On/Offcall: Help Create a Physician Movement

Welcome back to On/Offcall!

One of our own is running for Congress!

This week, physician superstar and friend of Offcall Dr. Tina Shah announced her candidacy for Congress in New Jersey’s 7th congressional district. If you’ve never met Tina, she’s not just a practicing physician. She reformed prior auth at the state level. She fought burnout as the VA’s first National Director of Clinician Wellbeing. And she more recently helped drive technology innovation at the AI startup Abridge.

Her mission? She told our co-founder Dr. Graham Walker that she's ready to fix the broken policies driving burnout, blocking patient care, and pushing physicians out of medicine. “This isn’t just about politics. It’s about saving medicine.”

Tina’s issued a challenge to every physician: Can we build the largest-ever physician movement and prove what happens when physicians come together to support other physicians?!

Here’s how you can help:
👉 Watch her powerful interview with Graham below
👉 Donate to Dr. Shah's campaign here
👉 Visit her campaign website here

♻️ And she’s asking you directly: Please tag one physician in the comments and share this post to help turn this into a physician-led movement. (Bonus points if you tag 10 physicians, & Tina is reading and responding to every comment!).

Watch Graham’s interview with Tina

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

FTEs, RVUs, PSLF…WTF?!

This week on How I Doctor, Graham talks to Dr. Ami DeWaters, an accomplished internist and director of Penn State College of Medicine’s Health Systems Science. Ami has mentored thousands of med students and residents, and says the #1 thing young physicians don’t understand is the business of medicine. So she gave Graham a non-BS breakdown of all the things you’re never taught in residency – but absolutely should know before signing your first contract.

In the episode, they break down:
👉 What FTE actually means (hint: it’s not just 1.0 = 40 hours/week)
👉 The "criteria" that control your pay, time, and billing — but no one explains
👉 What every first-year attending needs to hear before negotiating
👉 Why it's critical for doctors to become the change

Or in other words: FTE. RVU. PSLF. WTF?!

If you're about to take your first job — or already feel confused by what you signed up for — this one's for you. 👀

Listen to the full episode with Dr. Ami DeWaters here

Most Talked About On Offcall

Neurologist Stands Up for Pay Transparency
"If I feel valued, I will work harder and burn out less.”

5 Most Expensive Mistakes Attendings Make

What no one warns you about in your first job.

Congressman Greg Murphy: Young Doctors Need to Make the Ultimate Sacrifice

ICYMI, Graham’s sit-down with Congressman and practicing physician Greg Murphy.

Physician Builder Spotlight: Quinn Wang

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 Quinn Wang, founder of Doctors in Network (DIN) (more on the company’s mission below!). You can connect further with Quinn on LinkedIn.

1. Quinn, what inspired you to become a physician entrepreneur? Like most surgeons, I followed the standard path — SF Match, residency, then practice. But it didn’t take long to realize how little control we often have over how we work or how our care is valued. I didn’t want to be a cog in a system that kept me limited to one patient — or one pair of eyes — at a time. I wanted to design smarter ways for surgeons to scale their impact. The pandemic made that even more urgent. It exposed just how fragile our infrastructure is and reinforced the need to build more resilient, adaptable ways to deliver care.

2. Tell us what your company does and what problem you're trying to solve. Doctors in Network (DIN) is rethinking surgical access, starting with ophthalmology. We’re a modern staffing platform that connects skilled surgeons with hospitals and clinics in underserved areas through a flexible, logistics-enabled model focused on continuity, fairness, and strong outcomes. We’re tackling two core challenges: the underuse — and undervaluing — of surgical talent, and the difficulty of maintaining specialty care where it’s needed most.

3. What's your advice to anyone considering entrepreneurship or a nontraditional path in medicine? Don’t assume your career has to follow a straight line. Most of us went into medicine to solve problems — not to blindly follow systems that no longer serve patients or providers. You don’t need a perfect plan. Just start by noticing what’s broken, asking better questions, and being willing to explore unfamiliar territory.

4. How can a physician get over the “start” problem? Start with one specific problem you’ve seen in practice — something that bugs you or slows things down — and try to fix it. Talk to three people who’ve faced the same thing. Sketch out how you’d improve it. Write the workflow, build a scrappy prototype, test it with someone. Don’t worry about polish. Clarity comes from doing, not planning; action builds momentum, makes you feel more in control, and creates its own virtuous cycle.

5. What’s the #1 lesson you’ve learned that wasn’t obvious at the start? “Progress over perfection” is something my friend Jake Knapp says often, and it’s a mindset I’ve really come to internalize. You don’t need a flawless 10-year roadmap or airtight business plan — just enough clarity to take the next step with conviction.

6. What resources helped you most as an early entrepreneur?

- YC Startup School – A useful intro to startup thinking and language. A lot of the advice around speed doesn’t quite fit healthcare, but it's still worth knowing.

- Physician entrepreneur communities – InnovatorMD, SOPE, Startup Health, Rock Health. Talking to others building from within medicine made it easier to imagine a different path.

- First Round Review – Especially Jeanette Mellinger’s article on customer discovery: link.

- Sequoia Arc’s PMF Framework – One of the clearest takes on what product-market fit actually feels like: link.

- Books – Sprint and Click (Jake Knapp and John Zeratsky), The Mom Test (Rob Fitzpatrick), Shoe Dog (Phil Knight), and Creativity, Inc. (Ed Catmull and Amy Wallace) all helped in different ways.

7. How can other physicians support you? If you're a surgeon looking for a more flexible, sustainable way to practice — or if you're working at a hospital trying to improve specialty access — I’d love to connect. I'm always open to feedback, collaboration, or just trading notes. You can reach me at quinn@drs-network.com.

Bonus: Any AI resources you’d recommend to other physicians? I highly recommend using AI coding tools like V0 and Lovable to help you prototype your ideas. They’re intuitive, fast, and make it easier to bring rough concepts to life without needing a full dev team.

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

Best Things to Read This Week

Top 10 Nonprofit Health Systems by Operating Revenue (Fierce Healthcare)
See which hospitals top the list.

Read the 2025 AAPA Salary Report (American Academy of Physician Associates)
Read all the key trends for PAs’ compensation this year.

GenAI won’t replace physicians, but might make them miserable (Breaking The Healthcare Rules, Dr. Robert Pearl)
3 reasons GenAI won’t replace doctors — followed by one major caveat.

Healthcare Faces a Crisis of Trust (HealthData Management Grand Rounds)
From Editor in Chief Fred Bazzoli: Why science deniers are gaining steam.

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.

🏇 Let’s go, Paulius Mui!
Family medicine physician Dr. Paulius Mui is building a new virtual primary care practice for patients in Texas with a very innovative pricing model. Bravo, check it out here!

👍👍 Thank you, Preston Alexander
Preston Alexander opened up about who’s really to blame for declining access in healthcare (hint: it’s not physicians). Read it here.

🎉 Congratulations, Uché Blackstock
Dr. Uché Blackstock announced that she’s stepping back as CEO of Advancing Health Equity to reimagine what’s possible in public health. Read more here.

✍️ Well written, Adam Brown
Dr. Adam Brown writes about why the “Big Beautiful Bill” just handed doctors a big, painful blow. Read it here.

❗Important work, Rachel Solnick
Dr. Rachel Solnick just published a systematic review of 32,000 ED visits in Academic Emergency Medicine and found significant sex disparities in how we treat chlamydia and gonorrhea. Along with co-authors Rahi Patel, Maaz Munawar, Carlin Pendell, Judith Smith, Ethan Cowan, Keith Kocher, Roland Merchant and more. Read it here.

✅ Great job, David Hardin
Dr. David Hardin spoke on an Elation Health panel about how AI is showing up in primary care, along with a host of great speakers: Michael Hobbs, Vasanth Kainkaryam, Manisha Goud, and Sara Pastoor. Watch it here.

💙 Powerful words, Faye Bate
Dr. Faye Bate wrote about why she quit traditional medicine because it is failing women and what she plans to do instead: pursue a Master’s in Reproductive & Women’s Health, launch a new podcast Her Discussions, and build a new women’s health platform. Read all about it here.

🍾 Strong work, Lucy Ma
Dr. Lucy Ma graduated with her MD-MBA from Stanford School of Medicine and Stanford School of Business and wrote about what it means to her here. Congratulations!

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