Welcome back to On/Offcall!

🚨 Dr. Vivek Garg has spent his whole career trying to answer one question: Why don’t all patients get the care they deserve in the U.S. system?

He recently stepped into the CEO role of the National Committee for Quality Assurance (NCQA), the nation’s leading organization defining what “quality” in healthcare actually means. As only the second president in the organization’s history, he opened up to Offcall co-founder Dr. Graham Walker in a timely How I Doctor interview about his big plans for the future, what he believes it will take to finally bring quality care to every American regardless of zipcode, and how he believes AI will reshape the foundation of how we measure outcomes in medicine.

Together, they break down:

👉 How a quality measure actually moves from research to national requirement
👉 Why many measures feel disconnected from the patient in front of us
👉 The structural challenges facing independent practices
👉 How “measure sprawl” creates burden instead of better care
👉 Where AI could meaningfully improve outcomes, and where it won’t
👉 How physicians can engage with (and influence) the quality process

👀 Quality metrics undoubtedly shape your daily workflow, your bonus, and your reputation, and physicians deserve a voice in where it goes next.

🎧 Listen to the full episode here

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Most Talked About On Offcall

Physician Builder Spotlight: Dr. Mansi Kotwal

4 questions with pediatrician, allergist/immunologist, and Assistant Professor of Pediatrics at Children's National Medical Center, Dr. Mansi Kotwal.

1. Mansi, what do you think the public most misunderstands about being a physician in 2026? I think the public, especially right now, misunderstands the intent of healthcare providers. There’s a lot of mistrust in science communities at this time. Physicians tend to go into the healthcare profession because they truly want to make a difference in people’s lives in whatever way that is – whether it’s in primary care, speciality care, or surgical care. We want to make people feel better, help them, and keep people healthy. And if that bottom line is understood, and also believed and seen by the public, I feel that would be a great first step in managing this epidemic of mistrust.

2. What would you tell a first-year resident that no one told you — but should have? I was fortunate enough to do residency in Washington D.C. where I did get my share of teaching and eye-opening conversations about this: But I feel it is very important for young medical students and residents to understand that so much of what we can do to help patients is not under our control. Policy, insurance, funding, prior auth, and now unfortunately politics and social media, all play a huge role in our daily lives and can help, but often hinder, what we want to accomplish when it comes to addressing the needs in the lives of our patients. I feel that understanding this, and being able to navigate it, are a huge part of doctoring.

3. What’s the hardest part about being a physician that you think should be talked about more openly? Taking work home. As much as we want to believe that we can create a fine line between work and home, I think it is harder to do in our profession. It may be notes, emails, or patient call backs. If one is lucky enough to never have to bring those home, what sometimes can't be helped is the emotional aspects of the day. Maybe you’re thinking about someone you had to give bad news to. Maybe someone is crying in your office because they’ve seen so many doctors and no one seems to help them figure out what is going on. Maybe someone is frustrated because the medication they need is not covered by their insurance and they can’t afford the out of pocket cost. 

All of these things happen at various levels on a daily basis. It’s hard not to think about this on your drive home, at dinner, or when you sleep at night because we are humans. This is part of doctoring, and there is beauty to be able to empathize with families. It’s also important to know that we are human and need to learn how to handle these stresses in a healthy way so we can move forward and continue to do the work we do.

4. What is one thing you wish your patients would ask you more? I wish more parents or caretakers would ask the question: What would you do if this were your child? For me, this question usually comes up from a parent in the context of someone coming in with a significant worry about what is happening to their child. And it comes up after I go over a lengthy discussion of the science, in the context of trying to make a joint decision about the next best steps based on their level of concern and what they are comfortable with. 

When someone asks me this, I feel we have reached a level of trust, and I notice that whatever I say, it usually puts the parent at ease and in a place where they trust my judgment. I think it is so important to put ourselves in their shoes and bring up anything relevant that I may have experienced as a parent.

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

4 Things to Read This Week

A Large Language Model for Complex Cardiology Care (nature medicine)
“Overall, subspecialists preferred AMIE-assisted cardiology assessments 46.7% of the time, compared with 32.7% for cardiologists alone”

How Health Systems Are Competing with AI Search Tools (Healthcare Brew)
It’s the ultimate showdown: Hospital vs. Dr. Robot.

This Doctor Is Training AI to Do Her Job, and It’s a Booming Business (CNN)
“Dr. Alice Chiao used to teach emergency medicine to students at Stanford University’s medical school. Now, she’s teaching artificial intelligence-powered chatbots to think, diagnose and prescribe like her.”

Fat Signing Bonuses, and Concierge Service, for Family Doctors (NYTimes)
In a country where a quarter of the population lacks a family doctor, Canadian communities compete in a zero-sum battle to recruit family doctors.

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.

📹 Go and watch the video, Corinne Rao
Dr. Corinne Rao joined Dr. Kevin Pho to discuss why the traditional model of “physician on-call” compensation is a primary, yet rarely discussed, driver of burnout. Watch it here.

🎙️ Listen to the podcast, Joshua Liu
Dr. Joshua Liu joined Mark Bonta on the Ditch the Labcoat podcast to discuss what it actually takes to deploy healthcare AI and digital care journeys in health systems. Listen here.

⭐ Thanks for highlighting, John Dayton
Dr. John Dayton attended the ViVE conference in Los Angeles and summarized some of the key takeaways as it relates to physicians and the conversations impacting the clinical workforce there. Check out his recap post here!

‼️ Go and check out their conference, Nabla
On March 18, the Nabla team is hosting a 1-day virtual event examining how AI is reshaping care delivery, featuring a keynote fireside chat with Yann LeCun plus leaders from Cedars-Sinai, Stanford ARISE, UCLA Health, and M Health Fairview. Learn more and get registered for the event here.

👏 Well done, Michał Nedoszytko
Dr. Michał Nedoszytko finished in the top 3 out of 13,000 submissions at Anthropic’s recent hackathon, for the creation of PostVisit.AI, an AI-based system that guides the patients after they leave the doctor's office. Well done! Learn more here.

🎉 Congratulations, Arvind Ravinutala
Dr. Arvind Ravinutala has been appointed Associate Program Director for the Internal Medicine Residency Program at Adventist Health White Memorial. Learn more here.

🎉 🥳 Also congratulations, Charlene Wong
Dr. Charlene Wong is starting as Chief Clinical Officer at Pediatric Associates Family of Companies! Learn more and congratulate her here. 

🎉 👏 🎊 Still more congratulations, Ainsley MacLean
Dr. Ainsley MacLean was invited as the 2026 Distinguished Alumnus for this year's Mass General Brigham Radiology Hamptons-Abrams symposium and to deliver the keynote address on the AI-Augmented Radiologist. Love to see it!

🎉 🥳 🎉 🥳 More career news, Paresh Shah
Dr. Paresh Shah is starting a new position as Executive Vice President Eastern Market Cornell Sphere at NewYork-Presbyterian Hospital. Congratulate him here.

🎙️ And finally, go and listen to their podcast, Graham and Resa Lewiss
Graham appeared on Dr. Resa Lewiss’s podcast Visible Voices in an episode to discuss his work at Offcall, MDCalc, and using AI to keep doctors bedside. Listen to it here.

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