A rare disease survivor’s journey reveals a hidden truth about healthcare: before we can transform medicine, we must remove the friction preventing physicians from practicing it.
“AI is not here to replace physicians. It is here to
remove the barriers that prevent physicians from practicing at the top of their
license.” — Kimberly Powell, Vice President of Healthcare, NVIDIA
The Doctor Who Became the Patient
Dr. David Fajgenbaum knew what to do when patients were
sick.
He knew the language.
The algorithms.
The textbooks.
The clinical pathways.
He was a physician.
A researcher.
Someone trained to solve medical problems.
Until one day, he became the problem.
Not professionally.
Personally.
His body began attacking itself.
He developed Castleman disease, a rare and
potentially fatal immune disorder.
Suddenly, the physician who spent years studying disease was
lying in a hospital bed wondering whether he would survive the night.
The questions changed.
Before:
“How do we treat this patient?”
Now:
“Will I become one of the patients we cannot save?”
During his illness, Dr. Fajgenbaum experienced healthcare
from the other side.
He discovered something every physician eventually learns
when they become vulnerable:
Medicine is extraordinary.
But the healthcare system surrounding medicine is often
exhausting.
The science was not the only challenge.
The complexity was.
Information was scattered.
Research was fragmented.
Communication gaps existed.
The system was not designed around the human being
experiencing the disease.
It was designed around managing pieces of information.
And that lesson extends far beyond rare disease.
Because every day, thousands of physicians walk into clinics
facing their own version of the same problem.
They are not fighting an unknown disease.
They are fighting something else:
Administrative friction.
Healthcare’s Hidden Disease: Complexity
Here is the uncomfortable truth:
Healthcare has become incredibly good at treating disease.
But it has become incredibly complicated to deliver care.
A physician can spend years mastering medicine.
Then lose hours every week dealing with:
- Prior
authorizations
- Documentation
requirements
- Coding
confusion
- Claim
denials
- Insurance
complexity
- Revenue
cycle problems
The irony?
The people we trained to heal are spending increasing
amounts of time managing systems.
Imagine if a cardiologist spent 40% of their day repairing
broken medical equipment.
Everyone would agree something is wrong.
But when physicians spend hours correcting administrative
failures, it has become normalized.
Why?
Because healthcare has accepted complexity as inevitable.
I disagree.
The Contrarian View: Healthcare Does Not Need More
Technology. It Needs Less Friction.
The healthcare industry often asks:
“How can we add more innovation?”
More software.
More platforms.
More dashboards.
More artificial intelligence.
But maybe we are asking the wrong question.
The better question is:
“What unnecessary work can we remove?”
The future of healthcare will not belong to companies that
add the most features.
It will belong to companies that remove the most
frustration.
The Same Problem Exists in Medical Billing
Most people think medical billing is a financial problem.
It is not.
It is an information problem.
A claim does not fail because someone forgot how to submit a
form.
It often fails because the information needed to support
that claim was incomplete, disconnected, or captured too late.
The problem begins before billing.
It begins during workflow design.
A physician documents a patient encounter.
The clinical information exists.
But somewhere between:
Patient visit
↓
Clinical documentation
↓
Coding
↓
Claim submission
↓
Payment
valuable information can disappear.
The result?
A denied claim.
A delayed payment.
Hours of unnecessary administrative work.
The physician did their job.
The system failed them.
The Hidden Connection Between Patient Care and Revenue
Cycle
Here is what many healthcare leaders miss:
Revenue cycle is not separate from patient care.
It is part of the patient care ecosystem.
Why?
Because an unhealthy practice eventually affects patients.
When independent clinics struggle financially, they have
fewer resources to:
- Hire
additional staff
- Expand
services
- Invest
in better systems
- Spend
more time with patients
Financial sustainability is not greed.
It is infrastructure.
Three Lessons Physicians Can Learn From a Rare Disease
Survivor
Lesson 1: The person closest to the problem often sees
the solution first
Dr. Fajgenbaum did not wait for someone else to solve his
disease.
He combined:
- Patient
experience
- Physician
knowledge
- Research
- Data
Healthcare improvement requires listening to the people
experiencing the problem.
That includes physicians.
Lesson 2: Systems fail quietly before they fail visibly
A denied claim is not just a billing issue.
It is often evidence of a broken process.
The best organizations do not wait for failure.
They identify friction early.
Lesson 3: Innovation should return humanity to healthcare
The purpose of technology is not replacing physicians.
It is protecting physician attention.
Every minute saved from unnecessary administration is a
minute returned to patients.
Statistics: The Cost of a Healthcare System Designed
Around Complexity
The story of Dr. David Fajgenbaum is about rare disease.
But the lesson applies to every physician practice in
America.
Healthcare is facing a paradox:
We have more medical knowledge than ever before, yet many
physicians have less time than ever to use it.
The problem is not a shortage of intelligence.
The problem is friction.
The Administrative Burden Crisis
According to the American Medical Association,
physicians continue to identify administrative workload as one of the major
contributors to dissatisfaction and burnout.
The average physician spends significant time each day
dealing with:
- Documentation
requirements
- Electronic
health record tasks
- Prior
authorization processes
- Insurance
communication
- Administrative
workflows
Every hour spent managing avoidable complexity is an hour
removed from patient care.
The Revenue Cycle Challenge
Independent medical practices face increasing pressure from:
- Rising
operational costs
- Staffing
shortages
- Insurance
complexity
- Delayed
reimbursements
- Claim
denials
For smaller clinics, one denied claim is not just an
accounting issue.
It can mean:
- Delayed
payroll decisions
- Less
investment in equipment
- Reduced
ability to hire support staff
- Less
capacity to serve patients
A healthcare practice is not only a place where medicine
happens.
It is an operating system that must remain healthy.
The Physician Burnout Connection
Burnout is often discussed as an individual problem.
But many experts argue it is also a system design problem.
A physician who entered medicine to solve complex human
problems may become exhausted by solving administrative problems instead.
The question is not:
“Why are physicians struggling?”
The better question is:
“Why did we design a healthcare environment that consumes
the attention of the people we need most?”
Expert Opinion Round-Up: What Healthcare Leaders Can
Learn From This Moment
Expert Perspective #1: Dr. David Fajgenbaum
Physician-scientist, rare disease researcher, and
Castleman disease survivor
Core message:
Patients and clinicians are not separate from healthcare
innovation. They are the source of it.
Dr. Fajgenbaum’s journey demonstrates the power of
combining:
- Medical
expertise
- Patient
experience
- Data
analysis
- Scientific
collaboration
His story challenges traditional healthcare thinking.
The person experiencing the problem may hold insights that
the system cannot see.
Lesson for physician leaders:
Listen to the people closest to the workflow.
That includes:
- Physicians
- Nurses
- Medical
assistants
- Front
desk teams
- Patients
The best improvements often come from those living with the
problem every day.
Expert Perspective #2: Dr. Atul Gawande
Surgeon, author, and healthcare improvement leader
Core message:
Healthcare complexity is now one of medicine’s biggest
challenges.
Dr. Gawande has highlighted how modern medicine has become
too complex for individual heroics.
A physician cannot overcome a broken system simply by
working harder.
The solution requires:
- Better
processes
- Better
teamwork
- Better
coordination
Lesson for clinic owners:
Stop asking:
“How can my staff work harder?”
Start asking:
“How can we redesign the process so the work becomes
easier?”
Expert Perspective #3: Dr. Eric Topol
Physician, author, and digital medicine researcher
Core message:
Technology should restore the human connection in
medicine.
The purpose of artificial intelligence should not be
creating more screens, alerts, and administrative tasks.
The purpose should be:
- Reducing
burden
- Improving
accuracy
- Giving
physicians more time with patients
Lesson for healthcare innovators:
The best technology is not the technology physicians notice.
It is the technology that quietly removes unnecessary work.
Recent News: Why Healthcare Operations Have Become a
Physician Survival Issue
Healthcare conversations this year have focused heavily on:
- Artificial
intelligence adoption
- Healthcare
workforce shortages
- Physician
practice sustainability
- Rising
administrative burden
- Transformation
of healthcare delivery
But beneath the headlines is a quieter crisis:
Independent physicians are struggling to maintain
sustainable practices.
Many healthcare discussions focus on breakthrough
discoveries.
But innovation does not matter if physicians cannot
efficiently deliver care.
A new therapy does not help a patient if the clinic cannot
afford to stay open.
A new AI model does not improve healthcare if it adds more
workflow complexity.
The next healthcare breakthrough may not happen in a
laboratory.
It may happen inside everyday physician practices.
The Data Problem Before the AI Problem
Healthcare leaders are understandably excited about
artificial intelligence.
But there is a fundamental truth:
AI cannot create clarity from chaos.
The quality of AI output depends on the quality of
information entering the system.
Healthcare data often suffers from:
- Fragmentation
- Inconsistent
documentation
- Disconnected
workflows
- Manual
handoffs
This creates downstream problems.
A billing team may see incomplete information.
A coder may lack clinical context.
A claim may fail because the original workflow failed.
The industry often asks:
“How can we apply AI to healthcare?”
A better question:
“How can we create cleaner healthcare information so AI
can actually help?”
Practical Framework: How Physician Owners Can Reduce
Healthcare Friction
Technology is not the first step.
Understanding the problem is.
Here is a practical framework for independent clinics.
Step 1: Find Your Friction Points
Before buying software, identify where time and money
disappear.
Ask your team:
Where do we spend unnecessary hours?
Where do errors repeat?
Where do patients experience delays?
Where does information disappear?
Common answers:
- Eligibility
verification
- Documentation
gaps
- Coding
clarification
- Claim
follow-up
- Prior
authorization
Step 2: Move From Reactive Billing to Preventive Billing
Many practices operate like this:
Problem occurs.
↓
Staff investigates.
↓
Claim is corrected.
↓
Time is lost.
A better model:
Identify risk before submission.
↓
Improve documentation.
↓
Submit cleaner claims.
↓
Reduce unnecessary rework.
The goal is prevention.
Step 3: Create Better Information Flow
A successful healthcare workflow depends on information
moving smoothly.
The connection between:
Patient encounter
↓
Clinical documentation
↓
Coding
↓
Billing
↓
Payment
must be clear.
When information breaks, revenue breaks.
Step 4: Automate Repetition, Not Relationships
Automation should handle tasks that do not require human
judgment.
Examples:
Good automation:
- Identifying
missing information
- Organizing
claims data
- Detecting
patterns
- Reducing
repetitive review
Poor automation:
- Adding
unnecessary dashboards
- Creating
more alerts
- Making
physicians monitor another system
The goal is not more technology.
The goal is more time.
Step 5: Measure Improvement
Physician owners should monitor:
Clean Claim Rate
How often claims are accepted the first time.
Denial Trends
Not just the number of denials.
The reason behind them.
Days in Accounts Receivable
How quickly revenue returns to the practice.
Administrative Hours
How much staff time is spent fixing preventable issues.
Physician Time Recovery
The most important metric:
How much physician attention returns to patient care?
Pitfalls: Healthcare Innovation Mistakes to Avoid
Pitfall #1: Buying Technology Before Fixing Workflow
A new tool cannot repair a broken process.
Understand the workflow first.
Then choose technology.
Pitfall #2: Assuming More Features Mean More Value
Healthcare does not need more complexity.
Physicians already have enough systems.
The best solutions remove steps.
Pitfall #3: Ignoring Frontline Feedback
The people using the workflow every day often know the
solution.
Listen to:
- Nurses
- Billers
- Medical
assistants
- Physicians
Pitfall #4: Treating Billing as Separate From Care
Billing reflects clinical operations.
Poor information flow affects:
- Revenue
- Efficiency
- Practice
sustainability
Legal Considerations: Innovation Must Protect Trust
Healthcare technology must operate within strict
requirements.
Important considerations include:
HIPAA Compliance
Patient information must remain protected through:
- Secure
systems
- Proper
access controls
- Appropriate
data handling
Billing Accuracy
Technology should support compliant billing.
It should never encourage:
- Unsupported
coding
- False
documentation
- Improper
reimbursement
Transparency
Healthcare organizations should understand:
- How
data is used
- Who
has access
- How
decisions are made
Trust is the foundation of healthcare innovation.
Ethical Considerations: The Purpose of Technology
The ethical question is simple:
Does this technology help humans care for humans?
Healthcare innovation should protect:
- Physician
judgment
- Patient
dignity
- Human
connection
The danger is not technology.
The danger is technology designed without understanding
humanity.
Future Outlook: The Healthcare Leaders Who Win Will
Remove Friction
The next decade of healthcare will not only reward those who
create new tools.
It will reward those who simplify healthcare.
The winners will ask:
What can we eliminate?
What can we automate?
What can we make easier?
The future healthcare system will not be defined by how many
technologies it contains.
It will be defined by how much unnecessary burden it
removes.
Myth Busters: Challenging Healthcare’s Most Common
Assumptions
Healthcare has always valued innovation.
But innovation requires questioning assumptions.
Many of the problems facing physicians today continue
because certain beliefs have become accepted as “just the way healthcare
works.”
They are not.
Myth #1: “Healthcare billing is complicated because
healthcare itself is complicated.”
Reality:
Healthcare is complex.
Patients are complex.
Medicine is complex.
But unnecessary administrative complexity is different.
A physician treating a patient with multiple chronic
conditions requires expertise.
A physician spending hours correcting avoidable billing
errors requires a better system.
Complex medicine does not require inefficient operations.
The goal should not be simplifying patient care.
The goal should be simplifying everything that distracts
from patient care.
Myth #2: “More documentation always means better
healthcare.”
Reality:
Documentation is essential.
It supports:
- Patient
safety
- Communication
- Compliance
- Continuity
of care
But documentation requirements should serve medicine.
Medicine should not become a servant to documentation.
The question healthcare leaders should ask:
“Does this documentation requirement improve care, or
does it simply create more administrative work?”
Myth #3: “The biggest healthcare problems require bigger
systems.”
Reality:
Sometimes the opposite is true.
Independent physician practices often have something large
organizations struggle with:
Speed.
Small practices can:
- Change
workflows quickly
- Listen
closely to patients
- Experiment
faster
- Adapt
to local needs
The future of healthcare innovation will not only come from
large institutions.
It will come from physicians closest to the problem.
Myth #4: “AI will solve healthcare automatically.”
Reality:
AI is powerful.
But AI is not magic.
Artificial intelligence can accelerate good systems.
It can also accelerate broken systems.
The foundation must come first:
- Clean
information
- Clear
workflows
- Defined
goals
- Human
oversight
The best healthcare AI will not replace physicians.
It will remove obstacles preventing physicians from doing
their best work.
Frequently Asked Questions
Q1: Why should physicians care about revenue cycle
management if they are focused on patient care?
Because financial sustainability is part of patient care.
A struggling practice has fewer resources available for:
- Hiring
staff
- Improving
technology
- Expanding
access
- Supporting
patients
Revenue cycle management is not only about collecting money.
It is about protecting the infrastructure that allows
healthcare to happen.
Q2: What is the biggest reason medical claims fail?
There is rarely one single reason.
Common causes include:
- Incomplete
documentation
- Incorrect
coding
- Eligibility
problems
- Missing
information
- Communication
gaps
Many claim problems are symptoms of workflow problems that
started earlier.
Q3: How can a small medical practice begin improving
operations without a large budget?
Start with understanding the workflow.
Before purchasing technology:
- Map
current processes.
- Identify
repeated problems.
- Measure
delays.
- Ask
staff where friction exists.
- Improve
one process at a time.
Small operational improvements compound over time.
Q4: Should physician practices replace their current
billing teams with AI?
No.
The better question is:
How can AI help billing teams become more effective?
Experienced billing professionals provide judgment, context,
and problem-solving skills.
Technology should support people.
Not eliminate the human expertise that makes healthcare
work.
Q5: What should physicians look for when evaluating
healthcare technology?
Ask five questions:
1. Does it remove work?
Not add another task.
2. Does it integrate into existing workflows?
Not create another disconnected system.
3. Does it improve accuracy?
Not simply increase speed.
4. Does it protect patient information?
Security must come first.
5. Can we measure improvement?
Technology should produce meaningful outcomes.
Three Practical Actions Healthcare Leaders Can Take Today
1. Stop Accepting Administrative Friction as Normal
Every healthcare organization should regularly ask:
“What work are we doing because the system is broken?”
Not every burden deserves to exist forever.
2. Put Physicians Back at the Center of Healthcare Design
The people delivering care should have a stronger voice in
designing healthcare systems.
Physicians understand:
- Patient
needs
- Clinical
realities
- Workflow
challenges
Innovation without frontline input often creates more
problems.
3. Measure the Time You Return to Care
Healthcare often measures:
Revenue.
Productivity.
Efficiency.
But one of the most valuable measurements is:
How much time did we return to physicians and patients?
Time is one of healthcare’s most valuable resources.
Final Thoughts: The Future of Healthcare Is Not More
Complexity. It Is More Clarity.
Dr. David Fajgenbaum’s story began with a frightening
diagnosis.
A physician became a patient.
A researcher became someone searching for answers.
A person who spent his life studying disease experienced the
uncertainty that millions of patients face every year.
His story reminds us of something important:
Healthcare is not only a scientific challenge.
It is a human challenge.
And human challenges require human-centered solutions.
The healthcare industry has achieved extraordinary things.
We can transplant organs.
Treat cancers.
Decode genetic diseases.
Develop life-saving therapies.
But we must also solve a simpler problem:
Why do we make it so difficult for good healthcare to
happen?
The next era of healthcare will not be defined only by
breakthrough discoveries.
It will be defined by whether we can remove the barriers
between:
Doctors and patients.
Information and action.
Care delivery and sustainability.
Technology and humanity.
The greatest innovation may not be creating something new.
It may be removing what never should have been there.
The Conversation Starts Here
Every physician and clinic owner experiences friction
differently.
For some, it is billing.
For others, it is documentation.
For others, it is staffing, technology, or disconnected
systems.
So I want to ask:
What is the single biggest unnecessary burden preventing
you from spending more time doing what you entered medicine to do?
Share your experience in the comments.
Your answer may help another physician facing the same
challenge.
If this perspective resonates, consider sharing this article
with a physician, healthcare leader, or clinic owner who believes healthcare
can work better.
Healthcare transformation does not happen from the outside
alone.
It happens when the people closest to the problem step
forward.
Join the conversation.
Share your voice.
Help shape the future of healthcare.
About the Author
Dr. Daniel Cham is a physician, healthcare consultant, and
medical technology entrepreneur focused on improving healthcare operations
through practical innovation.
With experience spanning clinical medicine, healthcare
management, medical billing, and healthcare technology, Dr. Cham focuses on one
central question:
How can we remove unnecessary friction so healthcare
professionals can spend more time caring for patients?
As founder of OnnX, an AI-powered medical billing
SaaS platform designed for small and medium-sized physician practices, Dr. Cham
works at the intersection of:
- Healthcare
operations
- Artificial
intelligence
- Revenue
cycle transformation
- Physician
practice sustainability
- Human-centered
healthcare innovation
His mission is to help independent medical practices operate
more efficiently while preserving what matters most in healthcare:
The relationship between physician and patient.
Connect with Dr. Cham on LinkedIn to
learn more.
Disclaimer / Note
This article is intended for general educational and
informational purposes only. It provides perspectives on healthcare operations,
technology, and practice management but should not be interpreted as medical,
legal, compliance, or financial advice.
Healthcare professionals and organizations should consult
appropriate qualified experts when addressing specific clinical, regulatory,
legal, or operational situations.
Continue the Conversation
Healthcare continues to evolve.
The most important conversations are happening where
medicine, technology, operations, and human experience intersect.
Explore additional insights, practical strategies, and
behind-the-scenes perspectives on improving healthcare delivery,
innovation, and physician leadership.
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References
1. American
Medical Association — Physician burnout, administrative burden, and practice
sustainability
The AMA provides research and resources examining how administrative workload
impacts physicians and healthcare delivery.
2. National Institutes of
Health — Rare disease research and Castleman disease initiatives
The NIH supports research efforts focused on improving diagnosis, treatment,
and understanding of rare diseases.
3. Centers
for Medicare & Medicaid Services — Healthcare quality, payment systems, and
operational guidance
CMS provides resources related to healthcare delivery, reimbursement
structures, and quality improvement.
#HealthcareInnovation #PhysicianLeadership #HealthcareAI
#MedicalBilling #RevenueCycleManagement #HealthTech #DigitalHealth
#IndependentPhysicians #HealthcareEntrepreneur #PatientCenteredCare
#HealthcareTransformation #MedicalPracticeManagement #HealthcareOperations
#FutureOfHealthcare #PhysicianEntrepreneur #ClinicalInnovation
Final Message
Healthcare does not improve because we create more
complexity.
It improves because we remove barriers.
The physician who became the patient taught us something
powerful:
The future of medicine depends not only on discovering new
treatments.
It depends on creating a system where those treatments,
insights, and human connections can actually reach the people who need them.
The next healthcare breakthrough may not be another
invention.
It may be a simpler way to care.
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