https://www.spreaker.com/podcast/they-did-what--6752154
Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining what happened and why it matters.

Hosted by Dr. Anand Lalaji, better known as Dr. A, a physician and critic at The Radiology Group, we’ll talk about algorithms that reject care in seconds, prior authorizations that slow treatment, ‘networks’ with no available doctors, and surprise bills that arrive months later. Clear stories, plain language, practical takeaways.

Subscribe to They Did What? New episodes every week.]]>enMedicineDr. Anand Lalajihttps://d3wo5wojvuv7l.cloudfront.net/t_rss_itunes_square_1400/images.spreaker.com/original/0e56bcf49b617c0c395771eae990027e.jpghttps://www.spreaker.com/podcast/they-did-what--6752154Tue, 04 Aug 2026 10:15:12 +0000Dr. Anand LalajiDr. Anand Lalajialalaji@theradiologygroup.orgDid you ever get a medical bill or denial and think, ‘Who the hell approved this?’ If you have, you’ve come to the right place. Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy,...
Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining what happened and why it matters.

Hosted by Dr. Anand Lalaji, better known as Dr. A, a physician and critic at The Radiology Group, we’ll talk about algorithms that reject care in seconds, prior authorizations that slow treatment, ‘networks’ with no available doctors, and surprise bills that arrive months later. Clear stories, plain language, practical takeaways.

Subscribe to They Did What? New episodes every week.]]>false179d251c-3881-5e99-8daf-fdb2e274171cepisodichttps://www.spreaker.com/episode/they-denied-his-cancer-surgery-the-night-before--73400141The night before a man in his mid-forties was set for the cancer surgery that gave him his best shot at survival, his insurer called the treatment experimental and refused to pay. He was a father of three. He did not survive the fight that came next.In this episode, Dr. A lays out how insurers lean on algorithms trained on decade-old data to deny cancer treatments that are now standard of care, stamping proven therapies "experimental" because a cheaper, older option still technically exists. He walks through the quiet arithmetic behind it: the models fit the average patient, so the algorithm rejects the roughly one in three whose disease doesn't match the pattern. In the case he opens with, a retired OB-GYN upheld the denial of an oncology treatment, which he compares to taking your car to a burger counter for a repair.The denials are legal, they're profitable, and almost no one with the power to stop them has a reason to.We Also Cover

• For patients: A "not medically necessary" or "experimental" denial is often a first move, not a final verdict. An appeal that cites current oncology guidelines (the kind published by bodies like the NCCN) is the standard way to fight it.

• For clinicians: The denial rationale frequently hinges on outdated, cost-driven criteria rather than current evidence, Attaching guideline support to the initial request, not just the appeal, gives the "experimental" label nowhere to land.

• System-level: The whole model rests on a 1970s federal law that shields employer health plans from meaningful oversight, so denials can generate cash flow with little accountability

]]>https://api.spreaker.com/episode/73400141Tue, 04 Aug 2026 10:00:02 +0000Dr. Anand LalajiThe night before a man in his mid-forties was set for the cancer surgery that gave him his best shot at survival, his insurer called the treatment experimental and refused to pay. He was a father of three. He did not survive the fight that came...The night before a man in his mid-forties was set for the cancer surgery that gave him his best shot at survival, his insurer called the treatment experimental and refused to pay. He was a father of three. He did not survive the fight that came next.In this episode, Dr. A lays out how insurers lean on algorithms trained on decade-old data to deny cancer treatments that are now standard of care, stamping proven therapies "experimental" because a cheaper, older option still technically exists. He walks through the quiet arithmetic behind it: the models fit the average patient, so the algorithm rejects the roughly one in three whose disease doesn't match the pattern. In the case he opens with, a retired OB-GYN upheld the denial of an oncology treatment, which he compares to taking your car to a burger counter for a repair.The denials are legal, they're profitable, and almost no one with the power to stop them has a reason to.We Also Cover

• For patients: A "not medically necessary" or "experimental" denial is often a first move, not a final verdict. An appeal that cites current oncology guidelines (the kind published by bodies like the NCCN) is the standard way to fight it.

• For clinicians: The denial rationale frequently hinges on outdated, cost-driven criteria rather than current evidence, Attaching guideline support to the initial request, not just the appeal, gives the "experimental" label nowhere to land.

• System-level: The whole model rests on a 1970s federal law that shields employer health plans from meaningful oversight, so denials can generate cash flow with little accountability

]]>1362falsefullhttps://www.spreaker.com/episode/they-called-it-oversight-the-supreme-court-called-it-a-cartel--72638534
In this episode, Dr. A tears through four real cases where state medical boards — the bodies legally entrusted to protect patients — instead protected themselves. A dental board weaponized cease-and-desist letters against competitors. A telehealth giant had to sue its own regulatory body to keep serving patients. And an orthopedic surgeon in the Southwest had his license targeted on the basis of a complaint that included a fabricated patient — a man who never filed a grievance and said his doctor had saved his life. The boards in these cases shared one trait: they were controlled by active practitioners with something to lose. When the regulator and the competitor are the same person, the patient is the last thing on the agenda. These aren't edge cases. The Supreme Court has already ruled on one of them.

We also cover:

• For patients: If a medical board disciplines your doctor, the public record may not tell you why — and the case against them may rest on a complaint you never made, or a consultant who never spoke to you.
• For clinicians: Board consultants reviewing your case are often unnamed, unexamined, and operating solely from the written record — knowing this changes how you document everything, starting now.
• System-level: When active market participants control the regulatory body that governs their own competition, antitrust law — not medical ethics boards — may be the only lever that works.

]]>https://api.spreaker.com/episode/72638534Tue, 23 Jun 2026 10:05:02 +0000Dr. Anand LalajiA neurosurgeon kills seven patients. The state medical board lets him quietly resign — no license revocation, no public record, a clean slate to operate in the next state. That is not a failure of oversight. That is oversight working exactly as some...
In this episode, Dr. A tears through four real cases where state medical boards — the bodies legally entrusted to protect patients — instead protected themselves. A dental board weaponized cease-and-desist letters against competitors. A telehealth giant had to sue its own regulatory body to keep serving patients. And an orthopedic surgeon in the Southwest had his license targeted on the basis of a complaint that included a fabricated patient — a man who never filed a grievance and said his doctor had saved his life. The boards in these cases shared one trait: they were controlled by active practitioners with something to lose. When the regulator and the competitor are the same person, the patient is the last thing on the agenda. These aren't edge cases. The Supreme Court has already ruled on one of them.

We also cover:

• For patients: If a medical board disciplines your doctor, the public record may not tell you why — and the case against them may rest on a complaint you never made, or a consultant who never spoke to you.
• For clinicians: Board consultants reviewing your case are often unnamed, unexamined, and operating solely from the written record — knowing this changes how you document everything, starting now.
• System-level: When active market participants control the regulatory body that governs their own competition, antitrust law — not medical ethics boards — may be the only lever that works.

]]>1720false24fullhttps://www.spreaker.com/episode/the-investor-who-offers-to-save-you-is-the-threat--72422265
This week Dr. A talks about hard lessons from his own years fighting a former partner he can only name by a pseudonym while the case sits in court. His warning is for physician entrepreneurs: smart, fresh out of training, sitting on a real idea, and nearly defenseless against the kind of "investor" who shows up offering to be a savior. He lays out the exact playbook — the manufactured rescue, the grab for control of the money, the conflicted vendor referrals — then sets it beside a celebrity entrepreneur's recent suit alleging her own managers looted her fortune. The pattern is identical.The money, he says, you can earn back. The years you burn fighting for it, you can't.

We Also Cover:

• For physician entrepreneurs: Run a "progressive dating period" before anyone gets equity or control.
• For clinicians eyeing a deal: When a prospective partner pushes a specific vendor, ask straight out whether they own a piece of it or take a profit share — a referral that pays them twice is a conflict, not a favor.
• System-level: These setups run on blurring family and fiduciary — once a "partner" has cast himself as your mentor, big brother, or savior, questioning the books starts to feel like betraying a relative. That's the design.

]]>https://api.spreaker.com/episode/72422265Tue, 09 Jun 2026 10:05:02 +0000Dr. Anand LalajiYou trained fifteen years to become a doctor. Nobody trained you to spot the person who spends the next decade quietly draining everything you built. This week Dr. A talks about hard lessons from his own years fighting a former partner he can only...
This week Dr. A talks about hard lessons from his own years fighting a former partner he can only name by a pseudonym while the case sits in court. His warning is for physician entrepreneurs: smart, fresh out of training, sitting on a real idea, and nearly defenseless against the kind of "investor" who shows up offering to be a savior. He lays out the exact playbook — the manufactured rescue, the grab for control of the money, the conflicted vendor referrals — then sets it beside a celebrity entrepreneur's recent suit alleging her own managers looted her fortune. The pattern is identical.The money, he says, you can earn back. The years you burn fighting for it, you can't.

We Also Cover:

• For physician entrepreneurs: Run a "progressive dating period" before anyone gets equity or control.
• For clinicians eyeing a deal: When a prospective partner pushes a specific vendor, ask straight out whether they own a piece of it or take a profit share — a referral that pays them twice is a conflict, not a favor.
• System-level: These setups run on blurring family and fiduciary — once a "partner" has cast himself as your mentor, big brother, or savior, questioning the books starts to feel like betraying a relative. That's the design.

]]>2110falsefullhttps://www.spreaker.com/episode/they-don-t-care-about-your-doctor--71860881
In this episode, Dr. A pulls back the curtain on a pattern accelerating across specialties — radiology, oncology, anesthesia — where exceptional clinicians are being replaced not by better ones, but by cheaper ones. The engine behind it is private equity and insurance-owned hospital systems operating on a simple mandate: generate margin, cut cost, and move on.
If the numbers work out — 70% margin, 4% more deaths — hospital leadership has already told you which one they will choose. 

We also cover:

• For clinicians: Doctors who resist should focus their attention on the CFO, because is the only person in the building who speaks the language that can save your contract.
• For patients: Radiology is the canary in the coal mine. AI-driven replacement is not a future threat.
• System-level: Insurance companies now own hospitals, clinics, and imaging centers, and they are running physician staffing decisions like an Excel algorithm.

]]>https://api.spreaker.com/episode/71860881Wed, 06 May 2026 10:15:02 +0000Dr. Anand LalajiHospitals are quietly firing their best doctors — not for malpractice, not for complaints, but for costing 8 to 12 percent more than a cheaper alternative. When a 20-year oncologist with 100% patient satisfaction and zero blemishes gets cut to protect...
In this episode, Dr. A pulls back the curtain on a pattern accelerating across specialties — radiology, oncology, anesthesia — where exceptional clinicians are being replaced not by better ones, but by cheaper ones. The engine behind it is private equity and insurance-owned hospital systems operating on a simple mandate: generate margin, cut cost, and move on.
If the numbers work out — 70% margin, 4% more deaths — hospital leadership has already told you which one they will choose. 

We also cover:

• For clinicians: Doctors who resist should focus their attention on the CFO, because is the only person in the building who speaks the language that can save your contract.
• For patients: Radiology is the canary in the coal mine. AI-driven replacement is not a future threat.
• System-level: Insurance companies now own hospitals, clinics, and imaging centers, and they are running physician staffing decisions like an Excel algorithm.

]]>1379false22fullhttps://www.spreaker.com/episode/75-percent-of-physicians-no-longer-own-their-practice--71320611
In this solo episode, Dr. A breaks down what he calls the darkest deal in modern medicine: the private equity acquisition of physician practices. Between 2013 and 2020, nearly a thousand practices were absorbed by PE-backed consolidators — each time triggering the same playbook: cut staff, replace doctors with mid-levels, crank patient volume, code aggressively, and sell before the whole thing collapses. Dr. A traces how a model built for returns on IT companies and fast food chains has been force-fitted onto cardiology offices and ophthalmology suites — and why scaling a body is not the same as scaling a balance sheet.

We also cover:

• For patients: Knowing the ownership structure of your practice is the first step to protecting yourself.
• For clinicians: Before burning out and selling to a PE-backed consolidator, physicians should know that AI-powered practice management tools can now handle a significant portion of administrative workload.
• System-level: The doctrine of corporate practice of medicine exists in many states but is almost never enforced

]]>https://api.spreaker.com/episode/71320611Tue, 14 Apr 2026 17:38:44 +0000Dr. Anand LalajiThree out of four physicians in America no longer own their own practice. The entity that now controls their decisions, their staffing, their billing — is not a doctor. It is a private equity firm with a five-year exit strategy and no obligation to...
In this solo episode, Dr. A breaks down what he calls the darkest deal in modern medicine: the private equity acquisition of physician practices. Between 2013 and 2020, nearly a thousand practices were absorbed by PE-backed consolidators — each time triggering the same playbook: cut staff, replace doctors with mid-levels, crank patient volume, code aggressively, and sell before the whole thing collapses. Dr. A traces how a model built for returns on IT companies and fast food chains has been force-fitted onto cardiology offices and ophthalmology suites — and why scaling a body is not the same as scaling a balance sheet.

We also cover:

• For patients: Knowing the ownership structure of your practice is the first step to protecting yourself.
• For clinicians: Before burning out and selling to a PE-backed consolidator, physicians should know that AI-powered practice management tools can now handle a significant portion of administrative workload.
• System-level: The doctrine of corporate practice of medicine exists in many states but is almost never enforced

]]>1546false21fullhttps://www.spreaker.com/episode/the-first-business-mistake-doctors-never-see-coming--69421686One bad business decision can nearly end a medical career.

In this season-one finale, Dr. A tells a true story from early in his career—what happened when a newly trained physician stepped into entrepreneurship without business training, formal safeguards, or verification. Fresh out of fellowship, at the dawn of digital medicine, he partnered with close friends to build a new kind of radiology practice. The idea was right. The timing was right. The execution was not.

This isn’t about blame. It’s about pattern recognition—and stopping history from repeating itself. If you’re trained to save lives, who teaches you to protect your own?

We Also Cover

• For patients: Why physician burnout and system pressure often start long before you ever meet your doctor
• For clinicians: The hidden risk of entering business without verification, incentives, or guardrails
• System-level: How medical training structurally omits business literacy—and why that gap keeps costing careers

]]>https://api.spreaker.com/episode/69421686Tue, 13 Jan 2026 15:42:10 +0000Dr. Anand LalajiFourteen years of training doesn’t prepare you for this. One bad business decision can nearly end a medical career. In this season-one finale, Dr. A tells a true story from early in his career—what happened when a newly trained physician stepped into...One bad business decision can nearly end a medical career.

In this season-one finale, Dr. A tells a true story from early in his career—what happened when a newly trained physician stepped into entrepreneurship without business training, formal safeguards, or verification. Fresh out of fellowship, at the dawn of digital medicine, he partnered with close friends to build a new kind of radiology practice. The idea was right. The timing was right. The execution was not.

This isn’t about blame. It’s about pattern recognition—and stopping history from repeating itself. If you’re trained to save lives, who teaches you to protect your own?

We Also Cover

• For patients: Why physician burnout and system pressure often start long before you ever meet your doctor
• For clinicians: The hidden risk of entering business without verification, incentives, or guardrails
• System-level: How medical training structurally omits business literacy—and why that gap keeps costing careers

]]>1361false18fullhttps://www.spreaker.com/episode/when-physicians-stopped-acting-together--69177860
In this episode of They Did What, Dr. A delivers a blunt reckoning with the medical profession itself. He traces how professional culture, competition, and failure to unify created openings for insurers, corporate owners, and legal frameworks to move into clinical decision-making. The result: defensive medicine, productivity quotas, and care shaped as much by billing codes as by patient need.

This is not about blaming individual clinicians. It’s about how shared behaviors—embracing commercialization, tolerating fragmentation, and avoiding collective advocacy—slowly weakened professional authority.

 We Also Cover

• For patients: Why your doctor may be constrained even when they agree with your care plan
• For clinicians: How professional fragmentation reduced leverage with payers and institutions

System-level: How cultural norms inside medicine enabled long-term corporatization]]>https://api.spreaker.com/episode/69177860Tue, 30 Dec 2025 10:05:08 +0000Dr. Anand LalajiPhysicians no longer control many of the decisions that shape patient care—and that loss didn’t happen overnight. According to Dr. A, it took decades of fragmented choices, missed chances to act together, and quiet acceptance of outside control. In...
In this episode of They Did What, Dr. A delivers a blunt reckoning with the medical profession itself. He traces how professional culture, competition, and failure to unify created openings for insurers, corporate owners, and legal frameworks to move into clinical decision-making. The result: defensive medicine, productivity quotas, and care shaped as much by billing codes as by patient need.

This is not about blaming individual clinicians. It’s about how shared behaviors—embracing commercialization, tolerating fragmentation, and avoiding collective advocacy—slowly weakened professional authority.

 We Also Cover

• For patients: Why your doctor may be constrained even when they agree with your care plan
• For clinicians: How professional fragmentation reduced leverage with payers and institutions

System-level: How cultural norms inside medicine enabled long-term corporatization]]>1044false17fullhttps://www.spreaker.com/episode/doctors-are-quietly-reaching-a-breaking-point--68944958
In this episode, Dr. A breaks down how toxic hierarchies, unchecked “star performer” protection, and hostile peer dynamics create a workplace that can quietly harm both physicians and the patients who rely on them. From radiologists treated as “second-class,” to trainees pushed to silence, to real cases where speaking up triggered retaliation, we map how a broken culture ripples from the reading room to the exam room.

We translate the research, separate fact from opinion, and show how structural issues—weak leadership training, tenure shields, burnout, and rigid hierarchies—fuel the problem. If this culture drives physicians out, who is left to care for patients?

What happens to patient safety when the caregivers themselves are under constant fire?

We Also Cover

• For patients: What toxic culture can look like from the outside and how it may impact communication or wait times.
• For clinicians: Early warning signs of unhealthy hierarchies and how to protect your professional boundaries.

System-level: Why leadership training (not just clinical skill) is essential to stop the cycle.]]>https://api.spreaker.com/episode/68944958Tue, 16 Dec 2025 10:00:21 +0000Dr. Anand LalajiNearly 1 in 4 healthcare workers report being bullied by a supervising physician, according to a major 2019 review. And inside some large medical centers, that culture isn’t improving—it’s spreading. That is the minefield Dr. A walks us through today....
In this episode, Dr. A breaks down how toxic hierarchies, unchecked “star performer” protection, and hostile peer dynamics create a workplace that can quietly harm both physicians and the patients who rely on them. From radiologists treated as “second-class,” to trainees pushed to silence, to real cases where speaking up triggered retaliation, we map how a broken culture ripples from the reading room to the exam room.

We translate the research, separate fact from opinion, and show how structural issues—weak leadership training, tenure shields, burnout, and rigid hierarchies—fuel the problem. If this culture drives physicians out, who is left to care for patients?

What happens to patient safety when the caregivers themselves are under constant fire?

We Also Cover

• For patients: What toxic culture can look like from the outside and how it may impact communication or wait times.
• For clinicians: Early warning signs of unhealthy hierarchies and how to protect your professional boundaries.

System-level: Why leadership training (not just clinical skill) is essential to stop the cycle.]]>1332false16fullhttps://www.spreaker.com/episode/the-hidden-trap-in-medical-lawsuits--68740727
In this episode, Dr. A walks listeners through a real 2024 federal case involving a plaintiff-side medical malpractice lawyer. An example of how rare but extreme misconduct can distort a system meant to protect patients. Dr. A also breaks down why litigation data lives forever, how this shapes physician behavior, and why only a minority of states use patient-compensation funds to stabilize payouts.When a bad outcome happens, who’s accountable and who decides what counts as malpractice?

We Also Cover

• For patients: What a verified negligent act actually means—and how to vet an attorney.
• For clinicians: Why documentation is your strongest protection in non-negligent bad-outcome cases.
• System takeaway: How patient-compensation funds can reduce unnecessary lawsuits—and why they’re rare.

]]>https://api.spreaker.com/episode/68740727Tue, 02 Dec 2025 10:00:18 +0000Dr. Anand LalajiWhen one attorney can threaten a major transplant center with a multimillion-dollar payout, the whole system feels shaky. And when a federal jury convicts that attorney of attempted extortion, it exposes a pressure point most patients never see...
In this episode, Dr. A walks listeners through a real 2024 federal case involving a plaintiff-side medical malpractice lawyer. An example of how rare but extreme misconduct can distort a system meant to protect patients. Dr. A also breaks down why litigation data lives forever, how this shapes physician behavior, and why only a minority of states use patient-compensation funds to stabilize payouts.When a bad outcome happens, who’s accountable and who decides what counts as malpractice?

We Also Cover

• For patients: What a verified negligent act actually means—and how to vet an attorney.
• For clinicians: Why documentation is your strongest protection in non-negligent bad-outcome cases.
• System takeaway: How patient-compensation funds can reduce unnecessary lawsuits—and why they’re rare.

]]>957false15fullhttps://www.spreaker.com/episode/when-a-single-no-costs-a-lifetime-of-pain--68507482
In this episode, Dr. A unpacks the case of a teenager whose early-onset spinal degeneration was treated like a middle-aged backache by a major insurer. Despite MRI proof, failed physical therapy, and years of documented pain, coverage was denied, until public outrage forced a reversal. This story isn’t an outlier; it’s a mirror. A system built to “maintain health” has turned into a numbers game where denials come faster than diagnoses, and appeals buy time for profit.

What happens when the rules of care are written by those who never meet the patient?

We Also Cover:

• For patients: Why 15 % of claims are auto-denied and how to appeal effectively.
• For clinicians: What “gold-carding” means and how to qualify for it.
• For the system: How the Health Maintenance Act’s legacy fuels profit-driven coverage decisions.

]]>https://api.spreaker.com/episode/68507482Tue, 18 Nov 2025 10:00:16 +0000Dr. Anand LalajiShe couldn’t stand for more than a minute. At 18. Her doctor said surgery could fix it…her insurer said no. In this episode, Dr. A unpacks the case of a teenager whose early-onset spinal degeneration was treated like a middle-aged backache by a major...
In this episode, Dr. A unpacks the case of a teenager whose early-onset spinal degeneration was treated like a middle-aged backache by a major insurer. Despite MRI proof, failed physical therapy, and years of documented pain, coverage was denied, until public outrage forced a reversal. This story isn’t an outlier; it’s a mirror. A system built to “maintain health” has turned into a numbers game where denials come faster than diagnoses, and appeals buy time for profit.

What happens when the rules of care are written by those who never meet the patient?

We Also Cover:

• For patients: Why 15 % of claims are auto-denied and how to appeal effectively.
• For clinicians: What “gold-carding” means and how to qualify for it.
• For the system: How the Health Maintenance Act’s legacy fuels profit-driven coverage decisions.

]]>1174false14fullhttps://www.spreaker.com/episode/the-broken-economics-of-saving-lives--68304012
In this episode, Dr. A digs into the upside-down math of physician reimbursement. We walk through how lobbying tilts the playing field, why elective procedures outpay life-saving ones, and what this means for patients, doctors, and the future of medicine. Behind every hospital bill is a simple but devastating question: when the people who save lives are the ones most underpaid, how long can the system hold?

We Also Cover

• For patients: Why knowing procedure reimbursement rates helps you understand access and hidden incentives.
• For clinicians: How distorted pay scales drive burnout and career flight from life-saving specialties.
• System takeaway: Lobbying and fee schedules (not clinical need) set the value of life-saving care.

]]>https://api.spreaker.com/episode/68304012Tue, 04 Nov 2025 10:00:18 +0000Dr. Anand LalajiA surgeon saves your life by cutting out your inflamed gallbladder and gets paid less than the price of a MacBook. A heart transplant surgeon trains for 17 years, spends 10 hours in the OR, and takes home just $1,250, sometimes less than what’s paid...
In this episode, Dr. A digs into the upside-down math of physician reimbursement. We walk through how lobbying tilts the playing field, why elective procedures outpay life-saving ones, and what this means for patients, doctors, and the future of medicine. Behind every hospital bill is a simple but devastating question: when the people who save lives are the ones most underpaid, how long can the system hold?

We Also Cover

• For patients: Why knowing procedure reimbursement rates helps you understand access and hidden incentives.
• For clinicians: How distorted pay scales drive burnout and career flight from life-saving specialties.
• System takeaway: Lobbying and fee schedules (not clinical need) set the value of life-saving care.

]]>1150false13fullhttps://www.spreaker.com/episode/inside-the-broken-world-of-medical-licensing--68163944
In this episode, Dr. A takes us inside the hidden world of medical licensing boards. We look at how one board member was convicted of illegally distributing opioids while simultaneously judging other doctors, how lawsuits in states like Oklahoma reveal backroom deals and conflicts of interest, and why even honest physicians are afraid to come forward. At stake? Not just careers, but patient access and the worsening doctor shortage.If the people overseeing doctors are themselves unchecked, who’s really protecting patients and what can be done about it?

We Also Cover:

• For patients: Why physician shortages and licensing board abuse could limit your access to care.
• For clinicians: How even minor complaints can spiral, and the importance of knowing your state board’s culture.
• For the system: How legal immunity shields boards and fuels calls for reform.

]]>https://api.spreaker.com/episode/68163944Tue, 21 Oct 2025 10:00:08 +0000Dr. Anand LalajiA single complaint (true or not) can unravel a physician’s entire career. Once a state licensing board gets involved, the process can move like a runaway train: opaque, insulated, and nearly impossible to appeal. The boards were built to protect...
In this episode, Dr. A takes us inside the hidden world of medical licensing boards. We look at how one board member was convicted of illegally distributing opioids while simultaneously judging other doctors, how lawsuits in states like Oklahoma reveal backroom deals and conflicts of interest, and why even honest physicians are afraid to come forward. At stake? Not just careers, but patient access and the worsening doctor shortage.If the people overseeing doctors are themselves unchecked, who’s really protecting patients and what can be done about it?

We Also Cover:

• For patients: Why physician shortages and licensing board abuse could limit your access to care.
• For clinicians: How even minor complaints can spiral, and the importance of knowing your state board’s culture.
• For the system: How legal immunity shields boards and fuels calls for reform.

]]>1438false12fullhttps://www.spreaker.com/episode/the-ai-that-decides-if-you-get-care--68032968
In this episode, Dr. A unpacks how a major insurer deployed an AI tool that automatically rejected claims without a physician review, despite laws requiring it. What looks like efficiency on paper could mean millions of patients face roadblocks to life-saving treatments.

Dr. A breaks down why medicine’s complexity can’t be reduced to code, how profit-driven incentives shape these systems, and the long shadow cast by the HMO Act of 1973. If insurers hide behind AI, what happens when the denials pile up faster than appeals can ever catch?

We Also Cover

• How to request a human review of any AI-driven denial.
• Why documenting medical necessity in plain terms is more critical than ever.
• How regulatory gaps let insurers build and run their own decision-making algorithms.

]]>https://api.spreaker.com/episode/68032968Tue, 07 Oct 2025 10:00:08 +0000Dr. Anand LalajiWhen an algorithm can deny your care in seconds, who’s really making the call on your health? In this episode, Dr. A unpacks how a major insurer deployed an AI tool that automatically rejected claims without a physician review, despite laws requiring...
In this episode, Dr. A unpacks how a major insurer deployed an AI tool that automatically rejected claims without a physician review, despite laws requiring it. What looks like efficiency on paper could mean millions of patients face roadblocks to life-saving treatments.

Dr. A breaks down why medicine’s complexity can’t be reduced to code, how profit-driven incentives shape these systems, and the long shadow cast by the HMO Act of 1973. If insurers hide behind AI, what happens when the denials pile up faster than appeals can ever catch?

We Also Cover

• How to request a human review of any AI-driven denial.
• Why documenting medical necessity in plain terms is more critical than ever.
• How regulatory gaps let insurers build and run their own decision-making algorithms.

]]>1006false11fullhttps://www.spreaker.com/episode/introducing-the-they-did-what-podcast--67942443
Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining what happened and why it matters.

Hosted by Dr. Anand Lalaji, better known as Dr. A, a physician and critic at The Radiology Group, we’ll talk about algorithms that reject care in seconds, prior authorizations that slow treatment, ‘networks’ with no available doctors, and surprise bills that arrive months later. Clear stories, plain language, practical takeaways.

Subscribe to They Did What? New episodes every week.]]>https://api.spreaker.com/episode/67942443Tue, 30 Sep 2025 10:00:08 +0000Dr. Anand LalajiDid you ever get a medical bill or denial and think, ‘Who the hell approved this?’If you have, you’ve come to the right place. Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining...
Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining what happened and why it matters.

Hosted by Dr. Anand Lalaji, better known as Dr. A, a physician and critic at The Radiology Group, we’ll talk about algorithms that reject care in seconds, prior authorizations that slow treatment, ‘networks’ with no available doctors, and surprise bills that arrive months later. Clear stories, plain language, practical takeaways.

Subscribe to They Did What? New episodes every week.]]>55falsetrailer