Welcome back to On/Offcall!

This week, How I Doctor truly packed a punch. Graham sat down with Dr. Sanjay Divakaran, Associate Chief of Cardiovascular Medicine at Brigham and Women’s Hospital. He’s a highly accomplished cardiologist and also one of the wisest voices we’ve ever heard about how to still enjoy a successful career in medicine today.

Sanjay made a very astute observation, which frankly, is the perfect encapsulation of why we started Offcall in one quote:

“In some ways, medicine is so obsessed with data — until it comes to your career. Then all of a sudden, it’s a data-free zone.”

They covered:
- Why we need more transparency about salary and productivity benchmarks
- How to better understand your personal success metrics in medicine
- Why evaluating job offers and choosing a job is still a "black box"
- The importance of finding a board of mentors

And much more! For anyone navigating a first attending role, or if you’re just feeling lost, angry, or seeking more meaning in your own work, this episode is filled with practical career insights that will help you validate what you’re going through and also steer you toward solutions. Big thanks to Sanjay, and please let us know what you thought of the episode. Reply directly or add a thought in the comments to spark the conversation: Do you agree with Sanjay’s observation above? 🤔

Listen to the episode →

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Most Talked About On Offcall

Physician Builder Spotlight: Jake Kantrowitz

After the incredible response we received to our post about why more physicians should start companies, we’re shining a 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. This week, meet Dr. Jake Kantrowitz, Co-founder / Chief Medical & Scientific Officer at River Records. Connect with Jake on LinkedIn and learn more about his company here.

1. Jake, why did you decide to become a physician-entrepreneur? In the four years I spent studying to get my PhD in bioinformatics, I learned a lot about how to get things done. But much of my work was in failed computational experiments that led to more questions than answers. When I returned to clinical work, I realized that medicine can’t leverage the data it has for almost anything outside immediate clinical use. Genomics, if done at scale, has the potential to just break medicine. We are drowning in data. I want to help solve that problem, and prepare medicine for the future, which I thought would be accomplished best through entrepreneurship.

2. Tell us what your company does. Medicine has a data problem — there’s too much of it and not enough actionable information. The EHR was supposed to modernize medical documentation, but instead, it mimicked the structure of paper charts, preserving their inefficiencies without leveraging the power of digital tools. The result is a problem called information chaos. Clinicians have access to massive amounts of data, but because of redundancies, disorganization, and errors, they struggle to find the info they need, which can interfere with providing high-quality care. At River Records, we’re tackling this problem by developing clinical information management solutions that do more than transcribe notes faster. Our flagship product, Stream, is an ambient scribe that both generates documentation and also organizes it by medical problem, so that key information is structured and accessible, not scattered across the chart. We’re fundamentally improving how clinical information is managed and used over time.

3. What’s your advice for any physician considering entrepreneurship? In medicine, fix what you see is broken, whether it’s through traditional entrepreneurship, or intrapreneurship. But before you try to fix a clinical problem, make sure there’s someone willing to pay for the solution. Essentially, make sure there’s a customer for your solution.

4. What’s a surprising lesson you’ve learned from building? It will take you places you never imagined. You start out with an idea — “oh wouldn't that be cool.” Then you start to build that idea and grow your team, and all of a sudden you've created this thing that didn't exist before.

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

Gen Z increasingly listens to peers over doctors (Axios)
See how many say they disregard physicians’ medical advice over other sources.

How belief in science differs by political leaning (Issues in Science & Technology)
Survey data shows the divide that’s emerged over trust in science.

The hospital financial house of cards (Medpage Today)
“Any further cuts will cause the entire house of cards to collapse.” Must-read from Chris Van Gorder, plus see additional commentary from Ann Richardson here.

🚨Calling All Digital Health Builders: Neat Opportunity Alert

Two exceptional physician builders are teaming up for an event you won’t want to miss! Dr. Jay Parkinson and Dr. Paulius Mui invite you to apply for an opportunity to recharge in the mountains, learn more about digital health, and network with 12 fellow healthcare founders and builders who are interested in making a real impact and changing our healthcare system:

🗓️ June 25-29, 2025
🌎 Boulder, Colorado
🏔️ Apply to join here: https://luckysage.co/

Learn more from Jay here and Paulius here. Stop what you’re doing. Go apply!

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.

🎙️ Great pod listen, Kedar Mate and Don Berwick
On the latest episode of Turn on the Lights Podcast, Dr. Kedar Mate and Don Berwich talk with Dr. Dhruv Khullar about how funding cuts could jeopardize scientific innovation. Listen here.

📚 New publication alert, Hashem E. Zikry
Dr. Hashem E. Zikry published a new article with Dr. Austin Kilaru about the role of EM within the hospital-at-home movement. Learn more here and praise from Dr. Alexander Tran here.

🎙️ Another hot pod, Anwar Jebran
Dr. Anwar Jebran and Dr. Matt Sakumoto released a new episode of the ACP+Innovation podcast with Dr. Yair Saperstein. Great episode, check it out here.

👍 Well done, Joel Bervell 
Dr. Joel Bervell won a Peabody Award for his series, “What Does Racial Bias in Medicine Look Like?” Congrats!! Learn more here.

👏 Congrats, Justin Yang
Dr. Justin Yang became a fellow of the American College of Occupational and Environmental Medicine. Learn more here.

📚 New book alert, Kim Downey
Physician wellness advocate Kim Downey’s new book “Stand Up (For) Doctors” is coming soon! Read all about it here.

❗Important work, Shawn Martin
The American Academy of Family Physicians is launching a new initiative to bolster the Family Medicine residency selection process. Read all about it from Shawn Martin here.

🎉 Mazel tov, Andrew Becker
Dr. Andrew Becker proposed to his girlfriend at the Boston Marathon finish line! Congrats to the happy couple, and see it here.

🤔 Provocative insight of the week, Graham Walker
Graham’s insights about doctors and AI is making the rounds on social media and will truly make you think. Read it here.

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