The New Healthcare

S1E18 AI Is Not Just Theory, It's Practice: How Akshat Paliwal Built a Remote Radiology Company from Scratch

By Dr. Adama Diarra, DO, FACP, DipABOM | CEO & CMO, Diarra Health. Is AI actually changing radiology — or is it just hype? Akshat Paliwal has a definitive answer. As the founder of FlexRad, a remote radiology company built on AI-enhanced workflows, he's not theorizing about the future of medical imaging. He's living it. In this episode, Akshat walks us through his journey from traditional academic and private radiology practice to building a scalable, AI-driven remote radiology business — including what COVID-19 forced him to rethink, the hard lessons of physician entrepreneurship, and why he believes the radiology workforce is at an inflection point that most practitioners aren't ready for. We dig into the practical realities of integrating AI into radiology workflows — not as a replacement for clinical judgment, but as a force multiplier for efficiency, accuracy, and autonomy. Akshat also shares how FlexRad's hybrid model is redefining what a sustainable radiology practice can look like in the age of remote work and intelligent automation. In this episode: * How FlexRad's hybrid remote radiology model actually works * Where AI is delivering real results in radiology workflows today — and where it isn't * The risk profile every physician entrepreneur needs to understand before making the leap * Why referrals and reputation remain the currency of growth even in a tech-forward practice * What the radiology workforce will look like in 5 years — and how to position yourself now Whether you're a radiologist navigating a changing landscape, a physician considering entrepreneurship, or a healthcare leader thinking about AI integration, this conversation will challenge how you think about the future of your specialty. 🔗 Connect with Akshat: linkedin.com/in/akshatpaliwal 🌐 Learn more about FlexRad: flexrads.com 📧 Reach out directly: akshat@flexrads.com [akshat@flexrads.com]

S1E17 The Clinic of the Future with Dr. Holly Tse: What's Broken, What's Next, and How AI Changes Everything PART 2

Episode Summary — Part 2: Clinics of the Future with Dr. Holly Tse The cliffhanger is over. In Part 1, Dr. Holly Tse laid out everything wrong with primary care today. In Part 2, she builds the thing she believes can replace it. Her framework is called the Clinic of the Future — and it starts with a radical proposition: break the visit. Break the PCP. Maybe even break the note. Replace all of it with a continuous flow of care, supported by a trusted multidisciplinary team, standardized clinical protocols, and AI tools that do the heavy lifting so physicians can do what only physicians can do. Dr. Tse introduces two AI agents at the center of her vision: Charlie, a patient-facing empathetic agent available around the clock to listen, coach, and navigate; and Emily, an in-EMR clinical intelligence agent that synthesizes patient data in real time — surfacing rising risk, flagging missed refills, summarizing entire workup histories before you even ask. Together, they represent a shift from reactive, encounter-based medicine to proactive, panel-level care. The conversation gets honest about what stands in the way: a fee-for-service payment model that still rewards discrete visits, clinicians who are skeptical by training, patients who are increasingly transactional, and real HIPAA and liability questions that nobody has fully answered yet. Dr. Tse's position on all of it is grounded — value-based care is the financial engine that makes the flow of care work, and CMS's stated goal of moving all Medicare patients into VBC arrangements by 2030 means the window is closer than it feels. She and Dr. Diarra also go somewhere most healthcare podcasts don't: the future role of the physician when AI can handle the bread-and-butter cases. Dr. Tse's honest read is that physicians who don't evolve toward higher-complexity cognitive work risk being compensated like advanced practice providers — and she thinks that conversation is already happening, just not loudly enough. The episode closes with practical advice for independent and small practice physicians on where to start with AI today: website chatbots for FAQ and scheduling, productivity tools like Claude's Cowork for synthesizing presentations and documents, and a simple guiding question — what keeps you up at night, and can a tool help with that first? If Part 1 was the diagnosis, Part 2 is the treatment plan — specific, ambitious, and delivered by someone who has lived at every level of the healthcare system and still believes it can be redesigned for good.

S1E16 The Clinic of the Future with Dr. Holly Tse: What's Broken, What's Next, and How AI Changes Everything Part 1

What does it feel like when the system weaponizes your own compassion against you? Dr. Holly Tse has a phrase for it — and it stopped a colleague in his tracks: my compassion has been hijacked. In this episode of The New Healthcare, Dr. Tse — dual board-certified internist, former hospital CMO, and founder of Novella Insights — makes the case that primary care isn't just strained. It's past the breaking point. And the only way through isn't another workflow patch. It's a complete redesign. Dr. Tse brings a rare combination to the conversation: 20+ years of frontline clinical experience, a humanities background that shaped how she listens and leads, and a systems lens built from running a 25-clinic medical home program and serving as CMO of an underserved community hospital. She sees the whole elevator — from the individual patient crying in the exam room to the structural forces that put her there in 20 minutes with a quality metric hanging over both of them. In this conversation, she and Dr. Diarra dig into: * Why the clinic of 2026 is still running on a chassis built for 1995 — and why that matters * How physician burnout is a design failure, not a resilience failure * The "Clinic of the Future" framework — using AI and team-based care to protect the human moments that only physicians can deliver * Shared medical decision making as both a clinical skill and a leadership philosophy * What it actually looks like to leave a CMO role to have more influence on the future of medicine — not less If you're a physician wrestling with what sustainable, meaningful practice looks like in the AI era, this episode is for you.

S1E15 The Nephrologist Who Left the System to Save Her Patients—and Herself. With Marilia Campos, MD

Podcast Episode Summary In this episode of The New Healthcare, Dr. Adama Diarra interviews Dr. Marilia Campos, a nephrologist and founder of Optima Kidney Care in Oregon. Dr. Campos shares her journey from employed nephrology practice to opening her own independent clinic after realizing she needed more autonomy, more control over her schedule, and more time with patients, especially after becoming a mother. A major theme of the conversation is how traditional healthcare schedules often force specialists to see too many patients too quickly, leaving little time for education, shared decision-making, or prevention. Dr. Campos explains that in her new practice, she schedules one hour for new patients and 30 minutes for follow-ups, which allows her to better explain kidney disease, reduce patient anxiety, and practice more thoughtfully. Clinically, Dr. Campos emphasizes that primary care clinicians should pay closer attention not only to eGFR, but also to urine albumin-to-creatinine ratio or protein-to-creatinine ratio, especially in patients with hypertension, diabetes, obesity, cardiovascular disease, or early CKD. She suggests referral to nephrology when patients reach approximately CKD stage 3B, eGFR 45 or below, or when proteinuria is 300 mg/g or higher, though she notes that earlier collaboration can be helpful. The episode also covers the importance of aggressive prevention in CKD, including managing proteinuria, using ACE inhibitors or ARBs, considering SGLT2 inhibitors, and recognizing the growing role of GLP-1 medications in slowing CKD progression, especially in patients with diabetes and cardiometabolic risk. On the business side, Dr. Campos shares practical insights for physicians considering independent practice. She discusses credentialing delays, insurance reimbursement realities, overhead planning, referral relationships, community visibility, and the emotional leap of starting a practice. Her advice to burned-out physicians is simple: talk to doctors who have done it, do the math, use available resources, and realize that private practice is possible. At its core, this episode is about reclaiming time, restoring the patient-physician relationship, and building a medical practice around real life instead of burning out inside a broken system.

S1E14 Mastering Private Practice Accounting: Healthcare Perspective with Chuck Palmer, CFO

Primary Goal: Educational Summary: In this comprehensive interview, Chuck Palmer, a seasoned fractional CFO, shares invaluable insights on starting and managing a small healthcare business. Topics include choosing the right business entity, setting up accounting and payroll systems, tax strategies, and maintaining financial health for long-term success. keywords: small business, healthcare, accounting, taxes, LLC, S-Corp, payroll, financial management, startup tips key topics * Business entity selection (LLC, S-Corp, etc.) * Importance of proper accounting and payroll systems * Tax strategies and compliance for small businesses Title: Mastering Small Business Finances: A Healthcare Perspective Sound Bites * "Electing S-Corp status can provide tax advantages" * "Regular reconciliation catches mistakes early" * "Trust professionals, there's no magic tax bullet" Chapters 00:00 Introduction to Class 4 Accounting 03:38 Understanding Business Entities and Compliance 06:16 The Importance of Choosing the Right Business Structure 09:04 Transitioning from LLC to S-Corp 11:39 Timing and Importance of Accounting Services 14:22 Common Mistakes New Business Owners Make 16:52 The Consequences of Not Filing Taxes 19:38 The Role of Financial Metrics in Business Success 24:01 Understanding Financial Health 27:24 Best Practices in Bookkeeping 30:13 Revenue vs. Profit: Key Differences 33:32 Fair Compensation and Business Valuation 38:18 Reinvesting Profits vs. Distributions 41:06 The Importance of Employee Well-being 42:54 Debunking Tax Myths