Physician Shortage, Visas, and Why Doctors Are Leaving Medicine

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🎯 Why Listen

Is there really a physician shortage—or just bad incentives driving doctors out of practice? In this episode, the crew unpacks Representative Greg Murphy’s call for more foreign-trained doctors, the real barriers U.S. medical students face, the role of residency caps, gender dynamics in the physician workforce, and why private practice may hold the key to keeping doctors in medicine.

👥 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

• The “physician shortage” debate: is it real, or misallocation + burnout?
• U.S. med school demand vs. residency bottlenecks—and the 1997 cap that still shapes supply.
• H-1B visas for international medical graduates: help or band-aid?
• Gender workforce dynamics: why more women physicians work part-time and how that affects access.
• Why doctors leave clinical medicine early—and what would keep them in practice.
• Policy solutions: site neutrality, physician-owned hospitals, and cutting through regulatory capture.

💬 Notable Quotes

• “The ultimate failure of central planning is thinking you can measure physician demand.” – Anthony DiGiorgio
• “We have plenty of talent in the U.S.—why not open more medical schools and residency spots?” – Dan Choi
• “If being a doctor were enjoyable again, we wouldn’t be having this shortage conversation.” – Anish Koka
• “When physicians ran healthcare, the focus was on patients. Locking us out created today’s inefficiencies.” – Dan Choi

📚 What You’ll Learn

• Why residency slots—not interest in medicine—are the true bottleneck.
• How CMS payment and hospital consolidation drive burnout and early exits.
• The economic tradeoffs of foreign-trained vs. U.S.-trained physicians.
• How gender dynamics reshape workforce numbers.
• Policy levers that could restore independence and fix misaligned incentives.

⏱ The Episode (Timestamps)

• 00:00–02:00 Cold open: physician demand, central planning & burnout
• 02:00–06:30 Rep. Greg Murphy, H-1B visas, and the med school acceptance gap
• 06:30–13:00 U.S. applicants denied vs. foreign-trained routes; debt vs. no-debt training
• 13:00–16:30 Gender gap: women in medicine, part-time work, and policy backlash
• 16:30–21:30 1997 residency budget cap and whether slots are the real bottleneck
• 21:30–28:30 Private practice vs. health system consolidation: patient access and efficiency
• 28:30–36:00 RFK Jr.’s comments on physicians, incentives, and the “food as medicine” debate
• 36:00–46:00 Free market fixes: site neutrality, physician-owned hospitals, deregulation
• 46:00–55:00 Burnout, EMR inefficiencies, verbal order regulations, and why physicians leave

••55:00–End Closing reflections + next episode teaser

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• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X