On/Offcall: Watch 'The Pitt' Cast Noah Wyle's Heartfelt Emmy Speech Honoring Healthcare Workers

Welcome back to On/Offcall!

Are you an AI founder or are you using an AI tool that has been particularly impactful in your medical specialty? We want to hear from you!

As part of a new partnership with MD+, we’re kicking off work on an “AI Specialty Guides” series, where we’ll be releasing in-depth guides for every medical specialty – spanning use cases such as clinical decision making, administrative burden, patient experience, drug discovery, and more. Each guide will be comprehensive and aim to feature AI use cases and case studies for that speciality, the best, as well as the most non-obvious tools, and additional resources for clinicians to stay informed and get up to speed.

That’s why we need you’re help. To participate, you can either just reply directly to this newsletter or better yet, tag yourself (or the company you think should be included) in the comments, as well as the particular specialty (if applicable). The prompt is simple: What’s the best/most interesting AI tool you’ve come across for your specialty? We’ll include each one in that specialty’s guide. We look forward to hearing from you!

Also, here are a few examples of things we’ve recently released on this topic:

7 Actual AI Prompts and Use Cases That Clinicians Use in Clinical Practice

Our Free AI Resource Guide for Clinicians

Webinar Recap: How Every Doctor and Trainee Can Start Using AI Today

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

From Hospital Insider to Physician Advocate: How Ethan Nkana Switched Sides to Champion Doctors’ Voices

This week’s How I Doctor guest is truly one of the rarest individuals we’ve ever featured.

Ethan Nkana was formerly a hospital executive whose job was to quantify how much revenue each physician brought his hospital, and what he witnessed in closed door conversations left him fully disillusioned. So he decided to flip the script and start representing physicians in contract negotiations. Today, he’s the founder of Rocky Mountain Physician Agency and a self-described “Jerry Maguire” for physicians: He’s a contract negotiator and fierce advocate and he’s made millions for the physicians who he represents. In this one-of-a-kind conversation, he and Graham discuss:

👉 What hospital execs and non-clinical MBAs really say about physicians behind closed doors.
👉 The most common tactics that hospitals use to stall or shut down contract negotiations — and how physicians can push through them.
👉 Exactly which physicians got raises when he was in charge … and which ones did not.

👉 Why it’s time to ban the “G word,” AKA it’s not "greedy" to ask to be paid fairly for your skillset.
👉 How he’s won millions and millions of dollars for physicians by negotiating like talent agents do for professional athletes.

🎁 BONUS: Ethan also shared exclusive slides and a presentation for Offcall listeners, including the most common physician negotiation mistakes — and how to fix them.

Listen to the episode and download the slides

Most Talked About On Offcall

Watch The Pitt cast’s powerful Emmy speech

They nailed how to treat healthcare workers, in just 6 words. See Graham’s commentary on social media here.

Let us know if you’ll be at HLTH in Las Vegas!

If you’re planning to be at HLTH and haven’t gotten an invite to our upcoming event, let us know :) Reach out directly via email or tag yourself in the comments for more details.

Scenes from Offcall’s offsite this week!

Our team gathered in SF to plot what’s next for Offcall and meet in person with some of our most passionate users (thanks Scott McCusker for the shout out!) We’re energized, inspired and ready to build for and by physicians.

Physician Builder Spotlight: Bryce Piro

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 Bryce Piro, Founder and CEO of OpenScope Health (more on the company’s mission below!). You can connect further with Bryce on LinkedIn.

1. Bryce, what inspired you to become a physician entrepreneur? When I entered medical school, I had never given much thought to becoming an entrepreneur, but I’ve always had an inherent drive to build and discover innovative solutions to complex problems. My first entrepreneurial itch came from a social media page I built with my medical school roommates, which led me to found both a coffee company and an ed-tech startup while still in school. After graduating, I moved to San Francisco to team up with top AI researchers to build OpenScope Health.

2. Tell us what your company does and what problem you're trying to solve. At OpenScope Health, we’re leveraging AI to build Personalized Health Agents (PHAs): always-on health partners that understand your full health story, think like a physician, and help you cultivate lasting health instead of just treating illness. Our first step is SelfDDx, the on-demand symptom checker that delivers personalized, educational health insights.

3. What's your advice to anyone who's thinking about entrepreneurship or a nontraditional career in medicine? Try it, no matter how small. You don’t have to be the CEO of an AI medicine company to get a taste of entrepreneurship. My first venture was a small e-commerce coffee brand, but I learned more about business in three months building it than I ever could from years of research and hesitation. In the age of AI, there are still countless things waiting to be innovated. I tell everyone to keep one question in the back of their mind during their day-to-day work: What seemingly trivial thing could be made better with AI?

4. How can a physician overcome their biggest fear to start a company or organization? In Plato’s Apology, Socrates famously says, “I know that I know nothing.” Before I became an entrepreneur, I assumed every business leader knew everything about business and that I could never measure up. What I quickly learned is that even the most successful entrepreneurs felt completely lost at the start; they simply worked harder and came up with more creative solutions than the next person.

5. What's the #1 lesson you've learned since building your company that wasn't obvious to you before? If you build a company in a field you’re passionate about, the hours don’t feel like work. It is more like a challenging hobby, whether that’s building a Lego set or fixing up an old car. I “work” 16–18 hours a day right now, and while I’m exhausted at night, I wake up each morning excited to do it all over again.

6. Name the top resources you found most helpful to get going as an entrepreneur that others would benefit from. A lot of classes and organizations feel like reading a textbook on how to play basketball, i.e. useful in theory but the best way to learn is by actually playing the game.

That said, there is one resource I think is a true game-changer for physicians pursuing entrepreneurship, and it has little to do with medicine or business: Alchemy by Rory Sutherland. Medical training tends to beat the creative, non-analytical mindset out of you through years of schooling and residency. Analytical thinking is valuable, but so is the equally important creative pathway, and this book gave me permission to think with it again.

7. How can other physicians support you? We’d greatly appreciate any feedback on our first app, SelfDDx, especially from physicians, on our model’s performance. I’m also happy to connect with current (or future) physician entrepreneurs, investors, and med tech researchers. Feel free to email me at bpiro33@gmail.com or add me on Linkedin.

This excerpt has been shortened, 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

Public Perception of Physicians Who Use AI(JAMA Network)
A new study showed how statements on different types of AI use (diagnostic, therapeutic, and administrative) influence the public’s perception of respective physicians.

Can LLMs persuade people to vaccinate their children?(Scott J. Forman)
The answer seems to be increasingly yes.

Which clinical decision tools to physicians use most?(Health Tech Without Borders)
A new survey showed Graham’s first startup MDCalc (!) is the second-most widely used clinical decision tool of all time with clinicians, only behind UpToDate. Congrats Dr. Joe Habboushe and team! Read more context from Graham here.

What impact does unionizing have on healthcare workers?(Sage Journals)
A new study found that unionization is significantly associated with raises, not working overtime, less workplace harassment, and more.

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.

✅ Strong work, Jesse Ehrenfeld
Timed to National Physician Suicide Awareness Day, Dr. Jesse Ehrenfeld published an article in JAMA alongside Dr. Daniel Saddawi-Konefka and Dr. Christine Yu Moutier, about the immense barriers physicians face in accessing care. Thanks for your advocacy work, read more here.

✅✅ Thanks for speaking up, Lookman Lawal
Dr. Lookman Lawal shared a passionate social media post about why more physicians don’t choose to go independent (but why more should consider it). Read it here.

🥹 Proud of you, Rajiv Narula
Dr. Rajiv Narula, Founder and CEO of Sevaro, announced his company secured $39 million in Series B funding to accelerate growth for his virtual neurology company which was previously profiled in this newsletter and Offcall here🙂Read more about the funding announcement here.

👍 Great video, Alexis Purcell
Dr. Alexis Purcell created an passionate video about why physicians are not paid to take emergency room call and why no other profession is expected to be on call, 24/7 for free. Watch it here.

👍👍 Important read, Borah Kim
Dr. Borah Kim recently reflected on the emotional labor that clinicians carry quietly, often invisibly, and why our work matters. Thank you Dr. Kim, read it here.

📅 Tune in live, Gerardo Bonilla 
Dr. Gerardo Guerra Bonilla, Founder and CEO of Chartnote, is hosting an upcoming webinar on September 25th called “Chart and Chill: Podiatry Edition” about how Chartnote saves time, streamlines notes, and helps physicians focus more on patient care. Learn more and tune in here.

👏 Way to go, Hardeep Phull
Dr. Hardeep Phull was interviewed about why telemedicine has transformed access, improved patient experience, and redefined care delivery for patients with cancer (and why it should be protected). Read more here.

🎉 Congratulations Joseph Thomas
Dr. Joseph Thomas announced he is now ACMIO at Baptist Memorial Health Care! Congratulate him here.

🥳 Also congratulations, Camille Clare
Dr. Camille Clare announced she’s starting a new position as Professor of Obstetrics and Gynecology and Women’s Health at Albert Einstein College of Medicine! Congratulate her here.

👀 See you at Becker’s, Minal Shah
Dr. Minal Shah will be speaking at Becker's Healthcare 10th Annual Health IT + Digital Health + RCM Conference on Addressing and Mitigating AI Fears. Check out more details 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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