Why Doctors Are Pushing Back on Certification, Shortages, and Medical Monopolies | Dr. Paul Teirstein, Scripps Health

How Fairview Health Turned Around a $600M Performance Gap, Sameer Badlani, Fairview Health Services

Health system turnaround, payer pressure, ambulatory growth, diversified revenue, partnership strategy, and AI-enabled transformation- Sameer Badlani, MD, and Jason Schifman unpack what it takes for health systems to survive in today’s margin-constrained environment. In this episode of Analyzing Healthcare, Jason Schifman, President at SCALE Healthcare, speaks with Sameer Badlani, MD, Chief Strategy and Digital Officer at Fairview Health Services, about navigating healthcare inflation, concentrated payer dynamics, operational turnaround, and long-term sustainability. The conversation explores throughput improvement, physician alignment, joint ventures, specialty growth areas, interoperability, and why healthcare leaders must move beyond endless pilot programs toward scalable execution. What You’ll Learn • ✅ How payer concentration pressures health system margins • ✅ What drove Fairview’s turnaround — and what nearly derailed it • ✅ Why nonprofit systems still need strong margins to survive • ✅ How Fairview decides what to own, partner on, or exit • ✅ Why behavioral health, pharmacy, and home health require different models • ✅ How consumer expectations are reshaping healthcare growth • ✅ How Fairview approaches payer, pharma, medtech, and AI partnerships • ✅ Why healthcare must move beyond endless pilot programs Timestamps • (00:01) Meet Sameer Badlani • (00:31) Fairview's footprint and the Minnesota market • (01:54) Why Minnesota is innovative but hard on providers • (08:40) The turnaround and return to operating profit • (10:57) Throughput, length of stay, and operational discipline • (14:26) Service line exits, pivots, and new partnerships • (17:49) Specialty pharmacy as a diversified revenue engine • (18:33) Behavioral health, JVs, and the EMPATH model • (21:23) Strategic priorities today • (21:40) Women's health and consumer-led growth • (27:44) Physician strategy and flexible partnership models • (32:42) Payer, medtech, pharma, and AI partnerships • (35:25) How Fairview decides what to pursue — and what to walk away from • (38:28) Biggest opportunities in the next 24–36 months • (40:38) Interoperability: the difference between data and insight Key Takeaways • 💎 Margin pressure in healthcare is often structural — not just operational • 💎 Sustainable turnarounds require alignment across operations, labor, analytics, and finance • 💎 Nonprofit systems still need strong margins to reinvest and remain stable • 💎 Leading health systems focus on core strengths and partner for the rest • 💎 Not every service line should be owned — JVs and exits can create more value • 💎 Revenue diversification is becoming essential for long-term resilience • 💎 Strong strategy requires focus and discipline, not endless experimentation Resource Links • Guest: Sameer Badlani, MD – Chief Strategy and Digital Officer, Fairview Health Services • Host: Jason Schifman – President, SCALE Healthcare • Podcast: Analyzing Healthcare by SCALE Community • SCALE Community: https://www.scale-community.com [https://www.scale-community.com] Guest Bio Sameer Badlani, MD is Chief Strategy and Digital Officer at Fairview Health Services, where he leads strategy, digital transformation, partnership development, and innovation across one of Minnesota’s major integrated health systems. His work focuses on how health systems can improve sustainability, diversify revenue, modernize care delivery, and use data, partnerships, and disciplined execution to navigate a difficult healthcare landscape. SEO Keywords Healthcare strategy, health system turnaround, Fairview Health Services, Sameer Badlani, Jason Schifman, payer pressure, healthcare margins, nonprofit health systems, diversified revenue, specialty pharmacy, behavioral health, ambulatory surgery centers, physician alignment, digital transformation, AI in healthcare, interoperability, women’s health, perimenopause care, healthcare innovation, SCALE Healthcare, SCALE Community, healthcare podcast

Why Doctors Are Pushing Back on Certification, Shortages, and Medical Monopolies | Dr. Paul Teirstein, Scripps Health

Physician shortages, board certification, medical monopolies, residency bottlenecks, telemedicine policy, and healthcare regulation—this episode with Dr. Paul Teirstein explores why parts of U.S. healthcare may be structurally broken by design. Drawing from his experience as a cardiologist and founder of a competing physician certification board, Dr. Teirstein discusses physician frustration with maintenance of certification, residency bottlenecks, telemedicine restrictions, and how monopolistic structures across healthcare can drive higher costs, reduced access, and clinician burnout. What You’ll Learn• ✅Why many physicians are pushing back on maintenance of board certification• ✅ How the American Board of Internal Medicine became a gatekeeper in medicine• ✅ Why Dr. Paul Teirstein launched the National Board of Physicians and Surgeons• ✅ How certification requirements may contribute to burnout and early retirement• ✅ Why physician shortages stem from broader structural and funding challenges• ✅ How telemedicine restrictions continue to limit access to care• ✅ Why monopolies in healthcare often drive higher costs and weaker service• ✅ Why continuing medical education may matter more than repetitive testing• ✅ How policy and regulation continue to shape physician supply in the U.S. Timestamps• (00:04) Introduction to Dr. Paul Teirstein and Scripps Health• (01:43) Why Dr. Teirstein challenged the American Board of Internal Medicine• (03:12) How board certification became a de facto requirement to practice• (05:28) Revenue growth, maintenance requirements, and physician frustration• (07:12) Why Dr. Teirstein started the National Board of Physicians and Surgeons• (09:25) Payers, hospitals, and the barriers to alternative certification• (11:37) What initial certification gets right—and where ongoing requirements fail• (15:37) How AI and OpenAI’s ChatGPT expose weaknesses in board testing• (18:52) Is maintenance certification a real quality measure—or just a tax?• (20:32) Physician shortages, burnout, and unnecessary administrative burden• (22:27) Medical schools, residencies, and the supply bottleneck• (26:57) Why residency funding remains central to physician supply• (31:41) Telemedicine, regulation, and access to care• (36:07) The broader problem of monopoly power in healthcare Key Takeaways• 💎 Board certification requirements have become a major pain point for many physicians.• 💎 CME may do more to keep doctors current than repetitive testing.• 💎 Physician shortages stem from broader structural barriers, including residency limits.• 💎 Telemedicine can expand access, but policy hurdles remain.• 💎 Healthcare monopolies often drive higher costs and poorer service.• 💎 Reducing administrative burden could improve physician retention and care access. Resource LinksGuest: Dr. Paul Teirstein – Cardiologist, Scripps HealthHost: Roy Bejarano, CEO & Co-founder at SCALE HealthcarePodcast: Analyzing Healthcare by SCALE CommunitySCALE Community: ⁠https://www.scale-community.com⁠ [https://www.scale-community.com/]Guest BioDr. Paul Teirstein is a Chief of Cardiology at Scripps Health in San Diego, where he leads within the cardiology division and performs minimally invasive heart procedures including coronary stents and transcatheter valve interventions. In addition to patient care, training, and research, he is also the founder of the National Board of Physicians and Surgeons, created in response to growing physician frustration with the maintenance of certification processes. His work sits at the intersection of clinical excellence, medical policy, and physician advocacy. SEO KeywordsHealthcare, U.S. Healthcare, Physician Shortage, Board Certification, Maintenance of Certification, American Board of Internal Medicine, ABIM, National Board of Physicians and Surgeons, NBPAS, Paul Teirstein, Scripps Health, Telemedicine, Residency Funding, Medical Education, Physician Burnout, Healthcare Regulation, Medical Monopolies, Healthcare Policy

What Do Health Systems Actually Want From Vendors? Jason Szczuka, Chief Digital Officer, BSMH

Health Systems Innovation & Vendor Strategy | Analyzing Healthcare Podcast In this episode, Jason Schifman interviews Jason Szczuka—Chief Digital Officer at Bon Secours Mercy Health and President of Acrete Health Partners—on vendor evaluation, digital transformation, and scalable partnerships in healthcare. Szczuka, drawing from Cigna, Brighter, and Bon Secours experience, warns innovators: Start with operator pain points, not products. He covers the need-vs-demand gap, trusted relationships over cold outreach, and Bon Secours' investment-plus-implementation model for real-world testing. Essential for founders, providers, operators, and leaders driving health system adoption. What You’ll Learn • ✅ Why health systems should start with operator pain points, not shiny products • ✅ The difference between a health system’s need and actual demand • ✅ How Bon Secours and Acrete evaluate vendors beyond price and security • ✅ Why management team quality matters in healthcare innovation • ✅ Who vendors should build relationships with inside a health system • ✅ Why cold inbound outreach rarely works in enterprise healthcare sales • ✅ How Bon Secours sources, tests, and scales innovation faster than most health systems • ✅ How the internal acceleration fund helps projects move without waiting for the next budget cycle Timestamps • (0:02) Introduction to Jason Szczuka and Bon Secours Mercy Health • (2:22) Jason’s background across payer, startup, and care delivery • (5:19) How Bon Secours evaluates vendors and innovators • (8:14) Why health systems must start with real pain points • (10:31) What separates strong vendors from the rest • (14:49) Why intimate partnerships matter in healthcare innovation • (22:07) Who vendors should build relationships with inside health systems • (25:07) Why Bon Secours does not rely on digital RFPs • (29:19) How Bon Secours shortens the path from introduction to implementation • (31:34) The acceleration fund and how Bon Secours moves faster Key Takeaways • 💎 Health systems adopt solutions faster when operators are already motivated to solve the problem • 💎 Great products still fail if they do not earn real operational demand • 💎 Vendor selection is about team quality and execution fit, not just the product itself • 💎 CEO support alone is not enough—clinicians and operators must believe in the solution • 💎 Trusted introductions beat blind outreach in health system sales • 💎 Bon Secours combines investment and implementation to accelerate innovation • 💎 Internal funding mechanisms can remove one of the biggest barriers to adoption • 💎 The best partnerships start focused, prove value quickly, and then scale Guest Bio Jason Szczuka is Chief Digital Officer at Bon Secours Mercy Health and President of Acrete Health Partners, where he leads digital transformation, strategic partnerships, and venture-backed innovation. Previously, he served as Chief Digital Officer at Cigna and co-founded Brighter, a digital health platform later acquired by Cigna. With experience spanning payer, startup, and care delivery environments, he brings a rare cross-sector perspective on healthcare innovation and implementation. Resource Links • Guest: Jason Szczuka – Chief Digital Officer, Bon Secours Mercy Health; President, Acrete Health Partners • Host: Jason Schifman – President and Co-founder, SCALE Healthcare • Podcast: Analyzing Healthcare by SCALE Community • SCALE Community: https://www.scale-community.com [https://www.scale-community.com/] SEO Keywords Healthcare innovation, digital transformation, Bon Secours Mercy Health, Acrete Health Partners, Jason Szczuka, Jason Schifman, healthcare partnerships, vendor strategy, health system innovation, digital health, healthcare leadership, healthcare implementation, service provider strategy, healthcare operators, Scale Healthcare, SCALE Community, healthcare podcast

Why More Healthcare Data Might Actually Be the Problem- Angeli Moller - Pharma Data Scientist & Sequoia Growth Founder

AI in healthcare, clinical research, and pharma data science- how real-world data, biobanks, and AI are transforming drug development and patient outcomes. In this episode of Analyzing Healthcare, Roy Bejarano sits down with Angeli Moller, a global pharma data scientist and founder of Sequoia Growth. Drawing on leadership roles at Bayer and Roche, Angeli shares how data, AI, and clinical research are converging to reshape drug development, healthcare delivery, and global innovation ecosystems. From the importance of longitudinal data to the realities of biobanks, decentralized care, and global clinical research expansion, this conversation breaks down what actually drives outcomes- not just hype- in healthcare transformation. What You’ll Learn * ✅ Why AI fails without clinical and operational foundations * ✅ How real-world data can reduce drug development timelines * ✅ The importance of longitudinal datasets in healthcare innovation * ✅ Why biobanks like UK Biobank create national advantages * ✅ How data integration across research, manufacturing, and real-world use drives better outcomes * ✅ Why duplicating analytics infrastructure is inefficient and costly * ✅ The rise of decentralized care and remote patient monitoring * ✅ How India and China are emerging as global clinical research leaders * ✅ Why informed consent and data governance are critical for innovation * ✅ The evolving role of CROs and federated learning in pharma analytics Key Timestamps * (00:00) Introduction to Angeli Moller and her global data leadership * (03:47) Why AI fails without clinical foundations * (06:01) What actually drives adoption in healthcare systems * (07:41) $6B drug development and the role of data * (13:38) Why “data for data’s sake” fails * (15:21) Longitudinal data vs. speed in clinical research * (16:33) UK Biobank, Mayo Clinic, and data advantages * (18:16) Informed consent and secondary data use * (24:26) Global competition for clinical research infrastructure * (30:50) Hospital digitization and operational efficiency * (34:12) Are we overbuilding analytics in healthcare? * (37:23) The next 5-year transformation: decentralized care & global research Key Takeaways * 💎 AI is only as powerful as the clinical foundation it’s built on * 💎 Longitudinal data matters more than short-term speed * 💎 Biobanks and national data infrastructure create competitive advantage * 💎 Healthcare analytics is becoming overbuilt and inefficient * 💎 Decentralized care is inevitable—and accelerating * 💎 Emerging markets are becoming innovation hubs, not just participants * 💎 Data governance and consent will define the future of healthcare AI * 💎 Integration across the pharma value chain unlocks exponential value Resource Links Guest: Angeli Moller – Founder, Sequoia Growth Host: Roy Bejarano – CEO & Co-Founder, SCALE Healthcare Organizations Mentioned: • Bayer • Roche • UK Biobank • Mayo Clinic Podcast: Analyzing Healthcare by SCALE Community SCALE Community: https://www.scale-community.com [https://www.scale-community.com] Guest Bio Angeli Moller is a pharma data scientist who worked in leadership positions at Bayer, Roche and Zühlke who two years ago launched a boutique consulting firm, Sequoia Growth. , a consulting firm focused on life sciences analytics and clinical innovation. With leadership experience at Bayer, Roche, and Zürcher, she has led global data integration, clinical analytics, and informatics initiatives across pharma, medtech, and healthcare systems. Her expertise spans clinical trial design, real-world data, AI applications, and global healthcare strategy across Europe, Asia-Pacific, and Latin America. SEO Keywords Healthcare AI, Clinical Research, Pharma Data Science, Biobanks, UK Biobank, Mayo Clinic, Drug Development, Real World Data, Healthcare Innovation, AI in Pharma, Clinical Trials, Digital Health, Decentralized Care, Remote Patient Monitoring, Healthcare Strategy, SCALE Healthcare, Roy Bejarano, Angeli Moller, Healthcare Podcast, Global Healthcare Trends

Inside a 51-Hospital System's Agentic AI Playbook | Mark Townsend, Chief Clinical Digital Ventures Officer, BSMH

In this episode, Jason Schifman talks to Mark Townsend, Chief Clinical Digital Ventures Officer at Bon Secours Mercy Health, about digital transformation. Mark discusses how Acrete Health Partners drives operator-led solutions, successful tech adoption, and examples like agentic AI and nursing ambient documentation. They also cover AI risk, EHR limits, and distinguishing true innovation from trends. What You’ll Learn * How Bon Secours Mercy Health structures its venture and digital innovation strategy * Why BSMH shifted from investing in “solutions seeking problems” to operator-led problem-solving * Why Mark measures digital success through one word: profitability * Why health systems should frame initiatives as projects, not pilots * How executive accountability and P&L ownership improve implementation success * What “grow your way to success” means in a health system context * How BSMH evaluates Epic vs. third-party AI solutions * Why omnichannel appointment scheduling became a key system-level AI use case * How nursing ambient documentation differs from physician ambient tools * Why governance, human oversight, and informed consent matter in AI adoption Key Timestamps * (00:00) – Introduction to Mark Townsend and Bon Secours Mercy Health * (00:52) – Mark’s journey from congenital cardiology to digital ventures * (03:35) – Inside BSMH’s venture model and Acrete Health Partners * (06:21) – Why BSMH now focuses on operator-led problem statements * (10:55) – The real rules of technology adoption in health systems * (12:16) – Why Mark rejects the word “pilot” * (13:44) – Accountability, operational ownership, and project champions * (14:44) – The acceleration fund and matching operator investment * (16:52) – “Grow your way to success” and run-rate improvement * (18:23) – Fail fast, fail forward, and design for scale * (20:12) – Agentic AI for appointment scheduling: success and failure in one story * (23:39) – Epic, MyChart, and why the EHR cannot be all things to all people * (26:42) – Co-development, Brado, and the “big smelly onion” of implementation * (28:47) – Nursing ambient documentation with Epic and Abridge * (30:47) – AI governance, human-in-the-loop, and risk mitigation * (32:39) – Using AI for quality and compliance at scale Key Takeaways * Health system innovation works best when operators bring the problem, not vendors * Strategic investing loses credibility if the health system never uses what it funds * In Mark’s framework, margin is the mission—profitability is the baseline test * “Project” signals commitment; “pilot” signals optionality and weak accountability * Executive sponsorship matters more than enthusiasm from the technology vendor * The best digital initiatives are tied to strategic priorities and measurable scale * Epic remains central, but third-party tools still fill critical workflow gaps * Healthcare AI adoption requires governance, informed risk acceptance, and humans in the loop * Clinical AI use cases are moving beyond physicians to nurses and broader care teams * Real implementation is messy, bespoke, and deeply dependent on operational readiness Resource Links * Guest: Mark Townsend – Chief Clinical Digital Ventures Officer, Bon Secours Mercy Health * Host: Jason Schifman – President & Co-Founder, SCALE Healthcare * Podcast: Analyzing Healthcare by SCALE Community * SCALE Community: SCALE Community Website [https://www.scale-community.com] Guest BioMark Townsend is the Chief Clinical Digital Ventures Officer at Bon Secours Mercy Health, leading digital transformation at one of the largest U.S. health systems. With expertise in clinical practice, health system operations, and digital innovation, he focuses on scaling practical, ROI-driven solutions across the organization. SEO Keywords Healthcare AI, Digital Health, Health System Innovation, Bon Secours Mercy Health, BSMH, Mark Townsend, Jason Schifman, Healthcare Ventures, Epic, MyChart, Ambient Documentation, Nursing AI, Agentic AI, Appointment Scheduling, Healthcare ROI, Digital Transformation, Healthcare Operations, Clinical Innovation