Dr. Amy Vertrees reflects on the weekend screening of the documentary A Thousand and One Cuts and the coaching call that followed it, unpacking why women surgeons' careers are rarely derailed by one dramatic event but by an accumulation of small, repeated moments.

She backs this up with hard data: female physicians and surgeons consistently produce lower mortality and complication rates than their male counterparts across multiple large studies, including a JAMA Internal Medicine analysis of 1.5 million Medicare hospitalizations and a 2025 meta-analysis spanning 13.4 million patients — yet women retire from medicine at 49 versus 62 for men.

Amy then teaches the core coaching framework from that call: the difference between a fact (something everyone would agree happened) and a thought (your interpretation of it) — including why "microaggression" is a thought, not a fact, and why that distinction actually gives you more power, not less. She closes with tactical empathy, the "mythical white male" trap, and the idea that forcing yourself to be falsely polite is its own kind of self-inflicted harm.

Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med. 2017;177(2):206–213. doi:10.1001/jamainternmed.2016.7875

Heybati K, Chang A, Mohamud H, Satkunasivam R, Coburn N, Salles A, Tsugawa Y, Ikesu R, Saka N, Detsky AS, Ko DT, Ross H, Mamas MA, Jerath A, Wallis CJD. The association between physician sex and patient outcomes: a systematic review and meta-analysis. BMC Health Serv Res. 2025 Jan 17;25(1):93. doi: 10.1186/s12913-025-12247-1. PMID: 39819673; PMCID: PMC11740500.

Saka N, Yamamoto N, Watanabe J, Wallis C, Jerath A, Someko H, Hayashi M, Kamijo K, Ariie T, Kuno T, Kato H, Mohamud H, Chang A, Satkunasivam R, Tsugawa Y. Comparison of Postoperative Outcomes Among Patients Treated by Male Versus Female Surgeons: A Systematic Review and Meta-analysis. Ann Surg. 2024 Dec 1;280(6):945-953. doi: 10.1097/SLA.0000000000006339. Epub 2024 May 10. PMID: 38726676; PMCID: PMC11542977.

Wallis CJD, Jerath A, Aminoltejari K, et al. Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries. JAMA Surg. 2023;158(11):1185–1194. doi:10.1001/jamasurg.2023.3744

Shannon G, Jansen M, Williams K, Cáceres C, Motta A, Odhiambo A, Eleveld A, Mannell J. Gender equality in science, medicine, and global health: where are we at and why does it matter? Lancet. 2019 Feb 9;393(10171):560-569. doi: 10.1016/S0140-6736(18)33135-0. PMID: 30739691.

Rittenberg E, Liebman JB, Rexrode KM. Primary Care Physician Gender and Electronic Health Record Workload. J Gen Intern Med. 2022 Oct;37(13):3295-3301. doi: 10.1007/s11606-021-07298-z. Epub 2022 Jan 6. PMID: 34993875; PMCID: PMC9550938.

Branford GL, Bucala MD, Hepper A, Hadeed NM, Northway RM, Brenner MJ. The Gender Gap in EHR Workload: A Comparative Analysis of Primary Care Physician In Basket Usage. J Gen Intern Med. 2025 Jul;40(10):2255-2264. doi: 10.1007/s11606-025-09629-w. Epub 2025 May 29. PMID: 40439865; PMCID: PMC12344033.

Turning Pain Points Into Innovation | Dr. Prakash Gatta

FULL DESCRIPTION 
Dr. Prakash Gatta is a foregut and esophageal surgeon who built his hospital's surgical program from zero — and then built two healthcare technology companies from the pain points he kept running into in the OR. In this episode of BOSS: Business of Surgery, host Dr. Amy Vertrees talks with Dr. Gatta about what happens when surgeons stop waiting for someone else to solve the problems they see every day.

Company #1: Uncover — Dr. Gatta serves as VP of Clinical Affairs for this AI-powered surgical documentation platform. Uncover analyzes intraoperative video in real time and generates detailed, accurate operative notes automatically. Poor operative notes correlate with worse patient outcomes and cause 15-20% undercoding on procedures — a financial gap that affects both surgeon compensation and hospital facility fees. Uncover closes that gap by turning video into documentation, identifying missed CPT codes, modifier 22s, and APC codes that surgeons never capture.

Company #2: EmpowerMedical.ai — Dr. Gatta founded this physician financial transparency platform to answer a question most surgeons have never been able to ask: how much money do I actually generate for my hospital? Using publicly available CMS data and hospital-disclosed pricing, the platform converts a surgeon's case list into a complete financial picture — professional fees, facility revenue, payer mix, DRGs, APCs, and contribution margin. A surgeon performing 124 high-level hernia repairs generates $464,000 in professional fees and $12 million in total system revenue. Most surgeons have no idea. Dr. Gatta wants to make this tool free for all trainees entering practice.

The conversation also covers Dr. Gatta's remarkable personal story: born in India, raised in Kuwait during the Gulf War, self-evacuating as a 13-year-old refugee, medical school in Bombay, and arriving in the US in 2000 for surgical training under pioneer Lee Swanstrom in Portland.

🎙️ Website: prakashgatta.com | EmpowerMedical.ai (free blog on coding & billing)
💼 LinkedIn: Dr. Prakash Gatta | Host: Dr. Amy Vertrees | bosssurgery.com
⭐ If this episode helped you, please leave a review on Apple Podcasts.

Dr. Erin King Mullins is a double board-certified general and colorectal surgeon with 12 years in practice and founder of Colorectal Wellness Center in Metro Atlanta. In this episode, she shares the hard-won business lessons from a difficult exit from her fellowship practice, how she navigated a non-compete clause that left her unable to stay or relocate, and the step-by-step path to launching solo private practice — while pregnant with her second child.  Dr. Mullins and host Dr. Amy Vertrees cover what every surgeon must know about physician employment contracts: why you should read your exit clause before your salary, the critical difference between radius-based and entity-based non-competes, and what at-will employment actually means for physicians. They also discuss the human side of running a medical practice — from firing employees the right way to separating friendship from business decisions.  In the second half of the episode,

Dr. Mullins pulls back the curtain on her experience as a volunteer director with the American Board of Surgery (ABS) — including how complaint reviews actually work, what due process looks like for a surgeon facing a board action, and how the new Entrustable Professional Activities (EPA) framework is transforming resident training and surgical education. 

Whether you’re considering private practice, navigating a contract negotiation, or just want to understand what the ABS actually does for surgeons, this episode is required listening. 
🎙️ Find Dr. King Mullins: @DrTushyTouchUp (IG/TikTok/FB) | colowellness.com 🎙️
Host: Dr. Amy Vertrees | bosssurgery.com ⭐

Timestamps:

0:00

Intro: Meet Dr. Erin King Mullins

1:00

12 Years in Colorectal Surgery

1:30

COVID, Maternity Leave & a Difficult Exit

3:30

Locums as a Bridge

4:00

Business Is the Third Person in the Room

5:00

Firing Employees: The Human vs. Business Side

7:00

Read Your Exit Clause First

7:30

At-Will Employment Law for Physicians

8:00

Non-Competes: Radius vs. Entity-Based

10:30

Why Locums Works for Some Physicians Permanently

11:00

Going Solo: One Person, Infrastructure for Two

12:00

Setting Culture from the Top Down

14:00

Biggest Challenges in Solo Practice

16:00

Business Resources That Helped

18:30

Joining the American Board of Surgery

19:30

The ABS Mission Statement

21:00

Who’s in the Room: Board Diversity

22:00

How the ABS Views Locums Physicians

23:30

What Happens When a Complaint Is Filed

26:00

The Standardized Complaint Review Process

28:30

EPAs: Entrustable Professional Activities

31:00

Get Involved with the ABS

33:30

How to Pivot When You’re Stuck

37:00

Going All In — With a Safety Net

38:00

Women’s Colorectal Health & New Focus

38:30

Where to Find Dr. King Mullins

If this episode helped you, please leave a review on Apple Podcasts — it helps other surgeons find the show.

What do you do when you discover something that could harm patients—and the system doesn't want to hear it?

In this powerful episode, Dr. Amy Vertrees sits down with renowned breast surgeon Dr. Beth Dupree to discuss her extraordinary journey after identifying multiple missed breast cancer diagnoses within a healthcare system.

After discovering what initially appeared to be a single missed cancer, Dr. Dupree followed established quality and reporting pathways only to uncover a much larger pattern. What followed was years of advocacy, resistance, investigation, personal sacrifice, and ultimately transformation.

The conversation explores not only healthcare accountability but also physician resilience, moral injury, leadership, healing, and the courage required to continue speaking up when the personal cost becomes significant.

Beth Dupree is a nationally recognized breast surgeon, educator, author, and pioneer in integrative breast cancer care.

Over her career she:

Dr. Dupree shares how a routine consultation led her to discover a missed breast cancer diagnosis that had been visible on imaging for years.

Rather than dismissing concerns, she followed the data and pursued further investigation.

Key lesson:

Sometimes the first problem you find is only the beginning.

The episode explores what happens when:

Dr. Dupree discusses navigating:

One of the most powerful sections of the conversation centers on the personal impact of advocacy.

Topics include:

Dr. Dupree describes what it feels like to know something is wrong while feeling unable to protect patients in the way she believed they deserved.

A central theme emerges throughout the discussion:

Doing the right thing does not guarantee an easy outcome.

The conversation explores:

The latter part of the episode shifts toward recovery and transformation.

Dr. Dupree shares her journey through:

The discussion examines how physicians can learn to care for themselves while continuing to care deeply for patients.

Dr. Dupree challenges surgeons to think beyond traditional treatment models and remain open to innovation.

Topics include:

"Being right about something in a health system is not always the easy path."

"You cannot work in a system where you are not respected, heard, and valued."

"The truth sets people free."

"Bless the thing that breaks you down and cracks you wide open."

"Personal courage is what changes medicine."

"Sometimes the greatest gift comes from the hardest experience."

✅ Patient advocacy sometimes requires personal courage

✅ Following proper channels does not always guarantee action

✅ Moral injury can have profound effects on physicians

✅ Healing matters for doctors as much as patients

✅ Innovation often begins by listening deeply

✅ Integrity is often tested when the stakes are highest

✅ The experiences that challenge us most can transform our careers

This episode explores intimate partner violence (IPV) in the orthopedic/surgical patient population — an issue surgeons encounter frequently but often fail to recognize or feel unprepared to address.

The discussion focuses on:

Key message:
👉 Surgeons see IPV regularly — whether they realize it or not.

25 years in practice

Motivation: Bridging clinical care and education to help surgeons recognize hidden violence affecting patients.

Key realization:
Medical training teaches mandatory reporting for:

➡️ But no standardized system exists for adult IPV screening.

IPV is broader than many physicians assume.

❌ Only married couples
❌ Only male-on-female violence
❌ Only long-term relationships

IPV can involve:

Surgeons often encounter IPV first because injuries bring patients to medical attention.

Examples include:

Orthopedic and trauma surgeons are uniquely positioned to identify abuse patterns.

Training emphasizes:

But lacks:

Result:
➡️ Physicians suspect abuse but don’t know what to do next.

Surgeons should consider IPV when they notice:

Especially important in:

Statistically, surgeons encounter affected patients weekly.

You don’t need to solve everything — awareness matters.

Treat the whole patient, not just the fracture or operation.

Connecting repeated injuries can reveal abuse.

The episode highlights a broader shift:

What happens when a surgeon decides she's done being underpaid and undervalued — and refuses to sell her practice to private equity? She goes out of network. That's exactly what Dr. Sarah Bryczkowski did, and in this episode she walks us through every step of how she made it work.

Dr. Bryczkowski is a robotic general surgeon in Somerset County, New Jersey and a partner at Somerset Surgical Specialists. After making partner in a private practice and realizing she was barely covering overhead as an in-network surgeon, she convinced her partners to take the leap out of network. Since September of last year, they've been operating entirely out-of-network — and they've never looked back.

This episode breaks down a model that most physicians have heard about but don't fully understand. Sarah demystifies the billing process, explains what the No Surprises Act actually means for surgeons and patients, and talks honestly about the financial risks, the leap of faith, and what it finally feels like to get paid what you're worth.

"I'm doing quality surgery. I wanted to find a way to get paid what I'm worth for what I do — and the employed model didn't fit."

"Balanced billing is a term insurance companies use to scare people away."

"Even if I wasn't making money, I wouldn't want to be told what to do. It's worth it."

"I don't have people problems, I have checklist problems."

"You're sucking wind now, but as long as you've got the metrics, you know you're gonna be okay."

"It's a journey of faith and challenge and courage — but it's so worth it."

Dr. Sarah Bryczkowski is a robotic general surgeon and partner at Somerset Surgical Specialists in Somerset County, New Jersey. She trained at Hackensack University Medical Center, where she was first exposed to the out-of-network practice model. After several years in both employed and in-network private practice settings, she led her practice group to transition out of network — without selling to private equity. She specializes in complex robotic surgery including component separations, hiatal hernia repairs, and fundoplications.

What happens when the job you moved your family for turns out to be the wrong fit?

In this episode, Dr. Amy Vertrees sits down with urologist and entrepreneur Dr. Joe Pazona, founder and CEO of VirtuCare, to discuss the unexpected path from being fired to building a new model of healthcare delivery.

After experiencing broken promises, loss of autonomy, and ethical conflicts inside traditional employment models, Dr. Pazona realized something many physicians quietly suspect:

👉 The problem isn’t always the doctor.
👉 Sometimes the system itself is broken.

This powerful conversation explores how physicians can reclaim leadership, redesign their careers, and create healthcare systems that work for both doctors and patients.

When physicians stop trying to fit into broken systems, they can begin building better ones.

Dr. Joe Pazona is a urologist and CEO of VirtuCare, a healthcare company focused on supporting physicians while expanding specialty access in underserved communities through innovative team-based care models. Find him on LinkedIn here. 

The BOSS Business of Surgery Podcast, hosted by Dr. Amy Vertrees, teaches the lessons surgeons were never taught in residency — including leadership, negotiation, career design, communication, and professional fulfillment.

Follow the show, leave a review, and share with a colleague who’s questioning what comes next in their surgical career.

In this powerful and deeply human episode of the BOSS Podcast, Amy sits down with physician advocate Kim Downey — a three-time cancer survivor whose life changed after the tragic loss of her radiologist to suicide.

What began as personal grief became a national mission to support physician wellbeing.

Together, they explore the hidden emotional cost of practicing medicine, the culture of emotional suppression doctors are trained into, and why physicians must be seen — and supported — as human beings, not superheroes.

Kim shares how her advocacy work, including the Stand Up for Doctors and her book White Coats Human Hearts, helps physicians feel less alone while educating patients and communities about the realities of medical practice.

This episode is a moving conversation about grief, gratitude, complications, physician families, and the healing power of connection.

If you’ve ever wondered who takes care of the doctors — this conversation is for you.

🎧 Topics include:

Physician mental health and suicide awareness

Emotional suppression in medical training

Patient–physician relationships and trust

The power of gratitude in medicine

Rehumanizing doctors and healthcare culture

Perfect for physicians, healthcare professionals, and anyone who wants to better understand the people behind the white coat.

https://standupfordoctors.org/

Dr. Jessica Hott shares her journey from hospital-employed surgeon and medical director to private practice founder after uncovering systemic billing and coding failures that prevented physicians from receiving credit for the care they were already providing.

Her investigation revealed a critical truth: physician burnout is often not caused by workload alone — but by invisible, uncompensated work embedded within healthcare systems.