Welcome back to On/Offcall!

🚨This week, we released our first major gender pay gap study for emergency medicine, and the results were alarming. 🚨

Our study found women EM physicians make $21,000 less than men annually — even after adjusting for hours worked, experience, patients seen per day, and more. Among the report’s key findings:

🩺 For those with 20+ years in practice, men earn an average of $40,211 more.
🩺 For productivity-based roles, men earn $58,942 more.
🩺 Even when examining on an hourly basis, women make $17 less per hour than men.

Offcall’s co-founder and emergency physician Dr. Graham Walker reflected on what this data shows here, saying, “It totally shatters the illusion that EM is a fair-paying specialty.”

We also invited emergency physician and MicroSkills author Dr. Resa Lewiss to provide reflections here: “It’s been reported for decades, but sometimes you have to see it to believe it. So now the Offcall community will see it. What are we gonna do?”

We want to do everything in our power to bring about more transparency and advance real solutions, and we'd love your help.

Read the full data findings here.

♻️ Share this post or newsletter to spread the word.

And if you haven't already, be sure to sign up for Offcall to help bring transparency to every speciality: https://lnkd.in/eddsVSsu

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How Hawaii Gov. Josh Green Is Rewriting the Rules of Public Health

This week on How I Doctor, Graham sat down with Josh Green, an ER physician and health policy advocate who’s now the governor of Hawaii.

Alongside grassroots organization 314 Action, Governor Green wants more physicians to run for public office. Because he believes when physicians lead, problems start getting solved. Take housing, for example: Instead of using the same old playbook, Governor Green flipped the script by treating homelessness like a healthcare crisis and prescribing tiny homes. What happened next?

⬇️ Drug use went down.
⬇️ Hospital readmissions went down.
⬇️ Chronic disease indicators improved.
⬇️ Costs to the taxpayer plummeted.

In the episode, they unpack:
- How Governor Green landed in public office after starting as a rural ER physician
- How his physician experience gives him a unique edge in politics
- His unique approach to building tiny homes to fight homelessness
- Why more physicians should jump into public office

Listen to the full episode

Most Talked About On Offcall

Physician Builder Spotlight: Travis Meyer

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 Dr. Travis Meyer, CEO of Mineral City (more on the company’s mission below!). You can connect further with Travis on LinkedIn.

1. Travis, what inspired you to become a physician entrepreneur? Both of my parents were veterinarians who co-owned their own practice. My undergraduate degree in engineering was fed by my constant desire to figure out how things worked. When I turned my attention to people and embarked on the physician journey, I knew I loved the intersection of bringing what thoughts were in my head into the real world in a meaningful way. Some do that by running their own physician practice or doing research in academia, but for me, the draw was always making “real world things” that were useful and cool. My sister is also a veterinarian, so we lovingly tease that I’m the one in our family who has it easy … by only treating one species.

2. Tell us what your company does and what problem you're trying to solve. I started Mineral City with two physician colleagues to address the clinical problem of plastic and suture-based ortho implants being invisible or poorly visible on imaging modalities. This places limitations on Rads being able to give insights on what is happening with the implants. One key example is the all suture rotator cuff repair, where the suture tape is invisible to Xray and CT and only shows up as a black line (sometimes) on MRI. The core need was to make the invisible seen and to go one step further by using AI to analyze image patterns and glean some useful information about the item.

We applied the same approach to everyday settings and asked ourselves: If all these security scanners and threat detection X-ray machines (think carry-on airport screening) can look for what’s not supposed to be there… guns, drugs, explosives… why not take that same data, that same image and look for what IS supposed to be there? Using technology and AI to automate verification, authentication, track and trace and supply chain transparency. Mineral City now focuses on using advanced scanning technologies and AI to evaluate goods in bulk and provide real-time feedback on the authenticity, quality and safety of products in the supply chain.

3. What's your advice to anyone who's thinking about entrepreneurship or a nontraditional career in medicine? Do It! If you’re fresh out of Med School, or Residency, or have been in practice for 4 decades, if you have a passion and love for entrepreneurship, Do It. Entrepreneurship is not at odds with medicine. You are in service to humanity in both, you are doing valuable things, there aren’t enough of either in the world, and your medical training actually made you very good at many of the things needed to be a successful entrepreneur.

4. How can a physician get over the "start" problem to start a company/organization? When we start medicine, there’s a lot about it that we don’t know. The reasons we go into medicine, the things you wrote on your Med School essay, are probably not the reasons you are still in medicine. We start not knowing what the real practice of medicine is like, we start not knowing the true weight of making life and death decisions, we “know” it’s hard work and long hours, but we don’t really know the toll it will take on our families, relationships and ultimately on our own lives. But we start with gusto and excitement, and plenty of butterflies.

This is no different. Medical training has beat out of us the tolerance for uncertainty and replaced it with a compulsive need to find the answers, diagnose the problem, and know how to solve it. But, we still have in us that ability to take risks and have faith. The reasons you start the business won’t be the reasons you still wake up every day and deal with all the challenges of running it in 5 or 10 years, and that’ s OK. You won’t know exactly what it’s like, you won’t know if you can do it (spoiler alert: you can), you won’t know all the answers, just like you didn’t when you started medical school. But you did it once, so you can do it again.

5. What's the #1 lesson you've learned since building your company that wasn't obvious before? How much the first two years of Med School were necessary, and how much I didn’t like them. I wanted to jump right in, see patients, operate, get ‘dirty’… sitting and learning the Creb’s cycle almost broke me. Really, those two years were a foreign language crash course and a peek into all the different things that go into the whole of medicine.

The same is true for business. I thought it would be fun, physical, that I’d be making prototypes and making them better. There was a lot more of a crash course in many foreign languages and learning enough about a lot of other parts of the whole process than I imagined such as accounting, cap tables/equity management, contracts, PR, sales cycles, revenue cycles, cash flow, marketing, investor relations, etc… Those weren’t the things I was particularly excited about. You can’t hire out all the other jobs that need to be done, you have to wear every hat, sometimes many at once. But it does get better. Just like in medicine, you aren’t an intern forever, you will slowly be able to do more and more of the fun things you imagined when you started.

6. Name the top resources you found most helpful to get going. 1. Your Village: It takes a village, so bring them along with you on this journey. Just like when you started med school, everyone was supporting you, rooting for you, and encouraging you. Don’t go it alone. Enlist your village to do the same now, you’ll need those same Tupperware containers full of chocolate chip cookies in the mail from grandma, the same sticky notes on your door saying “good job,” the same late night phone calls home to tell mom you just can’t do it and then wake up in the morning and putting one foot in front of the other.

2. Your Peers: Entrepreneurship is lonely. Think how much you learned from your Med School study mates and friends and not from the textbook. It worked then, it works now. LinkedIn is a great place to find other entrepreneurs in the same space, they aren’t your competition, they’re your wolf pack. Your local small business association can also help. Don’t be shy to tell people what you’re doing and if they’ve done the same, make them a mentor. You can never have too many mentors.

3. Your Team: Cofounders are great. Your core team is important. It’s not personal, its’ business. If some of the initial folks can’t move in the way the company is shifting, then let them exit sooner than later. Listen to your team, take input and respect opinions, then make a decision that is concise and clearly communicated but can change as the situation unfolds. No idea is so great that it can overcome a bad team. People don’t invest in your product or service, especially at the start, in the friends & family stage, they invest in YOU and your team.

7. How can other physicians support you? Let others know how to get in touch. We are always open to investment, connections and opportunities. We are also open to mentors and to mentoring. [email protected] or LinkedIn (email is better).

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!

3 Things to Read This Week

Building Credible Evidence for Medical AI (The Lancet Group, h/t Brian Spisak)
"The path to successful LLM integration lies not in racing to publication but in methodical rigorous evaluation and communication, ensuring that these powerful tools truly advance the practice of medicine." Authors: Dr. Ramez Kouzy, Dr. Julian Hong, Dr. Danielle Bitterman.

When Patients Arrive With Answers (JAMA Network)
From Dr. Kumara Raja Sundar: As AI reshapes everything, what does it mean to be a doctor when patients bring AI insights into their clinic visit.

Hospital Acquisitions of Physician Practices: 10 Findings (Becker’s Healthcare)
Over an eight-year span, the number of physicians employed by hospitals nearly doubled, and that shift has come at a cost.

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.

🎙️Hot podcast listen, Stephen Klasko 
Dr. Stephen Klasko was featured on Becker’s Healthcare podcast with Scott Becker discussing workplace shortages among physicians, using AI to enhance care, and bringing about innovation in healthcare. Listen here.

🎉 Congratulations, Kedar Mate!
Dr. Kedar Mate is joining Stanford University's Clinical Excellence Research Center as a Senior Scholar! Congrats, learn more about it here.

🎉 Also congratulations, Jonathan Slotkin
Scrub Capital’s Dr. Jonathan Slotkin was promoted to Chief Medical Officer, Strategy and Growth at Geisenger. Congratulations! Show him some love here.

🗣️ Well said, Russell Ledet
Dr. Russell Ledet reflected on the long hours of residency, but why he still feels a sense of purpose and the desire to push through for patients. Read it here.

✅ Thanks for sharing, Ted Love
Dr. Ted Love reflected on one of the most under-appreciated aspects of watching ‘The Pitt’: how it helps to raise awareness of Sickle Cell Disease and the people who live with it. Read it here.

🤩 Well done, Nicolas Mouawad
Dr. Nicolas Mouawad was named by Newsweek as one of America's Top 30 Leading Doctors in Vascular Surgery! Congrats and celebrate him here.

⚕️Important perspective, Ge Bai and Kavi Devulapalli
Dr. Kavi Devulapalli and Dr. Ge Bai wrote about why independent physicians are disappearing and whether private equity is to blame. Read it here.

🩺 FACTS, Dutch Rojas
Dutch Rojas wrote about the need for independent physicians to band together and stand shoulder to shoulder rather than seeing one another as competition. Read it here!

📚 Buy the book, Adam Rosen
Dr. Adam Rosen published a new book, “O.R. Confidential: Confessions of a Gen X Surgeon” about the skills and techniques to claw back from burnout and depression. Learn more and download the book 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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