The New Physician: Today’s Difficult Problem

A commercial property can look healthy on paper and still run out of cash.

In this talk, I walk through a simple example: a $5 million building with $3 million of debt, but late rent, an uncertain lease renewal, roof work, taxes coming due, insurance obligations, and a lender payment due Friday.

The key point is simple: equity is not liquidity.

My first move would be to build a 13-week cash map and update it every week. Track what cash is actually coming in, what absolutely has to go out, and what happens if any payment is delayed.

Then separate expenses into three groups: what keeps the property alive, what can potentially be renegotiated, and what can wait.

Before missing a lender payment, have the conversation early. Bring the cash picture, the collection plan, and a specific request.

Finally, determine whether the problem is temporary timing or something structural.

Then make the call: hold and fix, restructure or refinance, recapitalize, or sell.

The lesson: you can be rich on the balance sheet and broke on Tuesday.

A project is months late, over budget, and everyone keeps saying it is “almost there.”

What do you do when you have 48 hours to decide whether to keep funding it?

Use a simple framework:

STOP
Freeze new commitments long enough to stop throwing money at the problem automatically.

SEE
Find out what is actually true. What was promised? What was delivered? What has already been spent? What still has to be spent? Is the problem technical, leadership, scope, vendor, or strategy?

Then ask the uncomfortable question:

If we were starting from scratch today, would we still choose to fund this project?

RESET
Within 48 hours, make a real decision:

Continue with a new stepwise plan, milestones, clear ownership, and kill criteria.

Replace the leader, vendor, or execution model if the project still makes sense but delivery is the bottleneck.

Stop if the economics or strategic reason for the project no longer holds.

The key rule:

Past spending is not a reason to spend the next dollar.

And the first 48 hours are not about fixing the project.

They are about deciding whether the project still deserves to be fixed.

Sonny Saggar, MD
Professional Problem Solver
NewPhysician.org

AI can make a new employee dramatically faster before they have developed the judgment to know whether the output is actually good.

Andrew Wang, CEO and co-founder of Valon, has taken a deliberately cautious approach: new hires first learn the job, then earn more freedom to delegate work to AI once they can recognize bad outputs, catch mistakes, and know when human judgment is still required.

The framework is simple:

LEARN
Understand the job, what good looks like, where mistakes happen, and what the important exceptions are.

EARN
Show that you can judge the output, catch errors, and know when to stop and escalate.

LEVERAGE
Then use AI aggressively for research, comparison, summarizing, drafting, automation, and other work where it can multiply your effectiveness.

This is not an anti-AI argument. It is a management argument.

AI should multiply competence, not replace the need to develop it.

There is also a business case: powerful AI models can be expensive, and using them indiscriminately for basic work can waste both money and compute.

Learn the work. Earn the judgment. Then leverage the machine.

Sonny Saggar, MD
Professional Problem Solver
NewPhysician.org

We are spending enormous amounts of money making AI more powerful, then handing it documents that were never designed for machines to understand.

This episode argues that the real bottleneck may not be AI at all. It may be the document format.

PDFs are excellent at preserving how something looks, but they often do not reliably carry the meaning underneath the page.

A machine may see text, numbers, and boxes without inherently knowing:

this is a diagnosis

this number is revenue

this one is EBITDA

this clause creates an obligation

this is the final approved version

this statement came from this source

That means humans and machines repeatedly have to reconstruct meaning that could have been built into the document itself.

The talk asks a simple question:

Instead of endlessly teaching smarter machines to interpret yesterday’s documents, should we build a better document?That is the idea behind Universal Document, an open, vendor-neutral standard intended to make documents simultaneously human-readable, machine-understandable, traceable, verifiable, and portable across systems.The goal is not another proprietary document platform. It is an open foundation that governments, businesses, developers, and software vendors can all build around.Sometimes the problem is not the workflow. It is the substrate underneath it.NewPhysician.org

You do not have to leave medicine to create a second professional lane.

Today's episode explains how physicians can use the judgment they have spent years developing in a different setting: expert witness work.

Modern clinical practice often rewards throughput, documentation, inbox management, checkboxes, call coverage, and administrative compliance. Expert work can reward something different: the ability to review complex records, identify what matters, explain it clearly, and give an independent opinion.

The key is independence.

The lawyer retains you. The truth employs you.

Expert witness work should never mean selling an opinion or becoming a hired gun. It means applying the same standard whether you are working for a plaintiff or a defense team, staying within your expertise, and being willing to say, “I don’t know.”

This can begin quietly. You can join an expert network, create a profile, set your rates and interests, and then go back to your normal work. Nothing may happen for months. Then the right matter may appear, and you decide whether to accept it.

I also explain why I built HIVE MedicoLegal around that idea: free to join, private by default, CV-assisted profile creation, you set your own rates, no HIVE commission, and no obligation to accept a matter.

You do not have to quit medicine.

You can simply create optionality.

Your expertise is valuable. Your independence is priceless.

This Loom addresses how a CEO should handle a disagreement between the CFO and the head of sales about cutting spending during a bad quarter. Instead of picking a side, the CEO should identify the decision variable by asking what fact would make each person correct, such as cash runway, conversion rate, gross margin, customer acquisition cost, or the sales cycle and payment lag. The discussion contrasts scenarios where there are 16 weeks of cash left versus only six weeks, showing how timing can settle the argument even if both executives are smart. The key is to agree on the scoreboard before funding decisions and make disagreement useful without humiliating either side.

In serious business negotiations, avoiding the uncomfortable issue rarely makes it disappear. It usually just wastes time.

In this talk, Sonny Saggar explains a simple four-part framework for restructuring, turnaround, investment, acquisition, and other high-stakes discussions:

WANT
Understand what each side actually wants, not just the polite version.

RISK
Name the other side’s concerns before they become an argument. If leverage, timing, control, downside, or execution risk is obvious, say it out loud.

ASK
Ask the hard question early: given those risks, is there still a structure here that you would seriously consider?

DECIDE
If there is a path forward, define the next step. If there is not, find out now instead of spending weeks or months pretending there might be.

The point is not to be blunt for the sake of being blunt. Forthrightness means being polite, professional, firm, and clear enough that both sides know whether there is actually a deal worth pursuing.

A fast no can be valuable.

Sometimes what looks like a disappointing meeting is actually three months of your life handed back to you.

WANT. RISK. ASK. DECIDE.

Sonny Saggar, MD
Professional Problem Solver
NewPhysician.org

Revenue is down 20%. The CFO wants cuts. Sales wants more investment. Operations warns that cutting too deeply could break service.

The wrong move is to react to the symptom before diagnosing the cause.

This Loom shows a simple executive decision process:

SYMPTOM → CAUSE → BOTTLENECK → ACTION

First, ask what actually changed. Is the decline coming from lower volume, weaker pricing, delayed collections, lost customers, margin compression, seasonality, or a deeper structural problem?

Then ask whether the problem is temporary or structural.

Next, identify what is actually dangerous. Is the real threat cash flow, debt service, margin, churn, collections, or operating capacity?

Finally, find the bottleneck. Do not attack every visible problem at once, and do not make blunt 20% cuts simply because revenue is down 20%.

The key lesson is simple:

A brilliant solution to the wrong problem is still the wrong solution.

Good executive decisions are not about moving fastest. They are about identifying the real problem, understanding what is controlling the outcome, and acting with discipline.

Most people track how many jobs they apply for. A better question is: how far does each application actually get?

This Loom gives you a simple three-step system:

VERIFY
Before applying, spend 60 seconds on the employer’s own careers site. Confirm the exact vacancy is still live, the location is correct, and the Apply button actually works. If the page says “job not found,” redirects to a generic careers page, or the application is closed, stop.

MATCH
Spend two minutes checking the real hard requirements: license, degree, location, security clearance, experience, and any other must-haves. Then make your CV clearly show why you fit this specific role instead of sending the same generic résumé everywhere.

REACH
After applying, try to find one real person connected to the role: a recruiter, hiring manager, team leader, employee, or mutual contact. A short human introduction can help keep you from disappearing into the application system.

Then track only four numbers:

Verified live jobs
Applications sent
Human conversations
Interviews

The goal is not to send more applications. It is to find where your job-search funnel is breaking and fix that exact stage.

Verify. Match. Reach. Then measure what happens.

Will AI take your job? Maybe that is the wrong question.

Most jobs are really bundles of tasks. A better way to think about AI is to look at the work you actually do and ask three questions:

1. Can AI do this?
Routine drafting, summarizing, searching, comparing, basic reporting, and some administrative work are already becoming easier to automate.

2. Can AI help me do this?
Research, planning, analysis, first drafts, and decision support can often become much faster and better with AI beside you.

3. Does a human still need to own this?
Judgment, trust, persuasion, relationships, leadership, ethical decisions, difficult conversations, and responsibility for the outcome still matter enormously.

The practical lesson is simple: do not just ask whether AI will replace your profession. Break your job into tasks, see which ones AI can handle, which ones it can amplify, and which ones still require human ownership.

AI attacks tasks before it replaces whole jobs.

Sonny Saggar, MD
Professional Problem Solver
NewPhysician.org