On/Offcall: New Study Shows 'Doctors Are Bad at Business' Is a Complete Myth
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On/Offcall is the weekly dose of information and inspiration that every physician needs.
🚨 “Doctors are bad at business” might just be one of the most expensive myths in healthcare.
Because according to a new study, more than 25% of healthcare companies that crossed a billion-dollar valuation had at least one clinician co-founder. That’s according to our newest How I Doctor podcast guest Dr. John Dayton, emergency physician and co-founder of Wildfire Partners, a healthcare seed fund focused on physician-led innovation and AI-enabled care delivery. 👏
In this week’s episode, John joins Offcall co-founder Dr. Graham Walker for a wide-ranging conversation about what physicians uniquely understand about healthcare problems and why that is the missing ingredient so many health tech companies need. They dive into:
👉 Why physicians may be uniquely positioned to build the next generation of healthcare companies
👉 How AI is fundamentally changing the barrier to entry for physician entrepreneurs
👉 Why physician-led innovation may be one of the biggest forces shaping the future of medicine
👉 What kinds of founders Wildfire Partners is looking back financially, and more!
🎧 Listen to the full episode out now
Offcall Physician Spotlight: Meet Dr. Rich Bruno
1. Rich, are you worried about deskilling — that idea that the next generation won't develop the clinical intuition you did because the model handles it? The short answer is yes - but they may gain skills and intuition in other ways. If you look back to how medicine was practiced even 20-30 years ago, there was much less reliance on technology and more on ‘intuition’. We didn’t have the imaging/diagnostics that we have now, and providers relied more on nuanced physical exams and detailed histories. The emerging concern was that increased reliance on diagnostics would somehow create a less competent workforce and lead to increased patient harm. I would argue that this is largely not the case. To translate the impact of today’s newest technology, AI, I think we will see providers more skilled at adapting to more clean, detailed information, with the ability to adjust care targeted at more specific demographics with even better outcomes. It may also allow for some ‘re-skilling’ to more interventional work as some of the more routine tasks no longer require a human interaction.
2. Do you think AI will solve the physician shortage or quietly make it worse? I don’t think that AI will inherently increase demand or decrease the potential supply of doctors. Whether it solves the issue completely or not remains to be seen. AI (without robotics that currently don’t exist) can’t deliver a baby, do surgery or procedures, or provide human touch. It’s very conceivable that medicine will become a more procedure heavy field for doctors but that simultaneously, the demand for health-driven procedures may increase.
3. What's something you used to judge other physicians for that you now completely understand? I’ve never been extremely judgmental of other physicians – we are all human and sacrificed a lot to get where we are. I’ve been lucky to serve hundreds of physicians in my career that ranged from engaging personal requests for accommodations at work, dealing with ’sub-optimal’ workplaces behaviors, or reviewing bad outcomes. In almost every case, there was a valid ‘human’ issue that warranted real consideration and understanding. The exception is when colleagues don’t treat each other well or professionally – that I’ll probably never understand.
4. If you had a magic wand for one thing in medicine, what would you fix tomorrow? It’s been clear for a long time that we need a more robust and functional national health system. The bottom line is that we have the ability to fund care for everyone, and the technological capabilities to get it to everyone, and I think it can be done in a way that doesn’t disrupt some very important economies within healthcare (i.e. pharma and R+D), still allows those with means to have access to additional options, and maintains compensation to attract the best and brightest into the field.
5. Who do you want to nominate next to get the next Physician Spotlight?? Dr. Joseph Scalea
Access the Complete Report
✓Complete quantitative breakdown of what physicians really think about AI
✓Strategic implications for healthcare organizations and AI companies
✓Sentiment analysis of physician attitudes about AI and the future
Best Things to Read
2026 Locum Tenens Physician Report (Weatherby Healthcare)
A comprehensive new look at the growth of the locum tenens industry, from the CHG Healthcare team.
Promoting Clinical Expertise in the Age of AI (JAMA)
From Dr. Ron Keren, Dr. Bimal R. Desai, and Dr. Daniel C. West: “As clinicians rely on AI for more advanced tasks, concerns have emerged about deskilling (losing previously acquired skills) due to overreliance on AI systems and mis-skilling (learning the wrong things) due to inaccurate AI systems.”
From Ihsan Ayyub Qazi, Ayesha Ali, Asad Ullah Khawaja, Muhammad Junaid Akhtar, Ali Zafar Sheikh, and Muhammad Hamad Alizai: “Doctors exposed to erroneous LLM suggestions had a mean diagnostic accuracy of 73.3%, compared to 84.9% in those who received error-free diagnostic suggestions, despite being free to accept, modify, or reject suggestions. Even those who completed a 20-hour program focused on critically evaluating AI outputs demonstrated substantial automation bias — the tendency to over-rely on automated outputs.”
I’m a Doctor. Here’s What AI Cannot Do (NYTimes)
From Danielle Ofri: “Sharing my experience of why it still matters that we have "real life" doctors and nurses.”
An Open Letter from the Medical Community on America’s Road Deaths (Op-Med)
From Eric Topol and Jonathan Slotkin: An Open Letter from the Medical Community on America’s Road Deaths – add your name in support! Co-signed by: Dr. Asima Ahmad, Dr. Susan Baro, Dr. Alexander Blood, Dr. Marissa Boeck, Shawna Butler, Dr. Richard Carmona, Garrett Chan, Kathryn Connell, Terry Cropf, Dr. Owais Durrani, Dr. Ali Khan, Dr. Daniel Kraft, Rhonda Manns, Dr. Rebecca Mitchell, Dr. Amit Phull, Dr. Aartik Sarma, Dr. Gina Siddiqui, Michelle Stephens, Dr. Christine Trankiem, and Dr. Graham Walker.
Community Highlights
Important study, Nicholas Stark
Dr. Nicholas Stark shared important research showing that across 859,000 Washington Medicaid ED visits, fewer than 15% of patients seen for a mental health condition, substance use disorder, or alcohol use disorder received condition-concordant primary care follow-up within 30 days. Learn more here and read the study from Dr. Jonathan A. Staloff, Edwin S. Wong, and Dr. Joseph H. Joo here.
Congrats, Olivia Njideka
Olivia Njideka announced she has been awarded a full-ride Knight-Hennessy Scholarship to Stanford University, where she will pursue her Master's in Community Health and Prevention Research. Congratulate her here.
Well done, Corey Gill
Dr. Corey Gill announced he is now board certified in Emergency Medicine! Congratulate him here.
Welcome, future doctors!
More congrats to several new incoming doctors this week, including James Macguire who will be attending the Alice Walton School of Medicine and Silvestre Cortes who will be attending UCSF.
Let’s go, Meena Madhur
Dr. Meena Madhur announced she has completed her MD-MBA from Indiana University. Congratulate her here.
Great career news, Daniel Egan
Dr. Daniel Egan has been named Editor-in-Chief of Emergency Medicine Practice with EB Medicine. See his post here.
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