38% of Doctors Gone in 5 Years? Inside the Battle for Independence

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Original Substack Release Date: August 9, 2025

🎯 Why Listen

This episode pulls no punches on the future of physician independence. From the looming physician shortage to the retaliatory tactics of insurers, you’ll hear an unscripted conversation about the raw realities inside American healthcare—and the strategies physicians can use to fight back.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

Three of the country’s sharpest physician voices—and guest Heath Veuleman—expose how insurers, hospitals, and even physicians themselves are reshaping healthcare in America. They tackle the physician shortage, why physician-owned hospitals outperform on cost and quality, and how small practices can unite to take on monopolistic health systems. If you’ve ever wondered what’s really happening behind the curtain, this is the conversation you won’t hear in a boardroom.

💬 Notable Quote

“We’ve only got about 1.1 million physicians left. 38% are going to age out in the next 60 months. Physicians have way more leverage than they know—they just don’t realize it yet.” — Heath Veuleman

📚 What You’ll Learn

• Why 38% of U.S. physicians could be gone in five years—and why it’s not just burnout
• The insurer retaliation playbook used against independent doctors
• How physician-owned hospitals lower costs, improve outcomes, and raise patient satisfaction—but remain shackled by federal law
• Why physicians’ biggest threat is internal: self-sabotage and lack of collaboration
• The business case for direct contracting and bypassing third-party payers
• How to scale small practices into a coordinated force against hospital monopolies

⏱ The Episode (Timestamps)

• [00:00] Why physician-owned hospitals matter
• [06:00] The coming physician shortage and workforce crisis
• [14:00] Why hyper-focused specialty hospitals succeed
• [22:00] Direct contracting: cutting out the middlemen
• [28:00] Insurer retaliation against outspoken physicians
• [36:00] Fragmentation, duplication, and cost inflation in healthcare
• [45:00] Outpatient innovation vs. hospital inefficiency
• [53:00] Regulatory barriers and the moratorium on physician-owned hospitals
• [57:00] Signs we’re at the end of a healthcare cycle
• [01:02:00] Physician leverage, consumer awakening, and the next wave of reform

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X