Tuesday, August 4, 2026

Jenn Carbajal Asked for a Second Opinion. Healthcare Leaders Need One Too.

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:

Knowledge creates progress.

Start your journey by exploring new ideas, challenging old assumptions, and helping build a smarter healthcare future.


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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.

CMS Innovation Center

 

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.


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Jenn Carbajal Asked for a Second Opinion. Healthcare Leaders Need One Too.

A cancer survivor’s journey reveals the hidden crisis inside medicine: we are collecting more data than ever, but still failing to connect t...