC2 compliance without building security expertise in-house

7. How can other physicians support you? We're always open to clinical feedback, pilot opportunities, and strategic partnerships. Here's how you can help:

• Share workflow pain points - If you're experiencing EHR challenges, let's brainstorm solutions together. The best innovations come from understanding actual clinical friction points.
• Specialty collaboration - We've developed ChemoFlow for oncology workflow management. Oncologists, I'd love your feedback on optimization and safety protocols.
• Leadership connections - Introductions to physician IT leaders, administrators, and clinical directors help us understand unmet needs and explore collaborative solutions.
• Beta testing - We're seeking forward-thinking physicians willing to pilot our solutions. Early adopters get input on development, preferential pricing, and satisfaction of building tools that work.
• Industry connections - Introductions to other physician entrepreneurs, healthcare investors, or strategic partners are always appreciated.
• Investment opportunities - We're raising our $1M SAFE round and welcome connections with qualified investors.

You can learn more at CareHealth, reach me at chaitanya@carehealth.ai, or connect on LinkedIn here. I respond to every message from fellow physicians - we're all in this together to fix healthcare technology.

This excerpt has been shortened, read the full article here. Know someone else who should be featured? Reply or tag them and their company in the comments!

3 Things to Read This Week

The Boring Truth About Why America Got Fat (Derek Thompson)
The truth about calories, ultra-processed food, and why “myth-busting” media sometimes makes more myths.

Building AI That Patients Can Trust (Sarah Gebauer)
Chandan Kaur on lessons from medical device development

Physician Perspectives on Pharmaceutical Promotion (JAMA Network)
See what the new study found.

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.

​​📚 Great read, Robert Pearl
Dr. Robert Pearl wrote an informative article entitled, “When patients become doctors: How GenAI is democratizing medical expertise” for his “Breaking the Healthcare Rules” newsletter. Read it here.

🗣️ Well said, Myoung Cha
Verily Chief Product Officer Myoung Cha wrote about why AI’s adoption in healthcare relies upon whether we invent payment models that reward value. Read it here.

⚕️Timely interview, Zachary Rubin
Dr. Zachary Rubin was interviewed by Katie Couric about public health issues here.

📚 Go and buy the book, David Sandberg
Dr. David Sandberg announced his book “Brain and Heart: The Triumphs and Struggles of a Pediatric Neurosurgeon" is being considered for Oprah’s Book Club (but he needs your help!). Check it out and buy the book here.

🩺 Way to go, Shikha Jain
Dr. Shikha Jain was named one of the Top 100 Influential Women in Oncology by OncoDaily (along with many others!). See the list here.

✅ Thanks for sharing, Elizabeth Garner
Sena Therapeutics CEO Dr. Elizabeth Garner wrote about the hopeful side of Ovarian Cancer Awareness Month, and why there’s hope worth celebrating. Read it here.

📚 Important read, Benjamin Schwartz
Dr. Benjamin Schwartz wrote about how U.S. hospitals spend millions on quality measurement, but we’re still not clear on what “quality” really means. Read it here (h/t Dr. Kevin Sexton).

👏 Congrats on your keynote, Taylor Nichols
Dr. Taylor Nichols won the Policy Pioneer Award and delivered a keynote address this year at ACEP. Congratulate him here.

⚕️Stay tuned for the talk, Dympna Weil
Dr. Dympna Weil is one of many impressive speakers who will address the Power of Women in Medicine Summit in Chicago on September 18-20. See more and get registered here!

🤣 Thanks for resurfacing this gem, Vineet Arora
Dr. Vineet Arora sent us this clip from Saturday Night Live (!) about the work she and several colleagues published about the gender pay gap in medicine. Read the original study here.

🎉Congrats Zaid Altawil
Dr. Zaid Altawil is stepping into the role of ED Medical Director at Merrimack Health's Methuen and Haverhill campuses. Read more and congratulate him here.

🎉Also congrats, Rishad Usmani
Dr. Rishad Usmani is starting a new position as Co-Founder at Manna Health AI! Learn more about the company and congratulate him here.

🎉Still more congrats, Maria Iliakova
Dr. Maria Iliakova is starting a new position as Bariatric & General Surgeon at The Brooklyn Hospital Center! Learn more here!

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