A cancer survivor’s journey reveals the hidden crisis inside medicine: we are collecting more data than ever, but still failing to connect the dots.
“AI is not the destination. Trust is the destination.”
— Dr. Margaret Lozovatsky, Vice President of Digital Health, American
Medical Association
Source: Dr.
Margaret Lozovatsky discussed that physicians must trust healthcare AI
technologies and that AI adoption succeeds when clinicians see technology as an
enabler rather than an obstacle.
The Healthcare Problem Nobody Wants to Talk About
When most people think about healthcare failure, they
imagine dramatic moments.
A wrong diagnosis.
A delayed surgery.
A medication error.
A missed emergency.
But some of healthcare’s biggest failures are quieter.
They happen in the spaces between people.
Between a patient and a physician.
Between a clinical note and a billing code.
Between a healthcare system and the human being depending on
it.
The most dangerous gaps in medicine are often invisible.
And one woman’s cancer journey shows exactly why.
Jenn Carbajal Did Not Accept the First Answer
In 2025, Jenn Carbajal, a 35-year-old mother, noticed
something that changed the direction of her life.
A lump in her breast.
Like many patients, she hoped it would be nothing.
But without health insurance, seeking answers was not
simple.
Time passed.
Eventually, Jenn received devastating news:
Stage 4 breast cancer.
For many patients, that moment feels like the end of the
road.
But Jenn asked a question that changed everything:
“Is there another possibility?”
She sought a second opinion.
That search led her to City of Hope, where physicians
reviewed her case and developed a treatment plan designed to fight aggressively
against her disease.
Her journey included chemotherapy, surgery, radiation, and
ongoing treatment.
But the most important moment was not a medication.
It was not a machine.
It was not a procedure.
It was someone looking again.
The Lesson Healthcare Leaders Should Pay Attention To
Jenn Carbajal’s story is not only a cancer story.
It is a systems story.
Because every day in healthcare, someone is asking:
“Can someone please look again?”
A patient asking for another opinion.
A physician searching for missing information.
A nurse trying to coordinate fragmented care.
A practice manager trying to understand why revenue
disappeared.
Different problems.
Same root issue.
Disconnected information.
The Healthcare Industry Has a Data Problem Disguised as a
Technology Problem
Healthcare leaders love to talk about transformation.
More AI.
More automation.
More platforms.
More dashboards.
But here is the uncomfortable truth:
Healthcare does not have a shortage of technology.
Healthcare has a shortage of connected intelligence.
We have:
- electronic
health records
- billing
systems
- clearinghouses
- payer
portals
- analytics
platforms
- automation
tools
Yet physicians still spend nights fixing documentation
issues.
Staff still chase denied claims.
Patients still struggle to navigate fragmented systems.
Why?
Because healthcare has built thousands of tools.
But we have not always built better connections.
The Same Story Happens Inside Every Medical Practice
Jenn’s journey involved connecting the right medical
information to the right decision.
Medical practices face the same challenge every day.
A patient walks into a clinic.
The physician provides care.
The encounter creates information.
Then something strange happens.
That information enters a maze:
Clinical documentation.
Coding rules.
Payer requirements.
Authorization processes.
Claim submission.
Payment decisions.
A single missing connection can create weeks of unnecessary
friction.
The patient may never see this.
But the physician feels it.
The Contrarian View: Medical Billing Is Not a Back-Office
Problem
For decades, healthcare treated billing as something that
happened after medicine.
The visit happened.
The doctor documented.
The biller processed.
The payer responded.
That model is outdated.
The modern revenue cycle begins at the moment information is
created.
A documentation decision today becomes a reimbursement
decision tomorrow.
A workflow mistake today becomes a denial weeks later.
A missing data point today becomes administrative work for
everyone downstream.
The claim is simply where the problem becomes visible.
It is not where the problem begins.
Why Physician Owners Should Care
Many physicians started practices because they wanted
independence.
They wanted:
- control
over patient care
- meaningful
relationships
- clinical
autonomy
- the
ability to build something better
But many independent physicians now spend their time
fighting systems.
They are forced to become:
- billing
experts
- compliance
managers
- technology
evaluators
- insurance
negotiators
- administrative
problem solvers
The irony?
The people trained to solve the most complex human problems
are spending their time solving preventable operational problems.
The Biggest Healthcare Innovation Opportunity Is Not
Another App
The healthcare industry has created countless solutions.
Another dashboard.
Another portal.
Another workflow tool.
Another AI assistant.
But innovation should start with a harder question:
What unnecessary friction should not exist in the first
place?
The future healthcare company will not win because it adds
another layer.
It will win because it removes one.
The AI Healthcare Conversation Needs to Change
Most AI conversations focus on:
“How can we automate this task?”
A better question:
“How can we prevent this problem from happening?”
The future of AI in healthcare is not just automation.
It is anticipation.
Imagine a system that recognizes:
- documentation
gaps before claim submission
- denial
risks before rejection
- workflow
breakdowns before revenue loss
- operational
patterns before burnout occurs
That is a very different vision.
Not replacing healthcare workers.
Supporting them.
The Hidden Connection Between Patient Care and Revenue
Cycle
Some leaders still believe billing is separate from
medicine.
But consider this:
A financially unstable practice has difficulty:
- hiring
staff
- investing
in technology
- expanding
access
- maintaining
services
Revenue cycle health influences care delivery.
The connection is simple:
Better information creates better decisions.
Better decisions create better outcomes.
The Question Healthcare Leaders Should Ask
Not:
“How do we process more claims?”
Not:
“How do we hire more people to fix denials?”
Not:
“What software should we buy next?”
The better question:
“Why are we allowing preventable failures to happen
downstream when we could prevent them upstream?”
Jenn Carbajal looked for a second opinion.
Healthcare organizations should do the same.
A second look at:
- how
information moves
- how
decisions are made
- how
physicians spend their time
- how
technology supports care
Because sometimes the breakthrough is not discovering
something new.
Sometimes it is seeing something differently.
The Healthcare Industry’s Most Expensive Mistake: Fixing
Problems Too Late
Healthcare has a pattern.
We wait until something breaks.
Then we hire people to fix it.
A claim gets denied.
A billing team investigates.
A patient needs follow-up.
A staff member searches through multiple systems.
A physician answers another administrative message.
A problem that could have been prevented becomes another
task added to an already overloaded system.
This is not innovation.
This is maintenance.
And healthcare has become very good at maintaining broken
processes.
The question we should be asking is:
Why are we designing systems that require humans to
constantly repair them?
Expert Perspective #1: Dr. Atul Gawande — Healthcare Is a
Systems Problem
Surgeon and healthcare leader Dr. Atul Gawande has
spent years highlighting a fundamental truth:
Healthcare failures are rarely caused by one person making
one mistake.
They are usually caused by systems that make mistakes more
likely.
A physician may be highly trained.
A nurse may be highly skilled.
A medical assistant may be incredibly dedicated.
But even excellent people struggle inside inefficient
systems.
The lesson for physician owners:
Stop asking:
“Who made the mistake?”
Start asking:
“Why did the system allow this mistake to happen?”
This mindset changes everything.
A denial is not just a billing issue.
It is a signal.
A documentation gap is not just a physician issue.
It is a workflow issue.
An authorization delay is not just a payer issue.
It is a process design issue.
Expert Perspective #2: Dr. Eric Topol — Technology Should
Give Medicine Back Its Humanity
Physician-scientist Dr. Eric Topol has repeatedly
emphasized that the promise of artificial intelligence is not replacing
physicians.
It is restoring time.
Time to think.
Time to listen.
Time to connect.
The irony of modern medicine is that we have developed
incredible diagnostic capabilities while making it harder for physicians to
simply be physicians.
Many clinicians did not enter medicine because they wanted
to spend hours navigating administrative systems.
They entered medicine because they wanted to help people.
The lesson for healthcare innovators:
The best technology should disappear into the background.
A physician should not think:
“I am using AI.”
A physician should think:
“I finally have more time to care for my patients.”
Expert Perspective #3: Dr. Donald Berwick — Better
Systems Create Better Care
Healthcare quality leader Dr. Donald Berwick has long
advocated for redesigning healthcare systems around improvement, safety, and
patient-centered care.
One of the biggest lessons from quality improvement:
You cannot create reliable outcomes through individual
effort alone.
You need reliable systems.
The lesson for independent practices:
Do not build a practice that depends on heroic employees
working overtime.
Build a practice where the right action becomes the easiest
action.
The Numbers Behind the Problem
Administrative Burden Is Becoming a Clinical Problem
Physicians today spend significant time outside direct
patient care dealing with:
- documentation
- inbox
management
- prior
authorization
- coding
questions
- insurance
requirements
This burden contributes to:
- burnout
- reduced
professional satisfaction
- less
patient interaction
- workforce
strain
The problem is not that physicians are unwilling to work.
The problem is that too much physician energy is spent on
activities that do not require physician expertise.
Healthcare Revenue Leakage: The Invisible Financial
Problem
Many practices focus on revenue growth.
But before growth, there is a more basic question:
How much revenue is quietly disappearing?
Revenue leakage often hides inside:
- preventable
claim denials
- missed
documentation opportunities
- delayed
submissions
- coding
inconsistencies
- incomplete
workflows
The challenge:
Most practices discover these problems after the money is
already gone.
The Old Revenue Cycle Model Is Backward
Traditional thinking:
Patient visit → Documentation → Billing → Denial → Appeal →
Payment
The future model:
Patient visit → Intelligent documentation → Risk
identification → Clean claim → Accurate payment
The difference?
One reacts.
One prevents.
The Future of Medical Billing Is Not About Billing
This may sound controversial.
But the future of medical billing is not really about
billing.
It is about information intelligence.
A claim is simply the final expression of thousands of
decisions.
Behind every claim are questions:
Did we capture the right information?
Did we understand the clinical context?
Did the documentation support the service?
Did the workflow create unnecessary friction?
The winning healthcare organizations will answer these
questions earlier.
A Practical Framework for Physician Owners: Building a
Smarter Practice
Step 1: Map Your Revenue Journey
Most physicians know their revenue number.
Few know exactly how revenue moves.
Document:
- patient
scheduling
- registration
- eligibility
verification
- clinical
documentation
- coding
- claim
submission
- payment
collection
- denial
management
Find where information breaks.
Step 2: Measure Preventable Failure
You cannot improve what you do not measure.
Track:
Denial Rate
Ask:
- Which
payers deny the most?
- Which
codes create problems?
- Which
physicians or workflows are affected?
Days in Accounts Receivable
This reveals:
- payment
delays
- unresolved
claims
- workflow
bottlenecks
Clean Claim Percentage
A clean claim is not just a financial metric.
It reflects operational quality.
Documentation Accuracy
Review:
- missing
information
- inconsistent
coding
- incomplete
notes
- payer-specific
requirements
Step 3: Move From Denial Management to Denial Prevention
The healthcare industry has created an entire economy around
fixing denials.
But what if fewer denials happened?
Imagine:
A system identifies documentation risk before submission.
A practice sees authorization problems before treatment.
A physician receives guidance before a claim fails.
This is where AI becomes valuable.
Not as a replacement.
As an early warning system.
Step 4: Create Clinical-Billing Alignment
One of the biggest mistakes practices make:
The physician does not know what billing struggles with.
The billing team does not understand the clinical workflow.
The result?
Two teams solving the same problem separately.
A better approach:
Weekly feedback loop.
Billing shares patterns.
Clinical leaders identify solutions.
Operations redesigns workflows.
Small changes create large improvements.
The Mistake Many Healthcare Startups Make
Healthcare entrepreneurs often build solutions around what
is visible.
They see:
- slow
claims
- manual
tasks
- administrative
work
So they automate the visible process.
But the deeper opportunity is upstream.
The real question:
Why did the problem exist before the task started?
The future healthcare innovators will not simply automate
work.
They will eliminate unnecessary work.
Pitfalls: What Physician Leaders Should Avoid
Pitfall #1: Buying Technology Before Understanding the
Problem
Technology is not a strategy.
A new platform cannot fix unclear workflows.
Before buying anything:
Define the problem.
Measure the impact.
Understand the process.
Then choose technology.
Pitfall #2: Outsourcing Without Visibility
Outsourcing can help.
But outsourcing a broken process only moves the problem
somewhere else.
Physician owners still need:
- transparency
- metrics
- accountability
Pitfall #3: Ignoring Small Operational Problems
Healthcare leaders often focus on major issues.
But small failures accumulate.
A missing modifier.
A delayed authorization.
An incomplete demographic field.
Thousands of small problems can create millions of dollars
of lost efficiency.
Myth Busters
Myth: “Healthcare billing complexity is unavoidable.”
Reality:
Some complexity is unavoidable.
Preventable inefficiency is not.
Myth: “AI is only for large hospitals.”
Reality:
Independent practices may benefit the most because they have
limited administrative resources.
Myth: “More staff solves operational problems.”
Reality:
More people inside a broken system often create more
complexity.
Better systems create leverage.
The Future: From Reactive Healthcare to Predictive
Healthcare
The next generation of medical practices will not simply
collect information.
They will understand it.
They will know:
- where
problems are developing
- where
revenue is at risk
- where
physicians are losing time
- where
patients experience friction
The future practice will be:
clinically excellent + operationally intelligent
That combination will define the next era of independent
medicine.
The Bigger Question: What Kind of Healthcare System Are
We Building?
Jenn Carbajal’s story stays with us because it represents
something universal.
Every patient wants the same thing:
Someone who listens.
Someone who looks deeper.
Someone who does not stop at the first answer.
That is the heart of medicine.
But healthcare has created an uncomfortable contradiction.
We have more:
- data
- technology
- medical
knowledge
- automation
- computing
power
than any generation before us.
Yet many patients still feel lost.
Many physicians still feel overwhelmed.
Many independent practices still feel trapped by
administrative complexity.
The problem is not that healthcare lacks intelligence.
The problem is that intelligence is often trapped inside
disconnected systems.
Healthcare’s Next Breakthrough May Not Be a New Treatment
For decades, healthcare innovation has focused on visible
breakthroughs:
New drugs.
New devices.
New procedures.
New algorithms.
These matter.
But there is another category of innovation that receives
less attention:
Reducing the invisible friction that prevents healthcare
from working better.
A physician spending two fewer hours on administrative work
is innovation.
A claim being corrected before denial is innovation.
A patient receiving faster access because a workflow
improved is innovation.
A medical practice becoming financially stable enough to
hire another clinician is innovation.
Not every breakthrough happens in a laboratory.
Some happen in operations.
The Physician Entrepreneur’s Opportunity
Independent physicians are facing one of the most important
moments in healthcare history.
The old model is becoming harder to sustain.
Costs are rising.
Administrative complexity is increasing.
Payers are becoming more sophisticated.
Patients expect more accessibility.
At the same time, new technology creates opportunities that
did not exist before.
The question is:
Will technology create another layer of complexity?
Or will it remove complexity?
The winners will be the organizations that choose the second
path.
The OnnX Perspective: Healthcare Billing Is a Data
Intelligence Challenge
The mission behind OnnX comes from a simple
observation:
Medical billing problems are rarely created when the claim
is submitted.
They are created earlier.
The root causes often exist in:
- clinical
documentation
- workflow
design
- information
capture
- communication
gaps
- disconnected
systems
The future of revenue cycle is not just processing claims
faster.
It is understanding the healthcare journey before problems
occur.
The goal is not more administrative work.
The goal is fewer administrative problems.
Practical Considerations Before Implementing Healthcare
AI
Healthcare organizations considering AI should begin with
discipline.
1. Start With the Problem, Not the Technology
Do not ask:
“What AI tool should we buy?”
Ask:
“What repetitive problem is consuming physician or staff
time?”
2. Protect Human Judgment
AI should support:
- physicians
- administrators
- billing
teams
- patients
It should not remove accountability.
3. Demand Transparency
Healthcare leaders should understand:
- what
data is being used
- how
recommendations are generated
- where
limitations exist
- how
privacy is protected
Trust is not optional in healthcare.
Legal and Ethical Considerations
Healthcare innovation carries responsibility.
Organizations adopting AI-enabled healthcare solutions
should consider:
Privacy and Security
Protected health information requires appropriate
safeguards.
Organizations must evaluate:
- security
controls
- access
management
- vendor
practices
- compliance
processes
Human Oversight
Automation should not replace professional responsibility.
Physicians remain responsible for clinical decisions.
Healthcare leaders remain responsible for operational
decisions.
Patient Trust
The ultimate question:
Does this technology improve the patient experience?
Efficiency alone is not enough.
Healthcare must remain human.
Frequently Asked Questions
Q: Is medical billing really connected to patient care?
Yes.
The information created during a patient encounter affects
documentation, coding, reimbursement, staffing, and ultimately the ability of a
practice to continue serving patients.
Financial sustainability supports clinical sustainability.
Q: Will AI eliminate medical billing jobs?
The more likely future is transformation.
AI can reduce repetitive tasks while allowing experienced
professionals to focus on higher-value work:
- problem
solving
- communication
- quality
improvement
- complex
cases
Q: Why should small physician practices care about AI?
Because smaller practices often have fewer administrative
resources.
A large health system may absorb inefficiency.
A small practice feels every unnecessary task.
Technology that reduces friction can create significant
leverage.
Q: What is the first step a physician owner should take?
Understand where time and revenue are being lost.
Measure:
- denial
patterns
- administrative
workload
- documentation
challenges
- workflow
bottlenecks
The best improvement opportunities usually become obvious
once measured.
Three Final Lessons From Jenn Carbajal’s Story
Lesson One: Always Look Again
Medicine advances when someone asks another question.
A second opinion changed Jenn Carbajal’s journey.
A second look at healthcare operations can change the future
of medicine.
Lesson Two: Information Is Only Valuable When It Moves
Healthcare does not need more disconnected information.
It needs better connections.
The future belongs to systems that help information move
intelligently.
Lesson Three: Technology Should Give Humanity Back to
Healthcare
The purpose of innovation is not to create more machines.
It is to give physicians more time to do what machines
cannot do.
Listen.
Understand.
Care.
Final Thoughts: The Future of Healthcare Will Be Built by
People Who Question the Current System
The healthcare industry has accepted too many broken
processes because they became familiar.
But familiar does not mean necessary.
For decades, we have built systems around managing problems.
The next generation of healthcare leaders will build systems
designed to prevent problems.
Jenn Carbajal asked healthcare to look again.
Healthcare leaders should do the same.
Look again at:
- administrative
burden
- physician
burnout
- revenue
cycle
- clinical
workflows
- technology
adoption
The biggest healthcare transformation may not come from
adding more complexity.
It may come from removing what never needed to exist.
Get Involved: Help Shape the Future of Healthcare
Healthcare transformation requires more than technology.
It requires conversation.
It requires physicians, operators, entrepreneurs, and
innovators willing to challenge assumptions.
The question I want to ask:
What is one administrative process inside your practice
that you believe should no longer exist?
Share your experience in the comments.
Your insight may help another physician leader facing the
same challenge.
If this perspective resonates:
Comment below with your biggest operational frustration.
Share this article with another physician or healthcare
leader who believes medicine deserves better systems.
Repost this conversation so more healthcare professionals
can rethink how technology should serve medicine.
The future of healthcare is not built by watching from the
sidelines.
It is built by people willing to participate.
Continue the Conversation
Healthcare progress happens when knowledge is shared.
Explore practical strategies, operational insights, and
behind-the-scenes perspectives focused on improving healthcare delivery,
physician practice operations, and healthcare innovation.
Continue learning:
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and watch on YouTube
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Knowledge creates progress.
Start your journey by exploring new ideas, challenging old
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About the Author
Dr. Daniel Cham is a physician, healthcare
consultant, and entrepreneur focused on the intersection of medicine,
healthcare operations, artificial intelligence, and practice transformation.
As founder of OnnX, an AI-powered medical billing
SaaS platform, Dr. Cham works on solutions designed to help physician-owned
practices reduce administrative friction, improve revenue cycle intelligence,
and create more sustainable healthcare operations.
His focus is simple:
Help physicians spend more time practicing medicine and less
time fighting unnecessary systems.
Connect with Dr. Cham on LinkedIn to
learn more.
Disclaimer / Professional Note
This article is intended for educational and
informational purposes only.
It does not constitute medical advice, legal advice,
compliance guidance, or financial advice.
Healthcare organizations should consult appropriate
qualified professionals when making decisions related to clinical care,
regulations, technology implementation, privacy, and operations.
References
1. American Medical Association — Physician Burnout and
Administrative Burden
Research and resources exploring how administrative
complexity affects physician well-being and healthcare delivery.
American Medical Association Physician Health Resources
2. Centers for Medicare & Medicaid Services
Innovation Center
CMS resources focused on improving healthcare quality,
value-based care, and healthcare delivery models.
3. National Academy of Medicine — Clinician Well-Being
and Healthcare Improvement
Research and initiatives focused on improving healthcare
systems and supporting clinicians.
National Academy of Medicine Clinician Well-Being Initiative
Encourage Repost
If this perspective resonates with you, consider reposting
it.
A conversation about better healthcare systems starts with
one person sharing a different perspective.
Help other physicians and clinic owners rethink how
administrative systems influence patient care.
#HealthcareInnovation #PhysicianLeadership #HealthcareAI
#MedicalBilling #RevenueCycleManagement #HealthcareTransformation
#DigitalHealth #IndependentPhysicians #PhysicianEntrepreneur
#HealthcareTechnology #AIHealthcare #HealthcareOperations #MedicalPracticeManagement
#PhysicianBurnout #FutureOfHealthcare #PatientCenteredCare #HealthTech
#ClinicalInnovation #HealthcareLeadership #HealthcareData
