Welcome back to On/Offcall!

Wow, thank you so much to everyone who’s listened, commented, and shared my interview with Mark Cuban this week – truthfully, I’m blown away by the outpouring of support!

Ever since launching the How I Doctor podcast, this was one of the interviews I wanted to do most, for two reasons: 1) Mark has disrupted the pharmacy world with Cost Plus Drugs by leaning on transparency and trust, and that’s exactly what we’re doing with physician compensation at Offcall; 2) He’s real, sharp, and might be the only person who actually enjoys healthcare complexity, and I knew he’d have a lot to say about what’s broken in healthcare (and boy was I right!).

As I shared on LinkedIn about the interview, most times when doctors complain about things like prior auth, pricing, or middlemen sucking value out of the system, people tune out, but Mark leaned all the way in. I’m grateful he’s using his voice and leadership in this way. 

If you haven’t had a chance to listen yet in full, I’m relinking the interview below – and please do add your comments or reply to this newsletter directly with your reaction (I read them all!). Also, I’d really appreciate it if you can also take 10 seconds to share the interview on social media and forward this newsletter to any other friends or colleagues to help spread the word. 

Finally, something I don’t want to get lost in the shuffle: This week we also released a MAJOR product upgrade for Offcall! After signing up for free, any physician can now get a detailed and personalized compensation assessment that benchmarks where you stand with your current job and displays your colleagues’ aggregated data to compare to as well. It’s truly the world’s first physician-driven data set around work and pay, and the data is already helping certain physicians negotiate higher salaries. 

If you haven’t already done so, I’d love for you to create an account, take a spin through the new tool, and let me know your feedback.

Graham Walker, MD, Emergency Physician

Co-founder, Offcall

How Mark Cuban Would Reform Healthcare If He Were In Charge

With clarity of conviction and a hard-charging spirit, Mark shared his vision for how to fix healthcare on How I Doctor, including the 9 ways he’d reform the system if he were in charge. 👀 Here were a few of his boldest ideas:

Paying doctors more
“Let me just tell you: Doctors are underpaid. When I look at individual bills, like a heart transplant: $25,000. Amount paid to the doctor: $2,200, for literally taking a heart out. If I’m getting a heart transplant, I want that motherf*cking doctor to make $10,000, so that he or she is paying attention, and not worried about getting to the next heart transplant or worried about the patient who’s got a boo-boo.”

Criminalizing insurance practices that screw doctors
“Insurance companies are the worst of the worst of the worst of the worst of the worst. If you look at how insurance plans are designed, it should be criminal. It’s the antithesis of trying to optimize for patient care. If they design a high-deductible health plan and they make it available to somebody with a take-home pay of $25,000, and there's a deductible of $5,000, [doctors] are screwed. Even if the patient is broke as a joke and doesn't have two nickels to rub together, you still have to care for them. That risk of debt default is something [doctors] have to take on and now you're the one also responsible for figuring out a payment methodology if there is one.”

Making medical school 100% free
“Would it be worth it so that we can expand — not only expand, but also make med school free? So you truly get the best of the best as opposed to the best of the people who can either afford it or are willing to take on the debt? If you put me in charge, I’m like, $24 billion is nothing, but it changes the dynamics considerably to improve the quality of care.”

Listen to the full episode below to hear the rest of Mark’s ideas and be sure to share your reaction in the comments about what you thought of the interview.

Listen to the episode →

Most Talked About On Offcall

Physician Builder Spotlight: Dr. Gerardo Guerra Bonilla

Our new series! After the incredible response we received to our post about why more physicians should start companies, we’re shining light on MD-entrepreneurs. Each week, we’ll feature a doctor who’s building a cool product or company that you definitely want to know about. Last week, we talked to Dr. Hillary Lin, Cofounder & CEO of Elevate X Health. This week, meet Gerardo Guerra Bonilla, CEO of Chartnote. Connect with Gerardo on LinkedIn and you can find out more about his company here.

1. Gerardo, why did you become an entrepreneur? Burnout from medical documentation was a big motivator. During residency, I learned firsthand what it’s like to stay after hours in the clinic finishing notes. My first child was born during my intern year, so I had to become super efficient with documentation. That meant creating boilerplate templates, or "dot phrases," for common clinic visits and hospital admissions. By the end of residency, I had accumulated over 1,000 dot phrases. After graduation, I worked at a community clinic and saw how much time clinicians spend charting. I started sharing my templates, and then eventually self-published a book on Amazon with all the content. It became a best-seller. I started selling an electronic version of my templates, and the main feedback I got was that clinicians couldn’t install the software to expand the dot phrases because they lacked admin privileges on clinic or hospital computers. That sparked the idea to build a web application, and that’s how Chartnote was born.

2. What does Chartnote do? Chartnote is an AI-powered documentation platform to make clinical charting easier. Our AI Scribe listens to patient encounters and helps transcribe and structure notes, so that doctors can focus on patient care instead of paperwork. We’re tackling the problem of documentation overload, a leading contributor to physician burnout.

3. What’s your advice for physicians considering entrepreneurship? Don’t be afraid to veer off the traditional path or leave your comfort zone. Medicine trains us to follow protocols and evidence-based guidelines, but entrepreneurship is messy and unpredictable — in a good way. Learn to embrace failure as part of the process, and always stay connected to your “why.”

4. What’s a surprising lesson you’ve learned from building? Realizing that it takes years of hard work to build a successful startup. In the early days, it’s a relentless effort just to keep the company alive. It doesn’t necessarily get easier, but you gain the skills and confidence to tackle bigger problems. The truth is, you won’t always know the right path forward. You just have to keep trying things until something works — and then double down. Having a great team is essential. If you want to move fast, you can go it alone, but if you want to build something great, you need a team.

This Q&A was shortened for the newsletter, but you can read the full-length version here.

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

3 Things to Read This Week

Are physicians at fault for AI errors? (Medical Economics)
How AI tools can actually increase physicians' liability and emotional strain, potentially leading to burnout and medical errors.

After private equity bought practices, what happened to turnover? (Fierce Healthcare)
According to new data, private equity acquisitions fuel rapid growth in head counts, as well as clinician turnover.

Mikhail Varshavski (aka Dr. Mike) takes on anti-vaxxers (Jubilee Media)
A masterclass on how to communicate and handle challenging conversations. Here’s a great summary from Graham.

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.

👏 Congrats, Alex Dummett
Dr. Dummett started a new role as Chair of the Scientific Session for the 2025 Conference of the American College of Artificial Intelligence and Medicine. Learn more here.

📝 Great perspective, Mario Amaro
Insightful reflections from Dr. Amaro about how physicians can remain independent. Read here.

😉What’s hot in health tech, featuring John Dayton
Dr. Dayton shares 3 of his favorite things in the healthcare innovation world today (we’re a little biased here! 👀). Read his list here.

💭Food for thought, Johns Hopkins Bloomberg School of Public Health
Researchers found that physician-owned hospitals negotiate 18% lower prices for outpatient procedures compared to other hospitals in the same market. Good writeup from Lawson Mansell.

👏Well said, Eric Arzubi
Dr. Arzubi shared why more psychiatrists need to band together rather than compete, for the long-term health of the profession. Read it here.

🎉 Fun conference, NextMed
Graham’s writeup from #NextMed25, featuring some powerhouse physicians!

Be Sure to Sign Up for Offcall!

New to 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 — enabling them to advocate confidently for themselves and ensure your compensation truly reflects your worth. Our new product is getting rave reviews!

Learn more and sign up here

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