Medicine is full of people doing the right thing inside systems that reward the wrong work.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Shikha Jain, a hematologist-oncologist, professor, and founder of Women in Medicine, to discuss why some of the most essential work in medicine happens after hours, off the clock, and without recognition - especially for women physicians.

Shikha makes a clear case for why physician distress isn’t a resilience problem, a time-management issue, or a pipeline failure. It’s a systems problem. From RVU-based compensation models that ignore invisible labor, to unpaid committee work that never counts toward promotion, to insurance barriers that put doctors in the crosshairs while profits flow elsewhere, she explains how modern healthcare quietly extracts more from physicians while valuing them less.

Together, Graham and Shikha explore how gender expectations shape leadership, why women physicians are “voluntold” into uncompensated work, and how stereotypes around empathy and agreeableness create double standards that follow doctors from the clinic to the boardroom.

The conversation closes with practical guidance for change: how physicians can set boundaries without guilt, how institutions can measure the work that actually matters, and how male allies can show up in ways that help rather than harm.

This episode isn’t about blaming individuals. It’s about fixing the system so doctors can keep doing the work that brought them to medicine in the first place.

1. Why physician burnout is a structural failure, not a personal one
2. How RVU-based compensation undervalues real clinical and cognitive work
3. The hidden, uncompensated labor disproportionately carried by women physicians
4. Practical ways physicians and allies can drive meaningful change

1. Dr. Shikha Jain: https://shikhajainmd.com
2. Women in Medicine: https://www.wimedicine.org
3. Women in Medicine Summit September 24-26, 2026: https://www.wimedicine.org/summit
4. Oncology Overdrive Podcast: https://oncologyoverdrive.com

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📝 For a full transcript of this episode click HERE

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Tim Peck has spent his career practicing medicine where the system is most fragile. A Harvard-trained emergency physician, healthcare entrepreneur, and frontline clinician in rural America, Tim has worked inside nursing homes, healthcare deserts, and communities shaped by the opioid crisis—places where delays, payment failures, and policy decisions have immediate consequences.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Tim to explore what emergency medicine teaches about leadership, systems failure, and responsibility beyond the bedside. Tim shares why ER doctors are uniquely trained to lead in chaos, how seeing patients too late distorts outcomes, and what he learned by embedding himself in the environments that generate avoidable hospitalizations.

The conversation moves beyond ideology into the mechanics of why U.S. healthcare breaks down—from fee-for-service incentives and uninsured rural populations to ambulance shortages and hospital closures that happen quietly, then all at once.

This is not a political debate or a campaign pitch. It’s a clinician’s diagnosis of a system under strain—and a candid discussion of what it would take to fix it.

1. Why emergency medicine is one of the most effective forms of leadership training
2. What changes when doctors see patients earlier instead of downstream in crisis
3. How rural healthcare deserts form—and what they look like in real time
4. Why nursing homes and opioid care expose the deepest system failures
5. How payment models shape clinical behavior more than most physicians realize

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📝 For a full transcript of this episode click HERE

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Eve Cunningham has spent her career navigating the hard edges of modern medicine from delivering babies and performing gynecologic surgery to leading large health system initiatives and now serving as Chief Medical Officer at Cadence. Along the way, she’s seen firsthand why chronic disease care continues to fail patients despite more data, more technology, and more dashboards than ever before.

In this episode of How I Doctor, Graham Walker sits down with Eve to unpack why clinic-based, episodic care is fundamentally mismatched to conditions like heart failure, diabetes, and hypertension. She explains why early efforts at remote patient monitoring fell flat, how change management and not technology has always been the real barrier, and why most health systems struggle to turn insight into action.

The conversation moves from the realities of governance-heavy decision-making and physician burnout to what it actually takes to manage patients upstream before they land back in the ICU. Eve also shares the deeply personal connection that drives her work, including how her father’s experience with chronic illness shaped her view of what patients truly need.

This is not a tech demo or a sales pitch. It’s a candid discussion about redesigning chronic disease care in a way that works for patients, clinicians, and the realities of modern medicine.

1. Why episodic, visit-based medicine is structurally incapable of managing chronic disease
2. What early remote patient monitoring efforts got wrong and what has finally made them work
3. How change management and incentives matter more than technology alone
4. Why health systems struggle to act on data, even when the answers are obvious
5. What proactive, upstream care looks like when someone is actually accountable

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/

IG https://www.instagram.com/ubergraham/

Bluesky https://bsky.app/profile/drgrahamwalker.com

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