On/Offcall: The Story of MDCalc, with Cofounders Dr. Joe Habboushe and Dr. Graham Walker

Welcome back to On/Offcall!

⭐ Special episode alert ⭐ This week’s How I Doctor guest helped build an app that millions (!) of doctors use to take care of hundreds of millions (!!) of patients.

… And that would be Dr. Joe Habboushe, who is Dr. Graham Walker’s co-founder at his first company MDCalc. If you don’t know MDCalc, it’s one of the leading clinical decision tools for clinicians, which according to a recent study from Health Tech Without Borders, is the #2 (!) most widely used and trusted app by physicians globally. 🚨

Joe’s approach is different than other CEOs in health tech: move slowly, thoughtfully, and don’t break things, even in the high-stakes world of medicine.

In this insightful and inspiring episode, Joe and Graham dig into:

👉 The origins of MDCalc and how a physician-built tool became indispensable worldwide.
👉 Why thoughtful product governance matters in healthcare tech.
👉 The philosophy behind building for clinicians first (and why it works).
👉 What makes MDCalc trusted by millions of doctors daily.

This isn’t just a story about an app, it’s a story about shaping the future of clinical decision-making while staying true to core values. ❤️

Listen now to the episode

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Physicians, see you at HLTH!

If you’re headed to HLTH next month, we can’t wait to see you there. It will be Offcall’s first time attending the conference, so we’re bringing the 🔥.

If you haven’t seen it yet, be sure to check out Dr. John Dayton’s schedule for all the physician events and happenings at HLTH (thank you for this amazing breakdown, John!). We’ll see you at Graham’s panel (on Monday October 20th at 2pm), and we’re also hosting an (oversubscribed!) event with Scrub Capital on Tuesday, October 21 at 8am. Reply directly if you want an invite!

Most Talked About On Offcall

Learn how to AI prompt as a clinician

Be sure to read and watch what was just this week called a “must watch for any healthcare provider” by Dr. Daniel Tarditi!

Exclusive for Offcall members: 7 lessons from MDCalc’s success
Key takeaways to build a startup successfully for and by clinicians (also, weigh in on social media here)

Why I started Offcall!
Watch and share Graham’s social media video!

Physician Builder Spotlight: Micah Levine

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 Micah Levine, Co-Founder and CMO of PulmaCare (more on the company’s mission below!). You can connect further with Micah on LinkedIn.

1. Micah, what inspired you to become a physician entrepreneur? I’ve always had an interest in business and making a meaningful impact in the world. I became a physician because of my passion for science and my love of caring for those who are ill and in need of support. While our health system has many strengths, it also has significant flaws that affect both patients and providers. I found the lack of autonomy challenging when it came to getting patients the care they needed, which also at times led to a lack of fulfillment in my daily work. Seeing patients, especially those in rural communities or elderly patients without transportation, struggle to access care fueled my drive to break down these barriers through virtual pulmonary rehab. Being a physician entrepreneur allows me not only to help one patient at a time, but also to change outcomes for the health system at large, exponentially expanding my impact.

2. Tell us what your company does and what problem you're trying to solve. PulmaCare is a virtual telehealth platform delivering pulmonary rehabilitation (PR) to people with chronic lung diseases such as COPD. PR is an insurance-reimbursable, multidisciplinary program that combines aerobic and resistance exercise, disease education, and psychosocial support to improve health and quality of life. COPD is one of the leading causes of death worldwide, and research shows PR can reduce shortness of breath, improve exercise tolerance and walking distance, lower hospital readmission rates, and improve overall well-being. Yet, fewer than 5% of eligible patients receive it, despite insurance coverage, due to significant barriers to access. Virtual PR breaks down these barriers by meeting patients where they are. Our completion rates are around 90%, compared to less than 60% for in-person rehab. The benefits extend beyond physical health. Patients often tell me they feel less depressed and less lonely through connecting with others facing similar challenges. Our care team is deeply committed, and our patients feel that. As a result, we improve outcomes for both the individual and the health system at large.

3. What's your advice to anyone who's thinking about entrepreneurship or a nontraditional career in medicine? If your heart is in the right place, your team shares your values, and your service gives more than it takes, you'll be successful. Keeping the patient’s well-being at the center of your “why” drives both growth and financial reward. Start something that fulfills an unmet need, or take an existing model and improve it. Build a team that fits your culture and values, even if it means delaying hiring until you find the right people. There are countless ways to make a difference, and a nontraditional physician career can be just as fulfilling — sometimes more so. Listen to your own wishes, not societal expectations. Protect yourself from burnout, which is widespread in healthcare. Take care of yourself first so you can be your best for others. Being a physician can be a calling, but it doesn’t have to be. It’s a rewarding career you can shape to fit you and your family.

4. How can a physician overcome their biggest fear to start a company? Fear often comes from inaction. The best cure is to start. Spend less time over-planning and more time taking action. The fear of failure is real, but the rewards go to those who try, especially those who try first. It’s a bigger failure to never try and fail by default than to try and not succeed the first time. You control your own narrative. Care less about the opinions of others and more about your own values and those of your loved ones. And remember, you’re not alone - surround yourself with a team whose expertise complements your own.

5. What's the #1 lesson you've learned since building your company that wasn't obvious to you before? Building a company is hard. Problems will arise — if it were easy, everyone would do it. It costs more than you expect, in both time and money, and obstacles must be pushed through. As your company grows, there may be fewer obstacles, but the ones that remain are often bigger. With them, however, come greater growth and momentum. Momentum compounds. Success begets success. So focus on small wins.

6. Name the top resources you found most helpful to get going as an entrepreneur that others would benefit from? My top resource has always been reading. It allows me to step into the mind of an expert and out of my own head. Two books I’ve especially enjoyed are Zero to One by Peter Thiel and The Laws of Human Nature by Robert Greene. Second, YouTube shorts and videos from other founders, visionaries, and thought leaders have been invaluable. Lastly, it’s not just what you know, it’s who you know. Leveraging your network is key. When you are genuine and sincere, people want to see you succeed and be part of it. And as a corollary, always look for ways to help others succeed, too.

7. How can other physicians support you? Let others know how to get in touch.

A) If you're a pulmonologist or primary care physician, consider referring your patients to PulmaCare!

B) If you’re part of a health system, we’d love to partner with you to improve COPD outcomes and reduce 30-day readmission rates. Together, we can improve patient outcomes, lower the cost of care, and save lives. Our team is always ready to connect with others on best practices and to listen to any thoughts/ideas you may have to continue to deliver quality care.

Bonus! Just for Offcall's Members: Tips on Using AI in Medicine: We're making a few of Micah's answers about how he uses AI in medicine available exclusively for Offcall's community. For example, what are Micah's top resources to get going with AI that others could benefit from?

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

“I’m a Doctor and I Introduce Myself By My First Name” (STAT News)
Op-ed from Dr. Jenny Tsai: “I don’t want my honorific to be the crutch that earns me attention and respect.”

How Do We Choose Doctors? Patient, Parent and Professional Perspectives (Health Affairs)
How do we choose an orthopedic surgeon not only capable of performing surgery, but also able to deliver strong long-term outcomes?

Educational Debt vs. Hours Worked and Burnout Symptoms Among Early Career Physicians (Annals of Family Medicine)
New study: Is medical debt associated with increasing work hours and more burnout amongst early-career family physicians?

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.

⚕️ Important watch, Hardeep Phull
Dr. Hardeep Phull delivered a talk entitled “Generate RVUs or Perish: Defeating Moral Injury and Reclaiming Joy in Medicine” in a Vumedi video (need to sign up). Watch it here.

🎉 Congratulations, Andrea Garcia
Dr. Andrea Garcia is starting a new position as Internist-Primary Care at Cooper University Health Care. Congratulate her here!

🚀 Let’s go Owais Durrani
Dr. Owais Durrani was nominated for a Lone Star Emmy for hosting STEM City and creating science and STEM content for the next generation. Congratulate him here.

✅ Thanks for sharing, Dutch Rojas
Dutch Rojas ran the numbers of physician compensation vs. inflation since 1998 and showed how Medicare payments to doctors have dropped even before inflation. See his analysis here.

👉 Check it out, Devdutta Sangvai
Dr. Devdutta Sangvai wrote in JAMA about how to radically reform medical education amid rising debt along with Mia Wells. Read it here.

🩺 Join the conversation: Graham, Kaveh Hoda and more
Graham reacted to this week’s announcement that Tylenol causes autism in a poignant social media post, while Dr. Kaveh Hoda created an explainer podcast alongside Andrea Love and Dr. Ryan Marino about what the research actually shows. Listen here.

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