"Bereavement leave ends. Bereavement doesn't." Everyone shows up for the funeral, then goes back to living - and that is the week your team member comes back to work.

Kelly Edmondson is a nurse executive with 25 years in healthcare and a certified grief counselor. After losing her son in 2023, she founded Timely Presence, which sends a year of gifts timed to the dates that land hardest - the birthday, the anniversary, the first Mother's Day.

She joins Jakub Grajcar on how a practice can support its own people, and a patient's family, through a loss.

We dig into:

🏥 Kelly's #1 tip for growing a practice - solve a real problem, and stop trading the two minutes of human connection for the next appointment
🕯️ Why grief doesn't start at the notification - people surround you, then they go back to living, and that is when grief actually arrives
🧭 Grief beyond death - a divorce, a lost role, a pet, a limb - and how to respond to them
📉 The number that surprises employers most - over half of people leave their job within a year of a significant loss
🔁 The three R's - regulate your own emotions first, respond by doing something concrete, then remain long after everyone else has moved on
💬 What to actually say: ""I don't know what to say, but I'm here."" Grief is not fixable, so stop trying to fix it
⚖️ Flexibility without ambiguity - name which duties shift and which they still own, then check it's working for the person and the practice
✉️ How a practice can support a patient's grieving family

Resources mentioned:

👤 Guest: Kelly Edmondson, MSN, MBA, RN, NEA-BC, CGC - Founder & CEO, Timely Presence
LinkedIn: https://www.linkedin.com/in/kelly-edmondson
Website: https://thetimelypresence.com

📱 Timely Presence on social media
Instagram: https://www.instagram.com/thetimelypresence
Facebook: https://www.facebook.com/TimelyPresence

🧭 Framework
The Presence Framework - Kelly's three R's: regulate, respond, remain

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

A real practice should survive two weeks with the owner gone. If it can't, you don't own a business - you own a job.

Alejandro "Alex" Fernandez has spent more than 30 years in physician practice management, front desk to boardroom. He ran multi-specialty groups as large as 150 physicians and was founding CEO of Gastro Health, the first private-equity-backed gastroenterology platform to sell. He now runs Synergy Orthopedic Specialists in San Diego.

He joins Jakub Grajcar on how practices actually scale - and what buyers see before they offer.

We dig into:

🏥 Alex's #1 tip for growing a practice - if it can't run for two weeks without you, you own a job, not a business
🪑 Why patient experience is the most neglected part of a practice, and what a twelve-page clipboard tells a new patient
📊 What to get right before you grow - your numbers, your billing, and the habit of pulling every dollar out of the business
💉 How to keep the revenue you're currently referring out - path labs, lasers, aesthetics, a shared PA, and the ROI math behind each
🤝 Merging vs. buying another practice - why a merger of equals is the harder move, and where those conversations break down
🚩 What physician alignment actually means, and what happens to a group when five owners have five different plans
💼 What buyers see when they look at your practice - and why two groups earning the same money don't sell for the same price

Resources mentioned:

👤 Guest:
Alejandro "Alex" Fernandez, MBA, CMPE - CEO, Synergy Orthopedic Specialists
LinkedIn: https://www.linkedin.com/in/alexfernandezmba/
Website: https://synergysmg.com

🏢 Organizations
Gastro Health - first private-equity-backed gastroenterology platform; Alex was founding CEO: https://gastrohealth.com

📚 Books
Traction: Get a Grip on Your Business - Gino Wickman

🎬 Off-topic but mentioned
The Odyssey - Jakub's unsponsored movie recommendation

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

Your insurance pays out when the building burns. It doesn't pay out when the hurricane misses and you close for ten days anyway.

Van Carlson is Founder and CEO of SRA 831(b) Admin, the largest administrator of 831(b) plans - a part of the tax code that lets small and mid-sized practices set aside pre-tax dollars for the risks insurance won't touch. He has almost 30 years in risk management and hosts the Unmitigated podcast.

He joins Jakub Grajcar on what practices are already self-insuring without knowing it.

We dig into:

🏥 Van's #1 tip for growing a practice - stay relevant. Embrace AI where it fits, and drop the wash, rinse, repeat: "if your competitors are willing to bob and weave, you better be willing to too"
💰 What an 831(b) plan actually is - an HSA for business risk: expense the dollars up front, hold them tax-deferred, use them when your insurer doesn't
🌪️ The losses nobody covers - COVID shutdowns, hurricane evacuations where the storm never lands, a washed-out bridge that stops patients reaching you
📄 Your policy in 2019 vs. today - higher premiums and more exclusions, and every exclusion is risk moved back onto your side of the ledger
🔍 Medicare and Medicaid audits - the auditors are paid a cut of what they find, and honest practices still get caught on a missing dot
🛡️ Brand protection - reviews and local news move your income and your exit value, and there is no policy that covers it
🔐 Cyber comes down to training - over 90% of breaches trace back to staff knowledge, so run phishing tests, pre-write the press release, and put cyber training into the review cycle

Resources mentioned:

👤 Guest: Van Carlson - Founder & CEO, SRA 831(b) Admin
LinkedIn: https://www.linkedin.com/in/vancarlson
Website: https://www.831b.com

🎙️ Podcast - Unmitigated (Van's show on risk management for business owners)
Apple Podcasts: https://podcasts.apple.com/us/podcast/unmitigated/id1751591180
Spotify: https://open.spotify.com/show/1XJMDNuF2FsqWgGtEdEIuW

🎙️ Also recommended - Darknet Diaries (Jakub's podcast pick on how breaches, social engineering and forensics actually work): https://darknetdiaries.com

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

Private equity owns a lot of medical practices - except it usually doesn't own the practice at all.

John Rhodes has practiced healthcare law for nearly 20 years, most recently leading the legal team at Walmart Health. In February 2025 he founded Health Law Counsel in Denver, where he represents everyone from large health systems to medical practice, behavioral health and AI startups. He also hosts the Health Law Pulse podcast.

He joins Jakub Grajcar to explain how practices are actually structured - and what changes when you scale across a state line.

We dig into:

🏥 John's #1 tip for growing a practice - the right tech stack, and leaders who actually know healthcare
🏛️ Who can own a medical practice - the three corporate practice of medicine prohibitions, and the states that have some version of them
🤝 How the MSO-PC model works
⚖️ The Art Center Holdings case pending in California - what a ruling on share transfer restriction agreements would change, and why John is rooting for the outcome he is
🗺️ Crossing a state line - NP and PA supervision rules, licensure, telehealth, record retention, and why most practices just apply the strictest state everywhere
📊 The three data basics - know where your data lives, decide your institutional position on de-identified data, then put a real approval process behind it
🤖 Adopting AI well - state disclosure rules for AI chatbots, the FDA line on clinical decision support, and keeping a human on prior auth

Resources mentioned:

👤 Guest: Johnathan A. Rhodes - Founder, Health Law Counsel, LLC
LinkedIn: https://www.linkedin.com/in/johnrhodesjd
Website: https://www.healthlawcounsel.com

🎙️ Podcast - Health Law Pulse
Apple Podcasts: https://podcasts.apple.com/us/podcast/health-law-pulse/id1864421920
Spotify: https://open.spotify.com/show/4vKjzL8Xr3Xdyv6uhUCuIN

📰 Where John keeps up
CMS listservs and rule updates: https://www.cms.gov
HHS Office of Inspector General enforcement briefings: https://oig.hhs.gov
Department of Justice press releases: https://www.justice.gov
LexisNexis: https://www.lexisnexis.com
Modern Healthcare: https://www.modernhealthcare.com
Newsletters from the larger healthcare law firms

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

Every touchpoint in your practice either builds trust or erodes it - including your hold music and the clipboard at your front desk.

Joshua Altman was a multimedia journalist at The Hill before founding beltway.media, where he works as a fractional chief communications officer. Instead of hiring an agency or a full-time comms team, practices bring him in to run the whole function - branding, PR, website, reviews, marketing.

He joins Jakub Grajcar to break down how a practice earns trust and actually gets found.

We dig into:

🏥 Joshua's #1 tip for growing a practice - make every communication useful, and never run an ad just to run an ad
📋 Clipboards and hold music - two touchpoints most practices hand over to drug brands and phone providers instead of using them
🔍 How to get found now that patients ask AI instead of Google
😄 Humor and white coat syndrome - where the line is, and how to check what your state medical board actually allows
🎥 The nephew effect - why a provider looking slightly uncomfortable on camera outperforms polished production
📅 Two hours on Thursday - the time-blocking system for practices with no marketing budget, plus his four languages model: read, see, hear, experience
🧩 Story vs. narrative vs. brand - the pyramid most practices only build the top of

Resources mentioned

👤 Guest: Joshua Altman - Managing Director, beltway.media
LinkedIn: https://www.linkedin.com/in/joshuaialtman/
Website: https://beltway.media
Social: @thecommschief

🏢 Platforms & tools
Substack - his pick for practice content: writing, video, audio, live Q&A in one place
Mayo Clinic and Cleveland Clinic - accessible vs. clinical, well-balanced content

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

Where does AI actually fit in a medical practice - and where should it never go?

Stephen Ferrara, DNP, has been a nurse practitioner for 26 years, served as president of the American Association of Nurse Practitioners, and ran the AI office at Columbia University School of Nursing. He now runs AI + Nurse Academy, teaching the world's largest healthcare workforce how to use this technology.

He joins Jakub Grajcar to cover the fundamentals - and the admin work AI is ready to take off your front desk today.

We dig into:

🏥 Stephen's #1 tip for growing a practice - remember you're there to serve patients
🤖 What AI actually is under the hood - probability machines, tokens, temperature, weights
📞 The admin case - and how there's no administrative task AI can't at least assist with
✋ Human in the loop, and why the clinician stays the final gatekeeper
🤝 What software teams miss when they build for clinicians - and the one question they skip
📹 Why video and computer vision is next in AI
🎓 How to actually get up to speed - free models, personal-life test cases, and a half hour a week

Resources mentioned:

👤 Guest: Stephen Ferrara, DNP, FNP-BC, FAAN, FAANP, FNAP
LinkedIn: https://www.linkedin.com/in/sferraradnp/
AI + Nurse Academy: https://www.ainurseacademy.ai - foundational on-demand AI course
Instagram: https://www.instagram.com/ai_nurseacademy

🏢 Organizations & tools
American Association of Nurse Practitioners (AANP) - Stephen served as president
Columbia University School of Nursing - led the school's AI efforts
Talkie.ai - AI medical receptionist
Shen.AI - camera-based screening, 30+ health markers from a face scan: https://shen.ai

📚 Worth following in healthcare + AI
Ethan Mollick - One Useful Thing newsletter: https://www.oneusefulthing.org
The AI Daily Brief podcast: https://podcasts.apple.com/us/podcast/the-ai-daily-brief-artificial-intelligence-news/id1680633614
Free intro resources from OpenAI and Anthropic

🎙️ Related SPM episode referenced in the conversation
Brendan Keeler on EHR data access and liability (ep. 32)

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

Your patients are already using AI. The question is whether your practice is ready for what they bring through the door.

Chris Hutchins spent 25 years building and defending the data systems behind real clinical care - including as Chief Data and Analytics Officer at Northwell Health and Lifepoint Health. He now advises health systems and boards on AI governance through Hutchins Data Strategy Consulting, hosts The Signal Room podcast, and just published his book Beneath the Signal.

He joins Jakub Grajcar to explain what makes AI actually work inside a practice - starting with the data underneath it.

We dig into:

🏥 Chris's #1 tip for growing a practice - be clear about who you are and why someone should trust you
📅 The visit type cleanup - why standardized time slots are what unlock no-show prediction and smarter schedule optimization
🌡️ Seasonality in your templates
✅ Book the follow-up before the patient leaves - the exam room door sign, the diabetic recall protocol every front desk should know, and why "not everything is an integration problem"
🤖 What to know about patients arriving with AI answers - what the models can't see and how to talk about it without losing trust
🔍 How to get much better output from AI
👤 Why the person using AI is the part that makes it valuable - and the one test worth applying to any tool

Resources mentioned:

👤 Guest: Chris Hutchins
LinkedIn: https://www.linkedin.com/in/chutchins-healthcare/
Hutchins Data Strategy Consulting: https://hutchinsdatastrategy.com
Speaking site: https://chrisjhutchins.com

🎙️ Podcast - The Signal Room (AI in healthcare: strategy, governance & ethical leadership)
Web: https://signalroompodcast.com
YouTube: https://www.youtube.com/@SignalRoomPodcast

📚 Book
Beneath the Signal - Chris Hutchins: https://www.amazon.com/dp/B0GYJDQBZR

🎙️ Related SPM episodes referenced in the conversation Saul Marquez on marketing and AI strategy (ep. 30) Dr. Louis Gilbert on people before profits (ep. 31)

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

How do you get a busy front desk to accept new technology - without a revolt?

Leasa Horst, CPA, has been practice administrator at ESD Pediatric Group - a two-location Cincinnati practice caring for families for over 80 years - for more than 30 of them. She's led her team through paper-to-EHR, central phones, and most recently an AI receptionist (ESD Group is a Talkie.ai client). In this podcast, she shares the change-management playbook that makes it all stick.

We dig into:

🏥 Leasa's #1 tip for growing a practice - be open to change, lean on your peers, and genuinely value your people
📅 The 90-day rule - why day 30 is the hardest, and how the complaints fade by day 90
🤖 How the team actually adapted to "Jessica," their AI receptionist - and what made it click
📞 From two phone lines to one central number - and why going to an EHR made it possible
🛋️ "You don't make money in the waiting room" - how closing waiting rooms during COVID created 3 new exam rooms
☎️ Hiring for the front desk - why former bartenders and waitresses make some of her best hires
📖 The book that shaped her leadership: Crucial Conversations

Resources mentioned:

👤 Guest: Leasa Horst, CPA
🏥 ESD Pediatric Group: https://www.esdpeds.com/

🏢 Companies & Tools
athenahealth (their EHR)
Talkie.ai - AI medical receptionist (ESD uses Talkie on their front desk)

📚 Books
Crucial Conversations: Tools for Talking When Stakes Are High - Kerry Patterson, Joseph Grenny, Ron McMillan, Al Switzler
The 7 Habits of Highly Effective People - Stephen Covey

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=WzBD7PorTsU&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

Most independent practices assume they're stuck with whatever their EHR ships with - the default scribe, the default CRM, the default everything. Brendan Keeler says that's no longer true.

Known to many as the "Health API Guy," Brendan leads the interoperability practice at HTD Health and has seen the EHR world from nearly every angle - 5.5 years inside Epic, plus stints at Redox, Zus Health, and Flexpa. He joins Jakub Grajcar to explain why independent practices have more power over their technology than they realize.

We dig into:

🔌 Brendan's #1 tip - lean on interoperability to get big-system efficiencies without giving up your independence
⚖️ Why the 21st Century Cures Act means your EHR can't just block the software you want to use
🏛️ How practices are winning against Epic, PointClickCare, and Henry Schein in court - and what it means for you
🧩 Point solutions vs. the EHR bundle - why the specialist tool is usually better, and how to force integration
🤖 Copilots vs. agents - the two kinds of AI, and why scribes took off first
🗺️ How to actually choose AI: map your workflows, find the bottleneck, then know your own buying priorities
📞 Why the AI front desk is the next wave after the scribe - lower clinical risk, faster efficiency gains

Resources mentioned:

👤 Guest: Brendan Keeler
LinkedIn: https://www.linkedin.com/in/brendan-keeler
Newsletter - Health API Guy: https://healthapiguy.substack.com
X: https://x.com/healthapiguy

🏢 Companies & Tools
HTD Health: https://htdhealth.com
Health information exchange on-ramps: Particle Health, Health Gorilla, Zus Health
Independent-practice-focused HIE tools: Connective Health, Abstractive Health

🏛️ Regulation & bodies mentioned
21st Century Cures Act (information blocking)
Office of the National Coordinator (ONC)
Office of the Inspector General (OIG)

📚 Book
Essentialism by Greg McKeown

⚖️ Court cases referenced
Information blocking suits against Epic, PointClickCare, and Henry Schein

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg

When you're growing a practice, it's easy to let the numbers start making your decisions for you. Dr. Louis Gilbert refuses to.

Dr. Louis Gilbert, founder and CEO of Cornerstone MD, is building a multi-location family medicine group across Houston and Pasadena, Texas - with a goal of opening a new clinic every year. He joins Jakub Grajcar to talk leadership, integrity, and growing a practice without losing sight of the people it serves. He also talks about his experience as a client of Talkie.ai, implementing an AI receptionist at his practice.

We dig into:

🏥 Dr. Gilbert's #1 tip for growing a practice - grow people before you grow locations, because culture and problem-solvers are what actually scale
🚶 The "Walk with a Doc" program - how a monthly community walk turned patients into family and grew the practice
🌱 "Grow where you're planted" - why the Pasadena and Houston clinics run differently, and how one core standard still holds both together
⚖️ People before profits - what integrity looks like in the everyday decisions practice leaders actually face
📞 Covering the calls you're missing - how Dr. Gilbert kept his front desk and let Talkie AI triage the overflow instead of hiring a 20-person call center
👥 The 3 I's of hiring (via Warren Buffett) - intelligence, initiative, and integrity, and why initiative is the hardest to spot

Resources mentioned:

👤 Guest: Dr. Louis Gilbert
LinkedIn: https://www.linkedin.com/in/louis-gilbert-26b646184/
Instagram: https://www.instagram.com/_drlouisgilbert_/

🏥 Cornerstone MD: https://cornerstonemd.health
Lumé Haus (medical spa): https://www.lumehaus.health/
myWelli (healthcare app in development): https://www.mywelli.health/

🏛️ Texas Medical Association - supported the launch of Walk with a Doc

🧠 Also mentioned
Warren Buffett's "three I's" hiring framework - intelligence, initiative, integrity

🎥 See how Talkie.ai works - AI medical receptionist demo: https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSg