On/Offcall: The Benefits of Choosing Independence As a Physician, Featuring Aledade and Dr. Umar Bowers

Welcome back to On/Offcall!

We hope everyone had a great Thanksgiving. This week on How I Doctor, we featured not one but TWO incredible guests: Offcall’s co-founder Dr. Graham Walker talked to Dr. Umar Bowers, who recently decided to leave employed medicine and open his own independent practice, and Dan Bowles, the General Manager of Practice Health Solutions at Aledade, Inc..

Aledade recently created a new solution called Project Turnkey to help physicians launch independent practices in just a few months. And the practices they work with are making hundreds of thousands (if not more!) of additional revenue using their model. One of those very practices is Dawson Med run by Umar, and he’s now made it his mission to educate other physicians about how to break free and become independent too. You’ll hear:

🛠️ How Umar reached his breaking point inside a large health system and what pushed him toward independence

📈 How Aledade’s value-based care model can help grow revenue substantially while cutting bureaucracy

🧠 What autonomy means for independent doctors today, from schedule control to real decision-making power

🚪How Project Turnkey enables any physician who’s dreamed of doing medicine on their own terms to finally do so

🤝 Why peer mentorship and peer support make independence possible (and sustainable).

🎧 Listen to the full episode here

And learn more about Project Turnkey here

And join the conversation about independent medicine on social media here!

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

Independent Physician Spotlight: Steven Murphy

We put out a call to celebrate independent physicians, and we’re featuring a different doctor who’s decided to go (or remain!) independent to restore their autonomy and provide better patient care. This week, meet Steven Murphy, Medical Director of Concierge Medical Associates. You can connect further with Steven on LinkedIn.

1. Steven, give us a little background on you and your practice. I'm a Board Certified Internist with training in Genetics from Mt. Sinai and Yale. There are under 200 internists with genetic training in the country and less than 100 doing clinical practice.

2. What were the biggest challenges for you as you decided to go independent? The biggest challenges to independence are human resources risks, dependence on insurance reimbursement and revenue cycles, and certificate of need laws preventing fair competition. For starting a practice independently? There are a bunch more. First issue is having the desire for an office. We address those challenges by not taking insurance. Our second solution to HR is rock solid training that includes hiring slow and firing quickly.

3. What have the biggest benefits been for both you and your patients? Independence allows you to make the right choices for the patient first. Not for a boss first. Whoever that boss is, they have their interests at heart. Physicians used to be trained to be independent, now it is a team-based approach which makes it harder to say "the buck stops with me." Patient ownership is something to be valued, not a punchline in a joke.

4. What's your advice to anyone who's thinking about making the leap or deciding what path to take straight out of training? If you are a primary care provider (Internist/Family Med) don't start with an office, start by accepting Medicare and seeing patients in nursing homes. Then once you have enough revenue, start with a single exam room. Grow from there. If you don't want to accept Medicare you will need to save 3 months worth of operating costs as a cushion to start at minimum if you are doing in-person care.

5. Are there any resources you can recommend to help physicians who are considering this pathway? Absolutely, there are legion of resources. If you accept insurance, you must understand billing and revenue cycle before you see a single patient. AMA has a great resource and with AI, it is even easier to set great processes upfront. If you are not going to take insurance, the best resources come from Atlas MD.

6. How can other physicians who are inspired support you? The best thing physicians can do is to support my Substack where I educate about Longevity Medicine and Geroscience: The Longevity Insider with Dr. Murphy

This Q&A was shortened for the newsletter, but you can read the full-length version here. Connect with Steven on LinkedIn and learn more about his practice here.

Last Chance! Our Physician AI Report Comes Out Next Week

We’re about to release our highly anticipated 2025 Physicians AI Report which will break down how physicians really feel about AI tools and their impact and feature some surprising and explosive conclusions. A huge thank you to everyone who has participated and if you haven’t yet, be sure to answer the short questions below (takes 2 mins!) so we can include you! Stay tuned for more details and the release later this coming week!

How do you really feel about AI?

Best Things to Read This Week

10 Healthcare Industry Predictions for 2026 (Forbes)
From Sachin Jain! Also see commentary from Trey Rawles, Suzie Bergman, Reza Hosseini Ghomi, Vivek Garg and many more on his social feed.

New Stanford – Harvard study should AI models can cause severe clinical harm in up to 22% of cases (Ethan Goh)
Read the full breakdown.

‘Academic institutions are where most of the progress will be made in medical AI’ (Stanford Report)
Featuring Stanford radiologist and data scientist Curtis Langlotz.

2025 Medicine and Pediatric Specialties Match Results (The Match)
See commentary from Stephen Bergin 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.

👏 Well done, Russell Ledet!
Dr. Russell Ledet completed his final 24-hour shift of residency — and reflected on why that milestone means so much to him. Bravo and read it here!

❗Powerful reflections, Pamela Buchanan
Dr. Pamela Buchanan shared powerful reflections about her personal experience unshackling herself from the golden handcuffs and leaving traditional medicine, and her advice to others thinking about doing the same. Read it here.

➡️ Go ahead and subscribe, Chrissy Farr
Scrub Capital co-founder Chrissy Farr announced the debut of her new podcast Lifers, where she’ll interview healthcare leaders (including Graham!) about building and operating in health tech. Learn more and go and subscribe here.

🙌 On point as always, Preston Alexander
Preston Alexander reflected on why it’s so important for clinicians to have a seat at the table when it comes to AI (we 100% agree 👍). Read it here.

🎉 Congratulations, Nicholas Chedid
Dr. Nicholas Chedid announced he’ll be serving as the Associate Chief Medical Officer and Head of AI-Enabled Care Delivery & Operations at Qualified Health. Congratulate him here!

🎉🎉 Also congratulations Michael Oppenheim
Dr. Michael Oppenheim announced that he’s joined MEDITECH as their newest Physician Informaticist. Congratulate him here!

🎥 Great video, Jake Goodman
Dr. Jake Goodman shared a great video about the things medical school never prepared us for, featuring al school never prepared for (featuring many physicians including Dr. Darien Sutton!) Watch it here.

✅ Thanks for sharing, Robert Singleton
Dr. Robert Singleton II shared a powerful video about burnout and what specialities physicians regret choosing the most. Watch it here.

👀 Watch the interview, Ben Schwartz and Graham!
Dr. Ben Schwartz interviewed Graham for The Surgeon’s Record about AI hype vs. reality and the importance of having clinicians at the table in healthcare innovation (amongst other topics). Watch it here.

📖 And finally, read Graham’s thoughts on the ACCESS model announcement
And join the conversation here.

Be Sure to Sign Up for Offcall!

At Offcall, we believe physicians deserve to be heard, valued, and treated fairly. Everything we do is driven by our commitment to empowering doctors with accurate, reliable, and trustworthy data — to advocate confidently for themselves and ensure their compensation truly reflects their worth.

Learn more and sign up here

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