Welcome back to On/Offcall!

🚨 MARK YOUR CALENDARS!

Offcall is launching The AI Residency for Clinicians — a four-part live webinar series designed to help every clinician confidently integrate AI into their practice.

The series is hosted by Dr. Graham Walker Offcall co-founder and Emergency Medicine physician, alongside Dr. Michael Hobbs, AI educator and Direct Primary Care pediatrician, and will feature special guest speakers throughout!

🗓️ Session #1 kicks off March 25: This first session will focus on practical ways to start incorporating AI today, featuring live demos and featured tools!

We’ll break down:

👉 How you can use AI for clinical documentation to actually save time
👉 A simple framework you can use to evaluate AI outputs immediately
👉 How to recognize AI failure modes in medical text before they affect patient care
👉 And Graham and Michael's personal AI toolkits and best practices

Clinicians: This is our moment to stay ahead of the curve, learn with peers, and level up so you can shape how AI shows up in medicine. A huge thank you to our sponsor Evidently for helping us bring practical AI education to clinicians!

🗓️ March 25: RSVP to claim your spot

Introducing: Office Hours With Graham!

What’s your biggest question about AI or the future of medicine?
We’re introducing something new: Office Hours with Graham, a special new series where Graham will answer all your open and honest questions about:

👉 How AI is changing medicine
👉 How to deploy technology to fit clinician workflows
👉 How to practice a career in entrepreneurship and medicine
Or anything else that’s on your mind!

As an Emergency Medicine physician, AI leader, and 2x startup co-founder, if you’re wondering about it, Graham has probably lived it firsthand. So you can either: watch this video and drop your questions in the comments, reply with your question directly to this email, or you can email a voice note to [email protected] so we can feature your question on Office Hours and the How I Doctor podcast. We can’t wait to hear from you!

Inside the First Autonomous AI Prescription Program w/ Doctronic’s Dr. Byron Crowe

It's the debate taking over healthcare: Should AI be able to renew prescriptions fully autonomously?

The minute Doctronic partnered with Utah to launch the first autonomous AI prescribing program in the country., we knew we had to have Dr. Byron Crowe on How I Doctor. This week, we were thrilled to welcome him to the show! 👏

Dr. Crowe is an internal medicine physician, former Harvard Medical School faculty member, and the Chief Medical Officer of Doctronic, the company behind the nation’s first state-approved program allowing AI to renew prescriptions autonomously. In this episode, he sits down with Graham to unpack this new category of care delivery. They break down:

👉 How the Doctronic team partnered with Utah regulators to launch the first autonomous AI prescribing program
👉 Why Byron believes AI won’t replace physicians, but will instead reassign us toward higher level work that requires human judgment and moral agency
👉 The hard question most AI companies avoid: Who’s liable when AI gets it wrong?
👉 Whether Utah represents the start of a national shift in care delivery or an experiment the medical establishment may try to stop

👀 If you’ve been wondering what cutting edge AI that pushes the boundaries of clinical care actually looks like in practice, this conversation pulls back the curtain.

🎧 Out now! Listen to the full episode

Physician Spotlight: Dr. Yair Saperstein

5 questions with Dr. Yair Saperstein, the internal medicine and clinical informatics physician who is also the co-founder and CEO of Avo, the company building AI-powered clinical copilots for your EHR. (thank you for the previous nomination, Dr. John Dayton!)

1. Yair, what would you tell a first-year resident that no one told you? You might find yourself in a system that treats you like a cog, but you've got the tools, the wherewithal, and now the domain knowledge to fix it from the inside. I've seen docs burn out when they collapse their whole self into the white coat, because they're stuck in a system they can't control. And I've seen docs thrive by embracing and driving what they can actually change.

Fix what's broken. Work together. Find your thing and get after it. You don't need anyone's permission. As Nate Gross told me years after my residency: no one got fired for building something to help their workflow.

2. Forget pizza parties — what's one way you've coped with burnout that's actually made a difference? Building. Not just building a product, but building with people toward something real. Clicking through meaningless documentation while watching patients fall through gaps I could see clearly but had no power to fix = no power to control something that was a major part of my life. My response was to start building: I helped implement a two-way communication system to replace pagers, worked on informatics infrastructure, started a wellness committee. Projects that made an actual dent. And eventually co-founding Avo, putting AI copilots directly into the EHR, because that let me drive the system from the inside out.

Building gave me back a sense of authorship over my work and a feeling of control over something that mattered. And then there's the stuff that keeps me human. I played in a jazz band during residency, started an open mic night, did a lot of ocean swimming. Real life outside the hospital.

3. AI just prescribed medications autonomously in Utah — should doctors be scared or embrace this? Embrace it. Autonomous prescribing for renewals in a narrow, well-defined scope is exactly the right place to start with agentic AI. Docs today are often already just querying OpenEvidence and following through, and Dr. Oz shared at HIMSS that the focus this term is getting every Medicare patient access to agentic AI.

Automate what should be automated. There will always be a need for connection, emotion, and the conversation that makes a patient actually trust the plan and follow through on it. The real concerns around data security deserve serious attention. But that infrastructure will keep maturing and we're headed in the right direction.

4. What's one under-the-radar AI tool that's made the most impact on your practice and why? When I first used Avo as a hospitalist to auto-draft my progress notes and discharge summaries, I thought: I'm never seeing a patient again without this. It was better than what I would have written, I wasn't missing anything, and it was already surfacing MCG recommendations and CDI flags so I wasn't getting calls from my CDI specialists after the fact.

Once you have the tools you actually need as a clinician, your whole relationship to the broken parts of the system changes. And separately, I think physicians building their own AI workflows is one of the most underrated trends in medicine right now. It's going to change who gets to shape clinical software. If you haven't tried vibe coding yet, try it. The barrier is much lower than you'd expect.

5. Who do you want to nominate for the next physician spotlight? Dr. Nisha Mehta. She's built one of the most important communities in medicine, helping physicians find meaning, income, and identity outside the traditional box. What makes her stand out is how she does it. She navigates enormous complexity with grace and genuine understanding, moves mountains, and builds community while actively encouraging others to build too. That combination is rare. Everything she does pushes back against the idea that being a doctor means sacrificing everything else. That story deserves a spotlight. Nisha, you're up.

Know someone else who should be featured? Reply or tag them and their company in the comments!

3 Things to Read This Week

Yann LeCun Raises $1 Billion for AI That Understands the Physician World (Wired) 
Meta’s former chief AI scientist’s new startup AMI aims to prove that human-level AI will come from mastering the physical world, not language. See Graham’s prior interview with him back in February here!

What Americans Sacrifice Due to High Healthcare Costs (Axios)
Here is the share of U.S. adults who say they postponed life events in the past four years due to health costs, according to a new survey.

Physician Workforce Projections 2023-2038 (HRSA Health Workforce)
Across all physician specialties, there is a projected shortage of 141,160 full-time equivalent physicians in 2038, and 30 out of the 35 physician specialties are projected to have shortages. See the full data set.

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.

🤔 Interesting read, Oanh Nguyen
Dr. Oanh Nguyen penned a provocative essay entitled “How Good is your Doctor? Medicine Doesn’t Know” arguing that our system does not have a clear, shared definition of what makes a doctor good. Read it here.

❤️ Beautiful words, Gigi Magan
Dr. Gigi Magan shared a heartfelt tribute for International Women’s Day, sharing her personal story of becoming a physician and AI leader and why we need more representation in medicine. Read it here.

✅ Great work, Aditya Jain
Dr. Aditya Jain traveled to Washington as a Harvard Medical School representative for the 2026 AMA Medical Student Advocacy Conference to advocate for PBM Reform, NIH funding for healthcare innovation, and reforming residency loans. See his post here.

🎉Congratulations, Dave Schneider (h/t Dr. Joel Gordon)
Dr. Dave Schneider was named Associate Chief Medical Information Officer at UW Health, with a focus on Procedural and Specialty Medicine. Congratulate him here.

🗓️Don’t miss it, Arlen Meyers
Dr. Arlen Meyers is hosting an engaging online event entitled “The Future of Medicine Won’t Build Itself: Why Physicians Belong in Venture” with speaker Dr. John Shufeldt. RSVP here.

🎊What an honor, Ashley Beecy
Dr. Ashley Beecy was included on Reuters’ Trailblazing Women in Healthcare list for her work at Sutter Health. See it here.

🎉🥳 Congratulations, Chanchal Yadav
Dr. Chanchal Yadav has stepped into the role of Chief Medical Officer at Arizona Complete Health. Congratulate her here!

Be Sure to Sign Up for Offcall!

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