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Latest articles
Health technology
A patient called my office at 9 p.m. on a Tuesday. She had a UTI. She knew she had a UTI. She'd treated the same thing twice before that year and could probably have diagnosed it faster than a med…
A patient called my office at 9 p.m. on a Tuesday. She had a UTI. She knew she had a UTI. She’d treated the same thing twice before that year and could probably have diagnosed it faster than a med student. What she needed was a one-minute conversation and a prescription. What she got was my voicemail, a suggestion to call back in the morning, and an appointment slot 17 …
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Why medicine is late to asynchronous telehealth
Health technology
My patients don't wait for me anymore. That's not a complaint. It's a clinical reality I had to sit with before I could do anything useful about it. Patients started arriving at appointments having already run their symptoms through an…
My patients don’t wait for me anymore. That’s not a complaint. It’s a clinical reality I had to sit with before I could do anything useful about it.
Patients started arriving at appointments having already run their symptoms through an AI chatbot. Sometimes they’d decided not to come in at all. Sometimes they were right. Sometimes they weren’t. I’ve spent the last several years building an AI-assisted triage and treat virtual …
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AI chatbots and patient safety need physician design
Health technology
For more than 25 years, I built physician extension systems. In rural family medicine, if you want your clinical judgment to reach more patients than your two hands can touch in a single day, you build systems. You hire nurses…
For more than 25 years, I built physician extension systems. In rural family medicine, if you want your clinical judgment to reach more patients than your two hands can touch in a single day, you build systems. You hire nurses who triage, educate, and even scribe. You bring on a medical assistant who keeps the workflow moving. You eventually collaborate with a nurse practitioner (NP) or physician assistant (PA) who …
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How artificial intelligence scales physician extension
Physician voices
Artificial intelligence is no longer approaching medicine. It is already embedded inside it. It drafts our notes. It summarizes research. It suggests differentials. It triages messages. It promises efficiency, scale, and relief from burnout. Physicians are adopting it quickly. That…
Artificial intelligence is no longer approaching medicine. It is already embedded inside it. It drafts our notes. It summarizes research. It suggests differentials. It triages messages. It promises efficiency, scale, and relief from burnout. Physicians are adopting it quickly. That speed should give us pause.
The greatest threat facing physicians in 2026 is not resisting artificial intelligence. It is allowing artificial intelligence in health care to be designed without us. Every …
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AI governance in health care: Why physicians must lead the design
Health technology
I have spent my career practicing medicine in the real world: caring for patients, managing uncertainty, and making decisions where the stakes are personal and immediate. In recent years, I have also spent considerable time designing and deploying medical software…
I have spent my career practicing medicine in the real world: caring for patients, managing uncertainty, and making decisions where the stakes are personal and immediate. In recent years, I have also spent considerable time designing and deploying medical software that uses artificial intelligence in live clinical environments. Together, these experiences have reshaped how I think about the future of our profession.
That combination of experiences has led me to a …
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AI in medicine: Why it won’t replace doctors but will redefine them
Health technology
When I trained in medicine, the learning path was predictable. Long nights of memorizing anatomy. Standing beside seasoned physicians in hospital hallways. Slowly absorbing the craft of diagnosis through repetition and proximity. It was an apprenticeship built on pattern recognition,…
When I trained in medicine, the learning path was predictable. Long nights of memorizing anatomy. Standing beside seasoned physicians in hospital hallways. Slowly absorbing the craft of diagnosis through repetition and proximity. It was an apprenticeship built on pattern recognition, intuition, and accumulated wisdom.
What I did not learn was how to practice medicine in a world increasingly shaped by artificial intelligence. That education came much later. It arrived quietly at …
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Why AI in medicine elevates humanity instead of replacing it
Physician voices
As a physician, I spent years training to care for patients, only to realize by the time I completed my education that I wasn't truly in control of my career. Like so many of us, I had been funneled into…
As a physician, I spent years training to care for patients, only to realize by the time I completed my education that I wasn’t truly in control of my career. Like so many of us, I had been funneled into a rigid system that pushes physicians toward employment with large health care systems rather than allowing for independent practice or entrepreneurial ventures. It felt like I had been herded—herded by …
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Systemic collusion: How big business and government herd physicians into traditional employment
Physician voices
According to the 2024 Doximity survey, the average annual compensation for a family physician is around $300,813. For 90 percent of family doctors, this is their reality—stuck in the matrix of traditional employment. They feel unloved, undervalued, and used by…
According to the 2024 Doximity survey, the average annual compensation for a family physician is around $300,813. For 90 percent of family doctors, this is their reality—stuck in the matrix of traditional employment. They feel unloved, undervalued, and used by the system to feed the corporate cash register. I know because that is what I did for the first 15 years of my career. However, I discovered a better …
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Rewriting the rules: Achieving a million-dollar income in family medicine
Physician voices
In our journey as physicians, the traditional narrative often presents a seemingly binary decision: you must choose between seeking employment within a hospital or health care institution or venturing into the challenges of establishing a private practice. However, this oversimplified…
In our journey as physicians, the traditional narrative often presents a seemingly binary decision: you must choose between seeking employment within a hospital or health care institution or venturing into the challenges of establishing a private practice. However, this oversimplified dichotomy fails to capture the evolving landscape of health care entrepreneurship, particularly the emergence of a third, less conventional path – that of the single-member professional micro-corporation.
The myth of the …
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Dismantling the mythical dichotomy of physician career options
Physician voices
Many of you prioritize the clinical aspects of our profession, but understanding the business side of medicine is equally crucial. One key area to consider is your contract, as it can significantly impact your career path and financial stability. I…
Many of you prioritize the clinical aspects of our profession, but understanding the business side of medicine is equally crucial. One key area to consider is your contract, as it can significantly impact your career path and financial stability.
I believe it’s essential for every doctor to be knowledgeable about the variety of contracts they may encounter in the marketplace. The most common type of contract is the business-to-individual contract, where …
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The hidden menu of physician contracts
Physician finance
Chance meeting In the fast-paced world of medicine, characterized by long hours, administrative burdens, and burnout, I'd like to share a story about an OB/GYN physician who discovered a path to professional freedom that revolutionized his career. Dr. B.A. had…
Chance meeting
In the fast-paced world of medicine, characterized by long hours, administrative burdens, and burnout, I’d like to share a story about an OB/GYN physician who discovered a path to professional freedom that revolutionized his career. Dr. B.A. had spent almost a decade working as a W-2 employee after finishing his residency. However, just before committing to a new contract with a substantial $500,000 annual salary, he came across an …
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Physician employment 2.0: Unveiling the secret world of employment lite
Physician finance
Change is a constant in the medical field, and one significant shift that's been shaking up the world of health care employment is the reform of non-compete contracts. Understanding the implications of these changes is crucial to every doctor. I…
Change is a constant in the medical field, and one significant shift that’s been shaking up the world of health care employment is the reform of non-compete contracts. Understanding the implications of these changes is crucial to every doctor. I believe it’s important for you to grasp what the new non-compete contract reforms mean and how they might affect your career.
During the first 15 years of my career as a …
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Freedom to roam: Breaking down the boundaries of non-competes
Physician finance
As a dedicated professional, your work is incredibly challenging as you strive to maintain your primary focus on providing excellent patient care. Your inherent business powers that generate revenue make you a highly valued asset in the health care marketplace.…
As a dedicated professional, your work is incredibly challenging as you strive to maintain your primary focus on providing excellent patient care. Your inherent business powers that generate revenue make you a highly valued asset in the health care marketplace. This is why many large corporations have offered financial incentives for you to join their employed workforce. As a result, you can expect a predictably substantial paycheck deposited regularly into …
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Tax tips for employed doctors: the allure and hazards of safe harbors
Physician voices
A recent post on KevinMD resonated with me, probably because I am a doctor who grew up in a rural area and returned to a small-town practice in my home county. Like the author, I experienced the suffocating grip of…
A recent post on KevinMD resonated with me, probably because I am a doctor who grew up in a rural area and returned to a small-town practice in my home county. Like the author, I experienced the suffocating grip of traditional hospital employment as it slowly drained the life out of me.
Before burnout consumed me, I took proactive steps to start a micro-corporation and transitioned
…
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I discovered the Holy Grail for doctors
Physician finance
The medical profession has long been associated with intense personal commitment and time-consuming work. However, in recent years, a new concept called job stacking has emerged, and it is revolutionizing the way physicians work. In this post, I will explore…
The medical profession has long been associated with intense personal commitment and time-consuming work. However, in recent years, a new concept called job stacking has emerged, and it is revolutionizing the way physicians work.
In this post, I will explore the concept of job stacking for doctors, discuss its benefits, and provide guidance on how to implement it effectively.
What is job stacking?
Job stacking is the practice of working multiple jobs in …
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Job stacking for doctors: a modern approach to work-life balance
Physician voices
The majority are wrong. Is it possible that the growing majority of doctors are mistaken in their decision to choose traditional employment? How is it that the most intelligent group of individuals on earth can be influenced to believe that…
The majority are wrong.
Is it possible that the growing majority of doctors are mistaken in their decision to choose traditional employment? How is it that the most intelligent group of individuals on earth can be influenced to believe that being confined to traditional employment is in their best interest, especially when the burnout rate is approaching almost 60 percent?
Don’t follow the herd.
In a world where the “herd mentality” often prevails, …
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20 reasons every resident should form a micro-corporation
Physician finance
The broken status quo The hard, cold truth is that half of you will end up teetering on the same burnout cliff that I found myself looking at a decade ago. It's a painful abyss, and many of you will…
The broken status quo
The hard, cold truth is that half of you will end up teetering on the same burnout cliff that I found myself looking at a decade ago. It’s a painful abyss, and many of you will experience it.
The status quo of resigning ourselves to accepting that half of the brightest and most altruistic humans on Earth will be injured and harmed by the current health care system …
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It’s time for every doctor to start a professional micro-corporation
Physician voices
There was a time when one doctor worked one job in one geographic location where he/she was altruistically dedicated to serving a population in the practice of medicine. For years this idea of working one job in one location was…
There was a time when one doctor worked one job in one geographic location where he/she was altruistically dedicated to serving a population in the practice of medicine.
For years this idea of working one job in one location was anchored within the private practice model which then gave way to the traditional employment model. The latter offered a parallel promise of a stable and long-term medical practice in one location—with …
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Revolutionizing physician work: Embracing location-independent careers and professional micro-corporations for autonomy and success
Physician finance
I have never known a doctor who wasn't interested in bringing more money into their home. There are so many reasons for this that can range from paying off large loans to the costs of having children (nannies, sitters, private…
I have never known a doctor who wasn’t interested in bringing more money into their home. There are so many reasons for this that can range from paying off large loans to the costs of having children (nannies, sitters, private schools, college, weddings, etc.) to the growing sense that your employer undervalues you.
Regardless of your reason, most of you will attempt to fill this void by working harder or by …
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How to retain more of your hard-earned money
Physician finance
My son is a fourth-year medical student, and we have had some great discussions about credit cards recently, including their benefits. I believe this information would be helpful for all medical students to consider. As a student my son once…
My son is a fourth-year medical student, and we have had some great discussions about credit cards recently, including their benefits. I believe this information would be helpful for all medical students to consider.
As a student my son once preferred to use a debit card or cash to keep his expenses controlled. This financially conservative approach is what he was taught during his young adult days in our home. Avoidance …
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4 reasons you need a credit card in medical school
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