Dr. Rana Awdish Almost Died as a Fellow. Now She's Teaching Doctors How to Heal.

How Stanford Health Care Is Rethinking What AI Should Actually Do for Clinicians with CIO Dr. Michael Pfeffer

Dr. Michael Pfeffer is Stanford Healthcare's Chief Information Officer and a practicing hospitalist, which means he builds AI tools in the morning and uses them on patients that afternoon. That combination is rarer than it should be, and it shapes everything about how he thinks. Stanford is one of the most AI-forward health systems in the country. It runs 1,500 software applications, has put generative AI into the hands of its clinicians through ambient documentation and a plain-language chart querying tool called ChatEHR, and has published the outcomes of all of it, including the parts that did not go as expected. Mike's argument is that none of that is the point. Healthcare spends three times more on AI than any other industry, and most of that investment is going toward automating processes that were broken to begin with. Digitizing the way medicine has always been done is not transformation. The real opportunity is redesigning what the encounter itself looks like, offloading guideline-driven busywork to agents that can own it, and building toward a world where the right test is ordered the first time and the right drug is prescribed before the patient leaves the room. In this episode of How I Doctor, Graham sits down with Mike to get into what Stanford has actually built, what the data shows, and what distinguishes a health system that deploys AI responsibly from one that just deploys it. They also get into clinical AI governance, how physicians interact with decision support versus how they should, whether the next generation of trainees is losing its curiosity or still has it, and what Mike's ideal AI-enabled hospital day actually looks like in five years. What You'll Learn in This Episode: * What the difference between digitizing and transforming healthcare actually means in practice * Why healthcare spending more on AI than any other industry may be a sign of lag, not leadership * How Stanford uses the FURM framework to evaluate every AI application * Why the biggest mistake medicine could make with AI is buying a lot of it without understanding the value, and what responsible deployment actually requires * Why Mike is less worried about AI deskilling the next generation of physicians than most and what he saw on rounds last week that gave him confidence 🩺 Offcall is more than a platform — it’s a community. Join today [https://www.offcall.com/]! 📝 For a full transcript of this episode click HERE [https://www.offcall.com/learn/podcast/stanford-cio-michael-pfeffer-ai] 🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315 [https://episodes.fm/1767429315] 👨‍⚕️Follow Dr. Graham Walker on LinkedIn https://www.linkedin.com/in/graham-walker-md/ [https://www.linkedin.com/in/graham-walker-md/] IG https://www.instagram.com/ubergraham/ [https://www.instagram.com/ubergraham/] Bluesky https://bsky.app/profile/drgrahamwalker.com [https://bsky.app/profile/drgrahamwalker.com] ✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe [https://offcall.beehiiv.com/subscribe] 🟧 Follow Offcall on LinkedIn https://www.linkedin.com/company/joinoffcall/ [https://www.linkedin.com/company/joinoffcall/] IG https://www.instagram.com/offcalldotcom/ [https://www.instagram.com/offcalldotcom/] TikTok https://www.tiktok.com/@offcalldotcom [https://www.tiktok.com/@offcalldotcom]

Meet the Doctor Who Went Anonymous to Say What the Rest of Us Can't: The Story of Dr. Orange

Dr. Orange [https://www.tiktok.com/@dr..orange]is a primary care physician, one year out of residency, practicing somewhere in the United States at a health system she can't name. She posts on TikTok as a talking orange, with her face obscured and her voice altered, because showing up as herself would cost her too much. Her employer might find out. Her patients might lose confidence in her. And after years of training and too much debt, she cannot afford either. What she says from behind that mask is not radical. It is what physicians say to each other in workrooms, in parking lots, in group texts that will never see the light of day. That the job is not what they signed up for. That the administrative burden is crushing. That corporate medicine has turned patient care into customer service. That they feel like children being managed by a system that owns them. She said it anyway. Thousands of people have found her. In this episode of How I Doctor, Dr. Graham Walker sits down with Dr. Orange for the most candid conversation about the state of medicine you will hear from a physician who is still inside it. They cover the financial trap that keeps early-career doctors locked in jobs they want to leave, the expectation gap that nobody warns you about before you become an attending, what would actually have to change for her to love her job, and why the anonymous fruit salad of healthcare workers she accidentally created online is one of the most honest signals medicine has produced in years. What You'll Learn in This Episode: * Why physicians who speak honestly about hating their jobs risk their patients, their employers, and their careers, and what it says about medicine that anonymity is the only safe container for that conversation * What the first year of attending life actually looks like when residency ends and the full weight of portal messages, non-clinical requirements, and production pressure lands all at once * How student loan debt and restrictive contracts function as a structural trap that keeps early-career physicians in systems that are making them miserable * Why autonomy, not salary, may be the variable that determines whether the next generation of physicians stays in medicine at all 🩺 Offcall is more than a platform — it’s a community. Join today [https://www.offcall.com/]! 📝 For a full transcript of this episode click HERE [https://www.offcall.com/learn/podcast/dr-orange-anonymous-physician] 🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315 [https://episodes.fm/1767429315] 👨‍⚕️Follow Dr. Graham Walker on LinkedIn https://www.linkedin.com/in/graham-walker-md/ [https://www.linkedin.com/in/graham-walker-md/] IG https://www.instagram.com/ubergraham/ [https://www.instagram.com/ubergraham/] Bluesky https://bsky.app/profile/drgrahamwalker.com [https://bsky.app/profile/drgrahamwalker.com] ✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe [https://offcall.beehiiv.com/subscribe] 🟧 Follow Offcall on LinkedIn https://www.linkedin.com/company/joinoffcall/ [https://www.linkedin.com/company/joinoffcall/] IG https://www.instagram.com/offcalldotcom/ [https://www.instagram.com/offcalldotcom/] TikTok https://www.tiktok.com/@offcalldotcom [https://www.tiktok.com/@offcalldotcom]

Moral Injury Is Why The Best Doctors Are Disappearing with Dr. Wendy Dean

Dr. Wendy Dean [https://wendydeanmd.com/] is a psychiatrist, author, and the co-founder of Moral Injury of Healthcare, a nonprofit dedicated to understanding and alleviating clinician distress. In 2018, she co-wrote a 500-word op-ed in STAT News that did something rare: it handed an entire profession the language for something most physicians had been carrying alone. The argument was simple and devastating. Physicians aren't burning out. That implies a personal failure of resilience. What's actually happening is moral injury, the damage that accumulates when you are repeatedly forced to act in ways that violate your own moral code. That piece started an international conversation that Wendy has been leading ever since, through her book "If I Betray These Words," her podcast 43cc [https://www.43ccpodcast.com/], and her ongoing research and consulting work with health systems around the world. In this episode of How I Doctor, Dr. Graham Walker sits down with Wendy to go deep on what moral injury actually is, why getting the language right matters so much, and what a healthcare system that takes clinician distress seriously would actually need to look like. They cover AI's entry into an already fractured system, the EMR as a cautionary tale the profession is at risk of repeating, and the grief that comes with watching a profession you love get slowly hollowed out. What You'll Learn in This Episode: * Why burnout and moral injury are distinct problems that require fundamentally different solutions, and why naming it correctly changes where responsibility sits * What it actually feels like to be morally injured, and why the absence of a bid to repair a betrayal is often where the real damage sets in * How physicians are trained to be independent thinkers and then placed in systems that give them no authority, no agency, and all of the responsibility * Why Wendy believes AI is walking into the same trap as the EMR, and what the liability question nobody in health law has answered yet tells us about where this is heading * What gives Wendy genuine hope that medicine gets to the other side, and why the grief physicians are carrying right now is also a signal that the fight is not over 🩺 Offcall is more than a platform — it’s a community. Join today [https://www.offcall.com/]! 📝 For a full transcript of this episode click HERE [https://www.offcall.com/learn/podcast/moral-injury-physician-burnout-wendy-dean] 🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315 [https://episodes.fm/1767429315] 👨‍⚕️Follow Dr. Graham Walker on LinkedIn https://www.linkedin.com/in/graham-walker-md/ [https://www.linkedin.com/in/graham-walker-md/] IG https://www.instagram.com/ubergraham/ [https://www.instagram.com/ubergraham/] Bluesky https://bsky.app/profile/drgrahamwalker.com [https://bsky.app/profile/drgrahamwalker.com] ✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe [https://offcall.beehiiv.com/subscribe] 🟧 Follow Offcall on LinkedIn https://www.linkedin.com/company/joinoffcall/ [https://www.linkedin.com/company/joinoffcall/] IG https://www.instagram.com/offcalldotcom/ [https://www.instagram.com/offcalldotcom/] TikTok https://www.tiktok.com/@offcalldotcom [https://www.tiktok.com/@offcalldotcom] Mentioned in this episode: It's all coming together Abridge is hosting its first-ever Keynote, live from New York City and streaming globally for the Offcall community. Join Abridge CEO and Founder, Dr. Shiv Rao, for a presentation on the future of AI in healthcare. Register at https://events.abridge.com/keynote

Now Is Not the Time for Silence. Dr. John Whyte on the AMA, AI, and the Stakes for Physicians Right Now

Dr. John Whyte [https://www.linkedin.com/in/drjohnwhyte/] is a board-certified internist who has spent his career at the intersection of medicine, policy, media, and technology. He served at the FDA, built a reputation as one of medicine's most trusted public communicators at WebMD, and 10 months ago became CEO and Executive Vice President of the American Medical Association, the oldest and largest physician organization in the United States. Whyte came into the role with a candid assessment: the AMA had lost some of its relevance and impact, and needed to become a real force for physicians and patients in Washington again. He's now leading that effort at a moment when the profession is navigating burnout, prior authorization, scope creep, a rapidly shifting AI landscape, and a payment system that fails to make the case for what physicians actually contribute to patient safety and access. In this episode of How I Doctor, Dr. Graham Walker sits down with John to cover what the AMA is focused on right now and why, how AI is already reshaping the way physicians practice whether they're ready or not, and what it means that the efficiency gains from AI tools are largely flowing to health systems rather than back to physicians or patients. They also get into the harder question underneath all of it: who speaks for physicians when the stakes are this high, and what happens to the profession if physicians stay on the sidelines. What You'll Learn in This Episode: * Why physician burnout remains at 40% across the profession and above 50% in emergency medicine and OB-GYN, and why the AMA believes it has to be solved at the systems level * How AI adoption among physicians jumped from 38% to 81% in three years, and why that speed of uptake hasn't translated into more time with patients * Why the real argument for physician payment is not compensation but patient safety and how the public narrative gets this wrong * What the AMA is doing on prior authorization and scope creep, and why those are the two issues where physicians are most aligned across specialties 🩺 Offcall is more than a platform — it’s a community. Join today [https://www.offcall.com/]! 📝 For a full transcript of this episode click HERE [https://www.offcall.com/learn/podcast/dr-john-whyte-ama-ai-physicians] 🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315 [https://episodes.fm/1767429315] 👨‍⚕️Follow Dr. Graham Walker on LinkedIn https://www.linkedin.com/in/graham-walker-md/ [https://www.linkedin.com/in/graham-walker-md/] IG https://www.instagram.com/ubergraham/ [https://www.instagram.com/ubergraham/] Bluesky https://bsky.app/profile/drgrahamwalker.com [https://bsky.app/profile/drgrahamwalker.com] ✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe [https://offcall.beehiiv.com/subscribe] 🟧 Follow Offcall on LinkedIn https://www.linkedin.com/company/joinoffcall/ [https://www.linkedin.com/company/joinoffcall/] IG https://www.instagram.com/offcalldotcom/ [https://www.instagram.com/offcalldotcom/] TikTok https://www.tiktok.com/@offcalldotcom [https://www.tiktok.com/@offcalldotcom]

Dr. Rana Awdish Almost Died as a Fellow. Now She's Teaching Doctors How to Heal.

Dr. Rana Awdish [https://www.ranaawdishmd.com/] is a pulmonologist, critical care physician, and Medical Director of Care Experience at Henry Ford Health in Detroit. She is also the author of In Shock, a book that has changed the way countless physicians walk into a patient's room, and her new book After Shock, which picks up where that story left off. Rana nearly died as a fellow from a catastrophic illness that left her hospitalized in the very system she had trained inside. What she heard, experienced, and absorbed from the other side of the bed became the foundation for a decade of research into how medical language shapes patient outcomes. In this episode of How I Doctor, Dr. Graham Walker sits down with Rana to explore what it actually means to heal, both for patients and for the physicians caring for them. They dig into Rana's Never Words research, published in Mayo Clinic Proceedings, which identifies specific phrases physicians use that strip power from patients and offers concrete alternatives. And they get into the harder questions: how do you build trust with patients, why the data shows compassionate care actually makes clinical visits more efficient, and what it means that medicine has spent decades rewarding physicians for ignoring their own bodies. What You'll Learn in This Episode: * The specific words and phrases from Rana's Never Words list that physicians should stop using, and what to say instead * Why redistributing power through language is not just ethical but changes clinical outcomes including adherence and return visits * Why medicine rewards disembodiment in physicians and what the cost of that has been for trainees, patients, and the profession * What curiosity can do when every other communication tool has run out * Why the culture of medicine is not fixed, and what physicians can actually do to reshape it from within 🩺 Offcall is more than a platform — it’s a community. Join today [https://www.offcall.com/]! 📝 For a full transcript of this episode click HERE [https://www.offcall.com/learn/podcast/rana-awdish-teaching-doctors-how-to-heal] 🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315 [https://episodes.fm/1767429315] 👨‍⚕️Follow Dr. Graham Walker on LinkedIn https://www.linkedin.com/in/graham-walker-md/ [https://www.linkedin.com/in/graham-walker-md/] IG https://www.instagram.com/ubergraham/ [https://www.instagram.com/ubergraham/] Bluesky https://bsky.app/profile/drgrahamwalker.com [https://bsky.app/profile/drgrahamwalker.com] ✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe [https://offcall.beehiiv.com/subscribe] 🟧 Follow Offcall on LinkedIn https://www.linkedin.com/company/joinoffcall/ [https://www.linkedin.com/company/joinoffcall/] IG https://www.instagram.com/offcalldotcom/ [https://www.instagram.com/offcalldotcom/] TikTok https://www.tiktok.com/@offcalldotcom [https://www.tiktok.com/@offcalldotcom]