On/Offcall: Start Growing Referrals For Your Practice Using Offcall!

Welcome back to On/Offcall!

This week, we’re excited to announce our partnership with AURO Health for Offcall's new referral tool! We're so excited to be working with psychiatrist Dr. Ujjwal Ramtekkar, who will now use Offcall to power referrals for his independent practice in Columbus.

"Every fax you send, every phone-tag voicemail, every patient who falls through the cracks — that's time and trust you're spending to prop up a broken system," he said. "Also, independent medicine can be isolating. Offcall has quietly become the place where that isolation breaks. It takes 3 minutes to join. Give it a week, and you'll wonder how you practiced without your colleagues this close."

This partnership marks a major step for Offcall, as we help clinicians and practices all across the country:

🔹 Simplify sending and receiving referrals
🔹 Cutting down on back-and-forth between offices
🔹 Reduce dropped referrals and missed follow-ups
🔹 Build an interconnected clinician community for independent practices

“Offcall is the first place I’ve found where independent clinicians are actually building something together,” he said. “We’re learning from each other, curbside consults, real conversations about different practices, sharing approaches that work.”

Read the full article here. If you're interested in partnering with Offcall and joining our private referral network, download the app here (Android here) and get in touch directly!

Download to join the waitlist

Medicine is complex enough.
Referrals shouldn't be.

Send and receive referrals, build wealth, and grow your physician community with Offcall.

Download on the

App Store

GET IT ON

Google Play

Most Talked About On Offcall

Your Questions About AI and Abridge’s New Clinical Decision Support Experience, Answered
Graham and Abridge’s Matt Troup answer the Offcall community’s questions about AI in our latest Office Hours with Dr. Graham Walker video

Meet the Doctor Who Went Anonymous to Say What the Rest of Us Can't: The Story of Dr. Orange
Dr. Orange is an anonymous doctor with 30,000 followers who has made it her mission to speak out about what corporate medicine is going to a generation of young physicians.

See the Slides From Our Intro to Vibe Coding Webinar
Doctors are building their own AI tools without writing a single line of code. See the highlights and slides from this week’s AI webinar! Featuring Dr. Michael Hobbs, Dr. Graham Walker, Dr. Kenneth Qiu, and Shreyank Kadadi.

Physician Spotlight: Meet Dr. Kameron Matthews

Have a response for Dr. Matthews? Reply to this post directly — she’ll personally read every message. Also, let us know who we should feature next by replying directly to this post!

1. What's something physicians are quietly worried about that the public doesn't know about yet? The thing physicians are most reluctant to say out loud is that we may not be the right people to speak on behalf of our patients. And the system has been built, for a very long time, as if we are.

I don't mean that cynically. I mean it structurally.

When I was at the VA, overseeing care for millions of veterans, the clinical voice in policy conversations was almost always a physician voice. When I was at Cityblock, building care models for Medicaid patients with complex needs, the people making decisions about what those patients needed were — again, largely clinicians, largely physicians.

The quiet worry I hear from the most honest physicians I know is a version of this: we have spent decades building advocacy infrastructure — professional societies, political action committees, scope of practice battles, payment reform coalitions — that is nominally about patients but is functionally about physicians. And we have told ourselves those are the same thing. They are not always the same thing.

The patients I've cared for at Cook County Jail, at Erie Family Health Center, at community health centers across Chicago — they had extraordinarily clear ideas about what they needed. Housing. Safety. Childcare. Time off work to actually attend appointments. Freedom from the particular terror of a medical bill arriving after a vulnerable moment. What they needed was not always what I was trained to provide, and it was almost never what the system was designed to deliver.

The community health worker model at the center of IMPaCT Care's work exists precisely because of this gap. CHWs are members of the communities they serve. They share lived experience with patients. They hear things in a kitchen or on a front porch that never make it into a clinical encounter. They hold a kind of knowledge that no amount of medical training produces — and for years, the healthcare system treated that knowledge as supplementary.

That inversion — where physician advocacy stands in for patient voice — has real consequences. It shapes what gets funded, what gets researched, what gets built.

The public doesn't fully know yet how much of what gets called patient advocacy in medicine is actually professional protection. The fix isn't physicians becoming better advocates. It's building systems where patients — particularly patients from communities historically excluded from those rooms — have direct, structural power over the decisions that shape their care.

2. Independent practice in 2026 — endangered species or quiet comeback? The independent practice conversation gets framed as survival versus extinction, and I think that's the wrong frame entirely. The more interesting question from my perspective is: what should primary care be — and who's responsible for making sure it exists everywhere?

A piece published in JAMA in May 2026 by Song, Altman, Crichlow, and Grumbach makes an argument I've been waiting for someone to put in print: that primary care should be treated as a public utility, financed through a common fund that pools spending across public and private payers and pays practices directly. The core problem they name is one I've lived in every setting I've worked in — state-level investments in primary care consistently leave out large swaths of the population because insurance fragmentation means no single lever reaches everyone. Medicaid, Medicare, self-insured commercial lives — they all sit in different regulatory buckets, which means even well-intentioned state policy lands unevenly on the ground.

Here's the honest take: I spent years in community health settings where the independence of the practice was treated as a point of pride. And I understand why. FQHCs, in particular, have a mission accountability and community governance structure that distinguishes them from corporate acquisition. That independence matters. But independence without adequate, stable financing is just a slower path to closure.

What I've come to believe — from running clinical operations at Cityblock, from my time at the VA overseeing the largest integrated care network in the country, and now at IMPaCT Care — is that the question isn't integration versus independence. It's whether the financial architecture underneath primary care is designed to sustain it as a common good or to extract value from it as a commodity.

If a common fund model creates stable, adequate payment for primary care practices serving Medicaid patients, uninsured patients, and complex populations in underserved communities — I don't much care whether the practice is independently owned or vertically integrated, as long as mission accountability is real and the community has meaningful voice. What I care about is whether the doors stay open, whether the panel reflects the actual community, and whether the payment is sufficient to do the work right.

3. If you had a magic wand for one thing in medicine, what would you fix tomorrow? If I could change one structural feature of American medicine tomorrow, it would be the reimbursement architecture for primary care — specifically its failure to value the work that most directly determines whether underserved patients receive adequate care.

The relative value unit system's bias toward procedural specialties is well-documented. What's less discussed is how this structural misalignment cascades into virtually every other major problem we're trying to solve.

The value-based care transition offers a pathway out of this misalignment, and I've seen it work in practice. When you're paid for outcomes — for keeping patients healthy, out of the emergency department, connected to their care team — suddenly the economics of investing in community health workers, in care coordination, in relationship depth, actually pencil out.

But the transition is slow, uneven, and still insufficient for the most complex populations. The magic wand isn't a technology. It's the political will to acknowledge that we have systematically undervalued the work of keeping people healthy — particularly people who are poor, Black, brown, unhoused, or incarcerated — and to pay for it differently.

Read the full-length version here. Know someone else who should be featured? Reply or tag them and their company in the comments!

Download to join the waitlist

Medicine is complex enough.
Referrals shouldn't be.

Send and receive referrals, build wealth, and grow your physician community with Offcall.

Download on the

App Store

GET IT ON

Google Play

4 Things to Read This Week

Immigration Ban and the U.S. Healthcare Workforce (JAMA Network)
From Dr. Tarun Ramesh, Dr. Michael Liu, and Hao Yu: We evaluated trends in physician and registered nurse immigration from the 19 banned countries over the past decade and characterized US communities most affected by the immigration ban.

Why doctors are worried about the patient affordability crisis (Medical Economics)
Featuring Brian Outland and Nele Jessel: According to athenahealth’s fifth annual Physician Sentiment Survey, access to affordable health care has officially displaced administrative burden as the single biggest policy concern among U.S. physicians.

Who Much Can You Earn as An Expert Witness? (Medscape)
Featuring James Mangriviti and Selena Ecker: The most popular physician side gig is now expert witness, chart review and training work. Here’s how much you can earn doing this work.

Our Penicillin Moment (Always On Call)
From Dr. Byron Crowe: “The potential of medical AI is now clear. Our moral obligation is to choose action over delay.” Plus, listen to Byron’s podcast interview with Graham here.

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.

Thanks for sharing, Preston Alexander (h/t Dr. Kanwar Kelley here and Dr. Jasdeep Dalawari here)
Spoiler: if you think all the money is being pocketed by some rich doctor, you are sorely mistaken. See Preston Alexander's breakdown of the real costs of U.S. healthcare spend here.

Fascinating study Bertalan Mesko
Dr. Bertalan Mesko shared a new study in which authors asked 2708 physicians throughout China to interrogate their opinions on drug-prescribing AI. See the results here.

Thanks for your leadership, AAFP
The American Academy of Family Physicians announced a new innovation network to put family physicians at the center of how AI is sharping primary care. See the release and meet the members here, including: Dr. Ricky Choi, Dr. Kameron Matthews, Dr. Paulius Mui, Dr. Christopher Crow, Dr. Jason Dees, Kyna Fon, Dr. Jackie Gerhart, Rachel Gruner, Dr. David Rushlow, Dr. Matt Sakumoto, Rosemary Weldon, and Dr. Travis Zack.

Check out the podcast, Michael Anderson
Dr. Michael Anderson hosts WittKieffer’s Accelerating Physician Leader Impact podcast episodes, featuring career lessons from physician leaders across healthcare including: Dr. Jennifer Baccon, Dr. Michael Parmacek, Dr. Niraj Sehgal, Dr. Jeff Sperring, and Dr. Joan Zoltanski. Learn more here.

Congratulations Destiny Green
Incoming Neurosurgery Resident Dr. Destiny Green posted a letter about her experience in medical and her reflections on becoming not only a physician, but also a woman transformed by the journey. Read it here.

Also congratulations Sa'Rah McNeely
Dr. Sa'Rah McNeely completed her pediatric residency training! See more from her partner Dr. Emmanuel McNeely here.

Way to go, Miguel Angel Jimenez
Dr. Miguel Angel Jimenez graduated from The University of Chicago Pritzker School of Medicine with a concentration in Healthcare Delivery Improvement Sciences. Congratulate Dr. Jimenez here.

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