Life of Flow

Surgeons measure fistulas with precision—then send them into a dialysis-unit “black hole” where the same injury cycle starts again.Dr. Erin Moore is a Jacksonville vascular surgeon and former Navy physician who left roughly 15 years of military medicine for private-practice independence. There he owned high-volume dialysis access—about two to three hundred fistulas and grafts a year—and later became VP of clinical affairs around chair-side access-mapping software he names Veristra.This is not a war-story sequel. It is the systems problem behind failing dialysis access: thin tech training, on-the-job habits, high turnover, missing longitudinal stick history, area puncture as default, and a field that overbuilt stents and balloons while underbuilding the moment the needle hits the arm. Moore softens the old “micrometer vs ax” joke—staff are not trying to wreck access; they often lack tools, time, and information. His fix is mundane on purpose: photo + QR scale, mark arterial and venous sticks, color-age recent marks, and heat-map hotspots so the chair regains memory.In this conversation, Dr. Aaron Moore reveals:⬛ Why the unit becomes an information black hole after a surgical create⬛ How same-site puncture wears access toward pseudoaneurysm and failure⬛ Why rope-ladder is known to work—and still fails to become habit⬛ What a photo, QR scale, color-aged marks, and a fistula heat map change at the chair⬛ How pilot staff who only recorded points said they were still flying blind⬛ Why treating ~50% annual fistula patency as “OK” is a systems indictment⬛ What a 1973 patient-engineer already plotted on graph paper that centers still lackEducational discussion of workflow and systems—not individualized treatment advice. Early pilot signals are not universal outcome proof.The Dialysis Unit Is a Black Hole: Why Fistulas Keep Failing | Aaron MooreTimestamps:00:00 The dialysis access black hole00:45 Life of Flow intro00:59 Welcome back: entrepreneurship, not war stories01:47 Navy medicine to Jacksonville independence05:02 Owning dialysis access in private practice05:34 Micrometer surgery, missing chair-side tools09:31 Same cannulation paradigm since 196509:55 Why the dialysis unit feels like a black hole10:31 Overbuilt rescue tech, underbuilt point of care12:29 Area puncture vs rope-ladder reality13:44 Photograph, QR scale, mark every stick15:25 Heat maps that show where you’ve been18:26 From curious investor to operator25:24 Pilot lesson: recording without history is still blind32:33 Stop predicting pseudoaneurysms—prevent the pattern34:22 A 50% annual fistula patency bar37:28 The 1973 engineer who mapped every poke50:04 Pilot size, clustering trend, what to prove nextFollow the guest:LinkedIn: https://www.linkedin.com/in/vascularmdjaxProduct named in-episode: Veristra (dialysis access management software; spelling normalized from transcript variants)Resources mentioned:Rope-ladder vs area-puncture cannulation (discussed as established literature; no single paper titled on-air)Guest-stated CMS-scale U.S. dialysis burden and annual intervention needFDA breakthrough device pathway as narrated for their concept1973 dialysis reimbursement moment and the patient-engineer access logIf you operate or cannulate access, watch the black-hole segment, then the heat-map workflow, and ask where your system is still flying blind.Life of Flow is hosted by Dr. Lucas Ferrer & Dr. Miguel Montero-Baker.🌐 Website: https://lifeofflowpodcast.com▶ YouTube: https://www.youtube.com/@LifeofFlowPodcast🎧 Listen: Spotify https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U · Apple https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604📩 Partner with the show: [email protected] with the hosts:Prepared for Life of Flow publication. Educational discussion only; not individualized medical advice. The core question is whether better chair-side memory can reduce repeated injury

WARNING: RVUs may measure a physician's activity, but they can keep doctors from seeing the real money their work creates. Hospitals know the value of every procedure. Most physicians never see the numbers.Dr. Eric Smuclovisky is an interventional radiologist, former academic physician and independent physician-entrepreneur. After opening an OBL/ASC, he watched reimbursement cuts and negative media pressure threaten the model. He then found another route to autonomy: negotiating professional service agreements that allow physicians to work with hospitals without surrendering their independence as W-2 employees.In this conversation, Dr. Eric Smuclovisky reveals:⬛ Why physician fees collapsed while hospital facility fees expanded—and how that changed who controls American medicine⬛ Why he calls RVUs “monopoly money,” and how doctors can begin discovering what is actually billed under their names⬛ How the No Surprises Act, charge lists, payer contracts, and IDR expose the hidden economics behind a medical bill⬛ Why the physician shortage may finally give doctors enough leverage to negotiate from strengthEric explains why a hospital's charge list is its “dirty little black book.” Hospitals set prices then negotiate discounts with commercial payers; those deals are not simple multiples of Medicare. A summary of benefits might show an $80,000 charge, roughly $20,000 paid, and $1,000 owed by the patient. The gaps reveal the private contracts behind the bill. It matters.Follow Dr. Eric Smuclovisky:LinkedIn: https://www.linkedin.com/in/eric-smuclovisky-58206927b/Resources mentioned in this episode:🏢 Outpatient Endovascular and Interventional Society (OEIS): https://oeisweb.com/🔗 Stark Law, CMS: https://www.cms.gov/medicare/regulations-guidance/physician-self-referral🔗 No Surprises Act and independent dispute resolution, CMS: https://www.cms.gov/nosurprises🔗 CMS Physician Fee Schedule and CPT reimbursement lookups👤 Ross Perot, referenced during the discussion of RVU historyLife of Flow is hosted by Dr. Lucas Ferrer and Dr. Miguel Montero-Baker.🌐 Website: https://lifeofflowpodcast.com▶ YouTube: https://www.youtube.com/@LifeofFlowPodcast🎧 Listen: Spotify https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U · Apple https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604📩 Partner with the show: [email protected] with the hosts:Dr. Lucas Ferrer — [Lucas LinkedIn]Dr. Miguel Montero-Baker — https://www.linkedin.com/in/miguel-montero-baker-a44354214/Follow Life of Flow:Instagram: https://www.instagram.com/lifeofflowpodcast/X: https://x.com/vascularpodcastLinkedIn: https://www.linkedin.com/company/lifeofflow

A 72-year-old man was sent for a major amputation. One angiogram exposed the anatomy everyone else had missed—and a path to save his limb.Dr. Mariano Palena is an interventional radiologist and vascular specialist focused on complex endovascular limb salvage and chronic limb-threatening ischemia. In this Case Cast, he joins Dr. Lucas Ferrer and Dr. Miguel Montero-Baker to reconstruct a rescue that began after failed surgical revascularization and ended with a healed foot.The patient had diabetes, ischemic heart disease, bilateral CLTI, a previous left transmetatarsal amputation, and extensive gangrene of the right forefoot. A prior team explored possible bypass targets and concluded that nothing more could be done. Mariano’s team challenged that conclusion with a rule every limb-salvage program should confront: no major amputation without angiography.In this conversation, Dr. Mariano Palena reveals:⬛ Why a foot that looks like a vascular “desert” may still contain hibernating vessels—and the clues that reveal them.⬛ How an anatomical variation in the plantar circulation can make a reasonable bypass strategy fail before the true target is recognized.⬛ Why telling patients that bypass is “one and done” creates the wrong expectations for a chronic disease that may require repeat maintenance.⬛ What changes when clinicians describe limb salvage as remission rather than cure—and why another intervention may still be a successful outcome.⬛ How Mariano follows angiographic “breadcrumbs,” crosses long chronic total occlusions, re-enters plantar vessels, and rebuilds flow through the foot.⬛ Why the team debated opening one tibial pathway versus two—and whether extra flow justified more time, contrast, radiation, and devices.⬛ What happened after the final angiographic “wow” moment: reconstruction, complete healing at three months, and a return to work.This is not a promise that every threatened limb can be saved. It is a close look at the reasoning, imaging, technical persistence, and honest patient counseling required before an irreversible decision is safely made.Timestamps:00:00 — The Life of Flow Case Cast returns01:20 — A limb referred for major amputation03:12 — Gangrene, failed bypass exploration, and WIfI05:31 — Limb salvage as remission, not cure07:24 — Why bypass is not “one and done”09:36 — Mariano on repeat interventions and expectations12:04 — “No amputation without angiography”16:11 — CO₂ angiography and severe below-knee disease20:19 — The “desert foot” appears21:44 — The anatomical variation that changed the case26:29 — Following the angiographic breadcrumbs30:07 — Crossing strategy for a long CTO35:53 — Recanalizing the peroneal pathway38:41 — Re-entry into the lateral plantar artery and arch43:58 — One-vessel versus two-vessel revascularization50:36 — The final angiographic “wow” moment53:59 — Why a limb-salvage second opinion matters54:56 — Fully healed at three months56:18 — Closing perspectiveFollow Dr. Mariano Palena:LinkedIn: https://it.linkedin.com/in/mariano-palena-35b62259Website: https://marianopalena.com/Resources mentioned in this episode:• WIfI classification and the Global Vascular Guidelines• BEST-CLI trial• CO₂ angiography• Navicross and Bernstein catheters• Terumo and Asahi guidewiresLife of Flow is hosted by Dr. Lucas Ferrer & Dr. Miguel Montero-Baker.🌐 Website: https://lifeofflowpodcast.com▶ YouTube: https://www.youtube.com/@LifeofFlowPodcast🎧 Listen: Spotify https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U · Apple https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604📩 Partner with the show: [email protected] with the hosts: Dr. Lucas Ferrer — [Lucas LinkedIn] Dr. Miguel Montero-Baker — https://www.linkedin.com/in/miguel-montero-baker-a44354214/Follow the show: Instagram https://www.instagram.com/lifeofflowpodcast/ · X https://x.com/vascularpodcast · LinkedIn https://www.linkedin.com/company/lifeofflow

The Microhospital Playbook with Dr. Adriano GoffiA physician can own 100 freestanding ERs—but direct ownership of one microhospital creates a completely different legal and financial reality. Dr. Adriano Goffi explains the economics, operating model, and ownership structures behind a more physician-led alternative.Dr. Adriano Goffi, MD, MPH, is a board-certified family medicine physician.  He is the Director at East Houston Medical Center. He brings an operator’s view of how clinical care, reimbursement, staffing, physician autonomy, and ownership collide.In this conversation, Dr. Goffi reveals:Why he believes a well-run microhospital can complete in eight hours what might otherwise require five to nine separate medical visitsHow physician-ownership restrictions shape the use of land companies, nonprofit structures, trusts, and other arrangements that require expert legal reviewHow reserving equity keeps clinicians invested Meet Dr. Adriano Goffi05:14Why locums gave Adriano control of his time08:59Learning medicine “backwards” through DRGs and medical decision-making12:18Why sending chest-pain patients home felt incomplete14:13The economics of eight ER patients per day15:00Turning a freestanding ER into a microhospital21:19The 24-hour-shift tradeoff and physician quality of life22:39Why doctors can own ERs but face restrictions on hospital ownership24:08Delivering five to nine visits’ worth of care under one roof28:13What a microhospital actually is33:34Staffing and equipping a standalone emergency room36:52Why inpatient beds open the door to Medicare participation39:11Capital raises, land, debt, and the opening-day clock40:26EBITDA multiples and why attached clinics matter41:32Why physician ownership changes culture and patient experience42:20Is the freestanding emergency-room boom ending?45:36The single screening question that generated 50 colonoscopies47:07Hypothetical: building a physician-led microhospital in Houston47:34Land ownership, trusts, and the need for specialized counsel49:46Site selection: traffic patterns, income, and the Walmart heuristic51:50What a $20 million state-of-the-art build could include53:14Why growth is shifting from standalone ERs to microhospitals53:54Building a hospital in six months with modular pods55:32Why 10 to 20 beds is Adriano’s sweet spot57:16Would you sell to a health system—or keep physician ownership?59:44 Reserving equity for the clinicians doing the work61:21 Could an office-based vascular model live inside a microhospital?LinkedIn: https://www.linkedin.com/in/adriano-goffi-md-mph-81b399a2/CMS guidance on physician-owned hospitals: https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/physician-owned-hospitalsCMS independent dispute resolution under the No Surprises Act: https://www.cms.gov/nosurprises/help-resolve-payment-disputes/payment-disputes-between-providers-and-health-plansU.S. Small Business Administration loan programs: https://www.sba.gov/funding-programs/loansLife of Flow is hosted by Dr. Lucas Ferrer and Dr. Miguel Montero-Baker.Website: https://lifeofflowpodcast.com/▶ YouTube: https://www.youtube.com/@LifeofFlowPodcast/🎧 Spotify: https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U🎧 Apple Podcasts: https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604📩 Partner with the show: [email protected] with the hosts:Dr. Lucas Ferrer: https://www.linkedin.com/in/lucasferrermd/Dr. Miguel Montero-Baker: https://www.linkedin.com/in/miguel-montero-baker-a44354214/Instagram: https://www.instagram.com/lifeofflowpodcast/X: https://x.com/vascularpodcastLinkedIn: https://www.linkedin.com/company/lifeofflow#Microhospital #PhysicianEntrepreneurship #EmergencyMedicine #HealthcareBusiness #LifeOfFlowPodcastThis episode is for educational and informational purposes only and does not constitute medical, legal, tax, investment, or financial advice.

Dr. Christoff Heunis is a biomedical and mechatronics engineer (PhD, University of Twente) and the founder & CEO of Flux Robotics, a University of Twente spin-off building a magnetically guided robotic system that steers a guidewire through the body from outside the patient. It started with a single phone call while he was an engineering student in South Africa — a best friend's mother had a stroke, and there were only a handful of surgeons on an entire continent who could treat it.In this conversation, Dr. Christoff Heunis reveals:⬛ Why one phone call — a friend's mother's stroke, with "three neurovascular surgeons" for the whole African continent — set the course of his life⬛ How an external robotic magnet can pull a guidewire around the tightest, most complex angles a surgeon's hands can't reach⬛ Why surgeons say they don't want to be replaced — yet "do want to press a button and then leave, and when I come back, the surgery is over"⬛ The first real-world use case: misaligned fenestrations, CTOs and the angles no combination of guide catheters can make⬛ How Flux got the FDA to confirm a 510(k) pathway — and why the predicate they found changes everything⬛ What Stereotaxis acquiring Robocath signals about the commercial future of magnetic surgery⬛ How he raised €3.2M in non-dilutive funding before giving up a single point of equityTimestamps:00:00 Intro — the "Afrikaans Slim Shady"04:58 The stroke that started it all06:29 Why a PhD in surgical robotics at Twente11:17 The surgeon's real bottleneck: navigation & radiation15:42 How the magnetic guidewire actually works20:02 "Press a button and the surgery is over"24:58 The first use case: misaligned fenestrations30:49 A carotid crossing, step by step34:37 The surgeon's new role: "PAD coach"36:00 Company update & new CMO Dr. Rob Beasley37:15 The 510(k) pathway, explained40:31 Stereotaxis buys Robocath50:04 Raising €3.2M non-dilutive59:24 Live: the Afrikaans rap "Soms"Follow Dr. Christoff Heunis:LinkedIn — https://www.linkedin.com/in/christoff-heunis/Flux Robotics — https://fluxrobots.comResources mentioned in this episode:🏢 Flux Robotics — https://fluxrobots.com🏢 Stereotaxis — https://www.stereotaxis.com🔗 Stereotaxis acquires Robocath (announcement) — https://ir.stereotaxis.com/news-releases/news-release-details/stereotaxis-announces-definitive-agreement-acquire-robocath🏢 Robocath — https://www.robocath.com/🏢 Intuitive / da Vinci Surgical System — https://www.intuitive.com🎓 University of Twente — https://www.utwente.nl/en/🎓 Stellenbosch University — https://www.sun.ac.za/english🏛 RVO — Netherlands Enterprise Agency — https://www.rvo.nl🏛 NWO — Dutch Research Council — https://www.nwo.nl/en🏛 Interreg (EU cross-border funding) — https://www.interreg.eu💸 NextGen Ventures — https://www.nextgenventures.nl💸 Future Tech Ventures — https://futuretechventures.nl👤 Dr. Rob Beasley — CMO, Flux Robotics — https://www.linkedin.com/in/robert-beasley-138124145/👤 David Fischel — Chairman & CEO, Stereotaxis — https://www.linkedin.com/in/davidfischel/🎵 Eminem — "Lose Yourself" — https://open.spotify.com/track/5Z01UMMf7V1o0MzF86s6WJ🎵 "Soms" — Christoff's Afrikaans rap single, with his brother Daniel (name only)Life of Flow is hosted by Dr. Lucas Ferrer & Dr. Miguel Montero-Baker.🌐 Website: https://lifeofflowpodcast.com▶ YouTube: https://www.youtube.com/@LifeofFlowPodcast🎧 Listen: Spotify https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U · Apple https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604📩 Partner with the show: [email protected] with the hosts: Dr. Lucas Ferrer — https://www.linkedin.com/in/lucasferrermd/ Dr. Miguel Montero-Baker — https://www.linkedin.com/in/miguel-montero-baker-a44354214/Follow the show: Instagram https://www.instagram.com/lifeofflowpodcast/ · X https://x.com/vascularpodcast · LinkedIn https://www.linkedin.com/company/lifeofflow

In this episode, we sit down with Dr. Shahla Moghbel, D.O., a board-certified neurologist based in California who works as an independent contractor, and Dr. Santoshi Billakota, M.D., a board-certified neurologist and epileptologist based in New York City who works full-time in locum tenens.They share why they stepped away from traditional physician employment, how they prepared financially for the change, and what doctors need to understand about credentialing, contracts, taxes, benefits, and retirement before going independent.They also speak candidly about the identity shift that can come with leaving academic medicine or another traditional institutional path, and learning to separate professional value from institutional affiliation.04:54 The shame and identity shift that can come with leaving a traditional career path11:34 The random Wednesday that changed Lucas’s definition of freedom17:10 Santoshi’s one-year plan for researching and preparing to leave her job21:26 Shahla’s strategy of reducing her hours and calculating her minimum financial needs27:32 Using locums as a bridge and learning how to negotiate better opportunities30:24 The difference between hospital privileges and insurance credentialing37:08 Why medical training leaves out contracts and the business side of medicine39:47 Moving from W2 employment to 1099 work with support from a lawyer and CPA44:10 Solo 401(k) plans, health benefits, and outsourcing financial planningWho Should ListenThis episode is for physicians considering locums, independent contract work, or a move away from academic or employed medicine. It is especially relevant for doctors who want more autonomy but need a practical view of the financial, administrative, and personal decisions involved.About Shahla Moghbel, D.O.Dr. Shahla Moghbel is a board-certified neurologist based in Walnut Creek, California. She completed her neurology residency at Georgetown University, an administrative and business fellowship at Vituity Stanford, and a clinical neurophysiology fellowship at Stanford Medicine. After working in a partnership, she moved into independent contract work across neurology and also does nonclinical work. She co-hosts the Be Empowered podcast, where she and Santoshi speak with physicians about burnout, career changes, and work outside the traditional path.Connect with Shahla Moghbel, D.O.💼 LinkedIn: Shahla Moghbel D.O.About Santoshi Billakota, MDDr. Santoshi Billakota is a board-certified neurologist and epileptologist based in Brooklyn. After completing residency at Duke, fellowship at Columbia, and an academic appointment at NYU, she left academic medicine and now works full-time as a locums physician while also taking on nonclinical work. She co-hosts the Be Empowered podcast, which focuses on healthcare issues, including topics concerning women.Connect with Santoshi Billakota, M.D.💼 LinkedIn: Santoshi Billakota M.D.🎙️Connect with Be Empowered: The PodcastSpotify: Be Empowered: The PodcastApple: Be Empowered: The PodcastYouTube: Be Empowered: The PodcastInstagram: @EmpowermedlifeAbout LocumstoryLocumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course.Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about physician independence, locums, and what it takes to step away from traditional employment without leaving the financial side to chance, share it with a colleague who’s considering a different path in medicine. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare leaders find conversations like this.

In this episode of Life of Flow, we sit down with Dr. Eric Smuclovisky, M.D., an interventional radiologist in Indianapolis, Indiana, affiliated with Elkhart General Hospital. Eric joins us for a direct conversation about physician independence, why the old private practice model became harder to sustain, what changed for OBLs, and how independent physicians can think about hospital service agreements without becoming hospital employees.04:30 What changed when OBL revenue took a hit07:56 How physician fees shaped the old private practice model13:04 Why hospital privileges once gave physicians more control15:40 The history behind physician lounges and hospital incentives31:28 Why physicians need to understand how the money moves40:17 Why OBLs may still matter, even as the model gets harder43:39 Why RVUs keep physicians disconnected from real revenue46:01 Charge lists, commercial payers, and understanding what hospitals bill56:28 Selling a service line to a hospital and negotiating a fixed rateWho Should ListenThis episode is for vascular surgeons, interventional radiologists, cardiologists, independent physicians, and early career physicians who want to understand the business side of medicine. It is especially relevant for anyone thinking about OBLs, hospital relationships, service agreements, or how to maintain more autonomy without working fully outside the system.About Dr. Eric Smuclovisky, M.D.Dr. Eric Smuclovisky is an interventional radiology doctor in Indianapolis, Indiana and is affiliated with Elkhart General Hospital. He received his medical degree from Ponce Health Sciences University and has been in practice between 11 and 20 years. In the episode, Eric shares that he started out in academics, later left, opened an OBL and ASC with a partner, and now works through a professional service agreement with a hospital alongside his partner Brian.Connect with Dr. Smuclovisky💼 LinkedIn: Eric SmucloviskyAbout LocumstoryLocumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course.Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about physician independence, hospital service agreements, and what it takes to build leverage without becoming employed by the system, share it with a colleague who’s thinking about the business side of medicine. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare leaders find conversations like this.

In this episode of Life of Flow, we sit down with Dr. Robert Pearl, M.D., former CEO of The Permanente Medical Group, author of ChatGPT, MD, and a leading voice on how generative AI could change American medicine.The conversation moves between physician-led systems, private practice, capitation, chronic disease control, and what happens when AI begins working inside the daily gaps between patient visits. Dr. Pearl makes the case that AI is not just an administrative tool, but a way to improve quality, lower costs, and give physicians more time for the patients who need them most.05:35 Writing ChatGPT, MD, and the malpractice question around AI08:47 Patient trust, human presence, and vulnerable moments in care11:14 AI-assisted diagnosis, malpractice premiums, and physician autonomy18:19 Administrative AI and the bigger shift inside care delivery25:58 What AI means for physicians entering medicine now33:42 Why generative AI has to be discussed in the context of capitation38:33 The tools physicians have today that did not exist three years ago45:17 Bringing the capitation conversation back to AI48:10 AI agents and the future of patient follow-up51:32 Where to find Dr. Pearl’s book and ongoing workWho Should ListenThis episode is for physicians, private practice owners, healthcare operators, and anyone thinking seriously about how generative AI, capitation, and physician-led care could change the economics and delivery of medicine. It is especially relevant for clinicians trying to understand where independence, technology, and patient trust fit into the next phase of healthcare.About Dr. Robert Pearl, M.D.Dr. Robert Pearl, M.D., served as CEO of The Permanente Medical Group, where he was responsible for physicians across the East Coast and West Coast, and describes Permanente as the physician side of Kaiser Permanente. In the episode, he explains that Permanente was physician-owned and physician-run, with its own board of directors, and that the organization established standards of care across settings, including the OR, cath labs, and ERs.Dr. Pearl is also the author of ChatGPT, MD, a book focused on how AI empowered patients and physicians can take back control of American medicine. He writes for Forbes, posts articles on LinkedIn, hosts the Fixing Healthcare podcast, and continues to speak and write about generative AI, healthcare strategy, capitation, and the future of physician-led care.Connect with Dr. Pearl💼 LinkedIn: Robert Pearl, M.D.🗞️ Website: robertpearlmd.comAbout LocumstoryLocumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course.Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about generative AI, physician-led care, and what it could take to improve outcomes without losing the human side of medicine, share it with a colleague who’s thinking about where healthcare is heading. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare leaders find conversations like this.

In this episode of Life of Flow, we sit down with Preston Alexander, co-founder of Forward Slash Health, for a practical conversation about the business side of private practice. Preston shares how he went from medical device product management to healthcare startups, consulting, revenue cycle work, and building a financial management platform for independent practices.We talk through the financial blind spots many physicians face when they leave employed medicine, including revenue cycle, cash flow, accounts receivable, accounts payable, outsourcing, staffing, and why understanding the numbers matters if you want to build a sustainable practice.07:30 Preston’s path from MBA to medical devices and healthcare business09:01 Using LinkedIn to learn how healthcare really works11:02 How Forward Slash Health started from private practice pain points18:27 Why Miguel keeps his revenue cycle team close to the practice24:04 Cash flow, seasonality, and why big checks can be misleading35:00 Where private practices commonly leak money42:40 Why “doctors are bad at business” misses the point54:30 What to know before outsourcing revenue cycle management57:35 How to connect with Preston and Forward Slash HealthWho Should ListenThis episode is for physicians, surgeons, private practice owners, and doctors thinking about leaving the hospital system to build something independent. It’s also useful for anyone in healthcare operations who wants a clearer understanding of how revenue cycle, staffing, vendor relationships, and cash flow affect a practice.About Preston AlexanderPreston Alexander is the CEO and co-founder of Forward Slash Health and Chief Operating Officer at Underscore Law. His background spans healthcare business, medical device product management, digital health, revenue cycle work, and private practice financial management.In the episode, he shares how his path from earning an MBA to working inside healthcare companies, launching and selling a medical device company, and helping build independent practices led him to focus on the financial systems physicians need to understand when running a practice.Connect with Preston💼 LinkedIn: Preston Alexander🗞️ Substack: The Healthcare BreakdownAbout LocumstoryLocumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course.Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcastIf this conversation made you think differently about the business side of medicine, share it with a colleague who’s building, running, or considering an independent practice. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare leaders find conversations like this.

Andrew Sponsler, founder of Axiom, joins us this week to talk about agentic AI, personal operating systems, and why physicians should start experimenting before the tools become fully packaged for everyone else. Andrew builds AI operating systems for businesses, and in this episode, he breaks down what agentic AI means, how founders are using it now, and where it could start removing real operational pain from medical practices, from case logging to revenue cycle management.03:04 What agentic AI is and why it matters04:10 Andrew’s four-layer framework for understanding AI tools07:00 How agentic AI acts beyond a single prompt08:41 Why most people still have not engaged with AI10:37 Should people start building now or wait for easier tools?14:32 Why surgeons are wired to spot problems worth solving17:44 Lucas’ case logging and billing workflow idea22:39 Where beginners can start with Claude Code30:29 Hardware, security, model routing, and basic setup34:34 How Andrew helps businesses map and automate workflows43:35 Why revenue cycle management may be the highest ROI use caseWho Should ListenThis episode is for physicians, surgeons, founders, operators, and medical practice owners who are curious about using AI to reduce operational friction without losing control of the work. It will especially resonate with anyone thinking about case logs, billing workflows, dashboards, communication overload, or the practical first steps of building with AI.About Andrew SponslerAndrew Sponsler is the founder of Axiom, where he builds AI operating systems for businesses. His background is in continuous improvement and process mapping, and in the episode, he describes working with small and midsize businesses to create AI native workflows, streamline operations, and automate processes that create bottlenecks for founders and teams. He also runs Builder Weekend in Austin, a hands-on event for people building with AI at different stages.Connect with Andrew📲 Instagram: @andrewsponsler💼 LinkedIn: @andrewsponsler Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about agentic AI, physician-built tools, and what it could look like to automate the parts of medical practice that slow people down, share it with a colleague who’s curious about where this is all heading. And if you’re enjoying Life of Flow, a quick review helps more physicians and builders find conversations like this.

El Dr. Michael Theodoulou, DPM, FACFAS, trabaja en uno de los entornos más complejos del salvamento de extremidades: pacientes diabéticos con heridas neuroisquémicas graves, infecciones extensas y pocas alternativas reales antes de una amputación mayor. En esta conversación explica cómo comenzó a utilizar la angiogénesis por distracción como complemento regenerativo en casos donde la revascularización por sí sola no era suficiente, y detalla paso a paso cómo realiza la técnica, qué resultados ha observado y por qué cree que puede cambiar la forma en que se aborda la cicatrización en pacientes sin opciones tradicionales de salvamento. El episodio también profundiza en las limitaciones reales de preservar una extremidad si esa extremidad deja de ser funcional, la importancia del trabajo multidisciplinario y un caso clínico complejo que muestra todo el proceso de toma de decisiones.02:26 Trabajo multidisciplinario con cirugía vascular y pacientes complejos08:18 El origen del concepto y la experiencia de la comunidad ortopédica china12:04 Cómo realiza la corticotomía tibial y el proceso completo de distracción18:44 Resultados iniciales, cicatrización y preservación de extremidades20:33 Desarrollo de un dispositivo para simplificar la técnica22:09 Debate sobre amputaciones tipo guillotina y respuesta regenerativa27:24 Caso clínico complejo con herida neuroisquémica del talón30:56 Calcanectomía parcial, control de infección y manejo de la herida35:26 Aplicación de angiogénesis por distracción en el caso presentado37:44 Uso de monorail y evolución final del paciente¿Quién debería escuchar este episodio?Cirujanos vasculares, podólogos, especialistas en salvamento de extremidades y profesionales que trabajan con pacientes diabéticos complejos encontrarán especialmente valiosa esta conversación. También puede resultar útil para médicos interesados en nuevas estrategias regenerativas y en enfoques multidisciplinarios para heridas complejas y preservación funcional de extremidades.Sobre Dr. Michael Theodoulou, DPM, FACFASDr. Michael H. Theodoulou es jefe de cirugía podiátrica en Cambridge Health Alliance y profesor adjunto de cirugía en Harvard Medical School. Se especializa en cirugía de extremidad inferior, preservación de extremidades, corrección de deformidades y manejo de pacientes diabéticos complejos. Obtuvo su formación en Kalamazoo College y en Dr. William M. Scholl College of Podiatric Medicine, y completó su residencia en cirugía podiátrica en Baptist Memorial Hospital en Memphis.💼 LinkedIn: Michael Theodoulou, DPM, FACFASSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre nuevas alternativas para el salvamento de extremidades, los procesos regenerativos en pacientes sin opciones tradicionales y el potencial de la angiogénesis por distracción en heridas complejas, compártela con alguien que esté explorando ese camino. Una reseña rápida también ayuda a que más médicos y especialistas encuentren conversaciones como esta.

Dr. Jacqueline Majors, MD has built her practice around one central idea: surgeons should have more control over how they care for patients, structure their lives, and build sustainable careers. In this week's episode, she talks openly about leaving high-volume practice models, building an independent multidisciplinary center in Memphis, and why she believes outpatient vascular care is changing the future of the specialty. The conversation moves far beyond business strategy into surgeon burnout, team culture, limb salvage, physician autonomy, and the realities of trying to create a practice that supports both high-level performance and a real life outside the hospital.The episode also dives into what it takes to create a physician centered system from the ground up. 04:43 Why physicians should understand the business side of medicine09:25 Leaving high-volume practice models and protecting long-term health11:02 How Dr. Majors met her business partner and built Zenith Vascular & Fibroid Center21:42 Why multidisciplinary outpatient models are becoming more important27:05 Narrowing procedural focus and building community-based vascular centers31:08 Why hyper-specialized limb salvage centers are needed35:02 Surgeon burnout, grind culture, and changing the future of surgical practice41:48 Female surgeons, leadership dynamics, and evaluating practice culture47:40 Peptides, wound healing, and innovation in independent practice Who Should ListenThis episode is for vascular surgeons, interventional specialists, physicians considering independent practice, and early-career surgeons thinking about how they want to structure their careers long term. It’s also highly relevant for physicians interested in outpatient care models, limb salvage programs, team culture, and practice ownership.About Dr. Jacqueline Majors, MDDr. Jacqueline Majors is a board-certified vascular surgeon and the owner and director of the Limb Salvage Program at Zenith Vascular & Fibroid Center in Memphis, Tennessee. She specializes in advanced limb salvage and endovascular interventions focused on restoring blood flow, wound healing, and preventing amputations. Dr. Majors co-founded a multidisciplinary outpatient vascular practice alongside an interventional radiologist partner and remains actively involved in physician advocacy, education, and private practice development. She is also the creator of Anatomy Pad, a patient education platform designed for vascular surgeons. Her background includes Division I athletics, competitive soccer coaching, and more than 25 years of surgical experience.Connect with Dr. Jacqueline Majors, MD💼 LinkedIn: Jacqueline Majors, MD Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about independent practice, surgeon burnout, limb salvage, and what it actually takes to build a sustainable career in medicine, share it with a colleague who’s navigating those same questions. And if you’re enjoying Life of Flow, a quick review helps more physicians find conversations like this.

Un caso que parecía simple terminó revelando algo completamente inesperado. En este episodio, recorremos paso a paso una intervención en una lesión corta de la arteria femoral superficial en un paciente que había sufrido una isquemia aguda relacionada con COVID-19 años antes. Lo que empieza como una conversación técnica sobre reducción de masa, IVUS y estrategia endovascular, termina convirtiéndose en una discusión muy honesta sobre decisiones intraoperatorias, dispositivos, entrenamiento y esos hallazgos que aparecen cuando creías que el caso ya estaba resuelto.01:16 Claudicación, dolor crónico y hallazgo de estenosis severa03:49 Debate sobre ejercicio supervisado y limitaciones reales de acceso05:33 Posible origen de la lesión tras la trombectomía con Fogarty07:33 Discusión sobre Láser, Rotarex y manejo de material blando10:40 IVUS muestra una lesión organizada y dudas sobre hiperplasia intimal15:00 Miguel explica por qué usa Rotarex y cómo aprende a utilizarlo18:43 Debate sobre aterectomía y falta de entrenamiento formal26:26 El IVUS final revela un hallazgo inesperado dentro de la SFA¿Quién debería escuchar este episodio?Cirujanos vasculares, fellows, especialistas endovasculares y médicos interesados en toma de decisiones intraoperatorias reales. También resulta especialmente útil para quienes trabajan con enfermedad arterial periférica y quieren escuchar conversaciones honestas sobre técnica, complicaciones y aprendizaje práctico dentro de la sala.Sigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre las lesiones que parecen simples, las decisiones que se toman dentro de la sala y la importancia de interpretar cada hallazgo en tiempo real, compártela con un colega que la aproveche. Una reseña rápida también ayuda a que más médicos e intervencionistas encuentren conversaciones como esta.

What can surgery learn from aviation, team dynamics, and building systems that actually function under pressure?In this episode, Dr. Kristofer M. Charlton-Ouw, MD, talks about building a vascular program inside a smaller hospital system, creating specialized OR teams, and why consistency, culture, and workflow matter so much in complex surgical care. The conversation also explores the realities of balancing patient care with administrative systems, how different incentives shape hospital operations, and why communication across teams can completely change outcomes for both patients and physicians.The second half of the episode shifts into aviation, where Dr. Kristofer M. Charlton-Ouw explains how studying aviation safety and crew resource management changed the way he thinks about surgery, complications, leadership, and high-performance teams.02:38 Building a physician-centered vascular program08:17 Creating specialized vascular OR teams14:36 Why consistency matters in vascular care19:46 The vision behind building a new system24:46 Understanding how hospital systems operate30:33 The billing code story that changed staffing34:54 Balancing physician priorities and administration42:16 How large organizations change over time49:58 What aviation taught him about surgery53:09 Crew resource management in medicineWho Should ListenThis episode is for vascular surgeons, physicians working inside large health systems, healthcare administrators, and anyone trying to build better systems of care without losing autonomy or quality of life. It is especially relevant for earlytheAbout Kristofer M. Charlton-Ouw, MDKristofer Charlton-Ouw graduated from Vassar College with a B.A. in History before earning his M.D. from Harvard Medical School. He completed his general surgery residency at NewYork-Presbyterian Hospital. He later completed his vascular surgery fellowship at Memorial Hermann Hospital and the University of Texas Health Science Center at Houston.Dr. Charlton Ouw served as Program Director for the UT Vascular Surgery Fellowship and Integrated Residency and was Director of the Memorial Hermann Heart and Vascular Institute’s Vascular Ultrasound Laboratory. His clinical and research interests include aortic aneurysm and dissection, prosthetic graft infection, hemodialysis access, peripheral arterial disease, and postoperative pain control. In 2020, he joined HCA Houston Healthcare and helped found Gulf Coast Vascular.Connect with Kristofer M. Charlton-Ouw, MD💼 LinkedIn: Kristofer Charlton-OuwAbout LocumstoryLocumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course.Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode changed how you think about hospital systems, physician autonomy, and the incentives shaping modern medicine, share it with a colleague who’s navigating the same realities. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare professionals find conversations like this.

En este episodio de Life of Flow, conversamos con Sean Morris sobre el recorrido que lo llevó desde las ventas y el desarrollo comercial hasta la creación y el liderazgo de empresas de tecnología médica enfocadas en problemas vasculares complejos. La conversación se centra especialmente en Amplifi Vascular y en una nueva tecnología diseñada para acelerar la maduración venosa en pacientes que necesitan acceso para hemodiálisis, utilizando una bomba centrífuga portátil para dilatar venas pequeñas en cuestión de horas en lugar de semanas.A lo largo del episodio, hablamos sobre el detrás de escena de construir startups médicas, las dificultades regulatorias, la relación con la FDA, la importancia de los datos clínicos y el rol que cumplen los médicos al momento de validar tecnologías nuevas antes de llevarlas al mercado. Sean comparte cómo evalúa oportunidades, por qué le atraen las tecnologías complejas y qué significa realmente comprometer años de trabajo a una empresa que todavía no tiene garantías de éxito.02:33 Cómo llegó al mundo de la tecnología médica04:21 Sus primeros años en AngioDynamics y la evolución de la angiografía12:08 La creación de Veniti y la venta a Boston Scientific14:08 Nanopartículas, campos magnéticos y estudios en isquemia crítica18:33 Qué hace falta para construir una startup de dispositivos médicos22:04 Regulación, FDA y por qué llevar tecnología al mercado es tan difícil25:04 Cuánto tarda realmente una startup médica en llegar al mercado27:46 El origen de Amplifi Vascular y la idea detrás del sistema30:57 Relación con la FDA y el desarrollo clínico de Amplifi32:11 Los primeros resultados clínicos en pacientes con venas pequeñas36:07 El desafío de llevar esta tecnología fuera del hospital38:59 Cómo esta tecnología podría cambiar el acceso vascular para hemodiálisis¿Quién debería escuchar este episodio?Este episodio es especialmente relevante para cirujanos vasculares, nefrólogos, especialistas en acceso vascular, profesionales de la industria MedTech y emprendedores interesados en desarrollo de dispositivos médicos y procesos regulatorios. También puede resultar valioso para médicos que estén considerando involucrarse en innovación o startups dentro del sector salud.Sobre Sean MorrisSean Morris cuenta con más de 25 años de experiencia en dispositivos médicos, incluyendo desarrollo, manufactura, testing, regulación, reembolso y lanzamiento comercial en distintos roles de liderazgo. Fue Senior Vice President y General Manager de la división Peripheral Vascular en AngioDynamics, además de fundador y CEO de Veniti Medical, empresa adquirida por Boston Scientific en 2018. También fue President y CEO de Euphrates Vascular, enfocada en tecnologías basadas en nanopartículas y campos magnéticos aplicadas a enfermedad vascular, stroke y STEMI. Actualmente es President y CEO de Artio Medical y Amplifi Vascular, además de participar activamente como inversor y asesor de startups médicas en etapas tempranas.💼 LinkedIn: Sean MorrisSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre el desarrollo de tecnología médica, el desafío de llevar innovación vascular al mundo real y todo lo que ocurre detrás de una startup de dispositivos médicos, compártela con alguien que esté construyendo o explorando ese camino. Una reseña rápida también ayuda a que más médicos y profesionales de la industria encuentren conversaciones como esta.

In this week’s episode of the Life of Flow podcast, a conversation about vascular surgery and entrepreneurship quickly turns into something far heavier: combat trauma, operating on wounded Marines in Iraq, life-or-death decisions made in minutes, and the emotional weight that follows surgeons long after the operating room goes quiet. Dr. Erin M. Moore, MD, shares the defining moments that shaped his career, from discovering surgery at Parkland Hospital to performing damage control operations during the surge in Al Anbar under conditions most physicians will never experience firsthand. The episode also explores military culture, mentorship, surgical training before endovascular therapy, life aboard aircraft carriers, and the moments that pushed him toward vascular surgery and eventually entrepreneurship.04:05 Growing up in Dallas, early interest in science, and working through college10:53 Miguel reflects on his own path into medicine and surgery16:46 Navy training, officer indoctrination school, and early lessons in discipline18:18 Life aboard the USS Kitty Hawk and seeing the world through military service21:00 9/11, the USS Constellation, and returning to San Diego under completely different circumstances37:55 Trauma surgery stories and the PTSD that can follow surgeons home45:59 The emotional reality of treating wounded Marines in Iraq58:10 Dr. Moore’s final reflection on conflict, culture, and understanding the long gameWho Should ListenThis episode is especially relevant for vascular surgeons, trauma surgeons, military physicians, surgical trainees, and anyone interested in the realities of combat medicine and leadership under pressure. It will also resonate with physicians exploring nontraditional career paths and the psychological side of practicing medicine in extreme environments.About Dr. Erin M. Moore, MDErin Moore is a vascular surgeon in Jacksonville, Florida, affiliated with Ascension St. Vincent’s Riverside Hospital and Ascension St. Vincent’s Southside Hospital. He received his medical degree from the University of Texas Southwestern Medical School and has been in practice for more than 20 years. During the episode, he reflects on his path through military medicine, service in the United States Navy, deployments aboard aircraft carriers, trauma surgery during the Iraq War, and the experiences that shaped his career in vascular surgery.Connect with Erin💼 LinkedIn: Erin Moore Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode changed how you think about military medicine, trauma surgery, and the emotional realities that come with caring for patients in combat, share it with a colleague who would value the conversation. And if you’re enjoying Life of Flow, a quick review helps more physicians find conversations like this.

En este episodio de Life of Flow, conversamos con el Dr. Mario Alejandro Fabiani sobre un problema que impacta directamente la toma de decisiones en la práctica clínica: qué significa realmente un paciente “sin opción”. A partir de esa pregunta, lidera un consenso internacional que busca ordenar una definición que hoy varía según el médico, la experiencia y el contexto. La conversación también expone cómo han cambiado los pacientes en el tiempo, por qué ciertos porcentajes no reflejan la realidad actual y cómo esto influye en decisiones como intentar revascularizar o indicar una amputación. Hacia el final, se plantea la necesidad de validar y adoptar este consenso en la práctica real.02:21 De la crítica a la acción: creación de evidencia03:35 Formación de un consenso internacional con metodología Delphi04:56 Qué es un Delphi y cómo funciona08:51 Necesidad de redefinir el concepto de “no option”13:12 Debate sobre el 15% de pacientes sin opción14:08 Cómo han cambiado los pacientes en la práctica clínica17:26 Variación geográfica en los casos y decisiones25:00 Presentación del consenso Delphi49:39 Resultados reales de amputación en Latinoamérica¿Quién debería escuchar este episodio?Cirujanos vasculares, médicos en formación y profesionales que toman decisiones en pacientes complejos y quieren entender cómo la definición de “sin opción” impacta la práctica real.Sobre Dr. Mario Alejandro FabianiEl doctor Mario Alejandro Fabiani es médico egresado de la Universidad Nacional de La Plata (Argentina). Realizó residencia en Cirugía General y fue jefe de residentes en el CEMIC de Buenos Aires. Realizó segunda especialidad en Cirugía Vascular y Trasplante en un programa conjunto entre el CEMIC y el Hospital de Clínicas de la Universidad de Buenos Aires. Fue becado por la Fundación Bunge y Born para asistir a la Universidad de Yale y por la Asociación Argentina de Angiología para asistir al servicio de Cirugía Vascular del New York University Medical Center.Se incorporó al Servicio de Cirugía Vascular y Trasplante del CEMIC, donde ejerció la docencia hasta 2013. Desde 2013 forma parte del Tecnológico de Monterrey como profesor de tiempo completo. Es director del Centro de Medicina Vascular de la Sociedad Académica Temperantia. Ha participado en cientos de congresos nacionales e internacionales, ha sido pionero en técnicas endovasculares y ha entrenado a decenas de especialistas.Es profesor honorífico de la Universidad de Valladolid y miembro honorario de sociedades en Colombia y Ecuador. Es miembro del SNI nivel I. Con veinticinco años de especialista, es una de las personas con más experiencia en México en el manejo de enfermedades de la aorta, carótida y oclusión arterial de miembros. Este episodio hace referencia al consenso internacional liderado por el Dr. Fabiani para redefinir el paciente “sin opción”. Puedes acceder al documento completo aquí:academic.oup.com/bjs/advance-article-abstract/doi/10.1093/bjs/znag040/8606833💼 LinkedIn: Mario Alejandro Fabiani🔗 Website: drfabiani.comSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre lo que realmente significa un paciente “sin opción”, las decisiones que se toman antes de indicar una amputación y la importancia de cuestionar lo que damos por hecho en la práctica clínica, compártela con un colega que la aproveche. Una reseña rápida también ayuda a que más médicos e intervencionistas encuentren conversaciones como esta.

In this week's solo episode, we step away from interviews to talk candidly about what’s happening behind the scenes in our own careers. Lucas shares how his plan to move to Puerto Rico fell through, how he handled leaving his job without a clear next step, and why he chose to pivot into locums while also starting a company through an accelerator. Miguel walks through how he’s structured his practice differently, building relationships with hospital teams, expanding into multiple sites, and figuring out how to grow without losing control of quality or culture.03:15 Why the Puerto Rico plan fell through and what changed05:54 Transition into locums and securing short-term opportunities09:42 Breaking down new compensation models and earning potential17:44 Miguel explains building a hybrid model with hospital integration27:14 Expanding into multiple sites and new service models37:41 The long-term vision for growth, partnerships, and eventual exit54:24 Closing thoughts on building, risk, and reaching outWho Should ListenPhysicians exploring different ways to structure their careers, and anyone thinking about combining clinical work with building something on the side.Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode made you rethink how to navigate career pivots, uncertainty, and the trade-offs between stability and building something of your own, share it with a colleague who’s figuring out their next move. And if you’re enjoying Life of Flow, a quick review helps more physicians find conversations like this.

Most founders build on assumptions they haven’t tested.From turning a master’s project into a product now used by fire departments to navigating a decade-long founder journey across Sweden, San Francisco, and Austin, Omer Haciomeroglu joins us to walk us through what it takes to bring something from concept to reality. This conversation focuses on how early product decisions shape everything that follows, where teams lose time and money, and why feedback, accountability, and the ability to step outside your own perspective become critical as the company grows.01:29 How the firefighting concept started as a master’s project in Sweden05:24 Bootstrapping the company and moving through Sweden, San Francisco, and Austin10:02 Why the founder journey is so isolating, even with co-founders12:32 What Omer brings to founders through product, fundraising, and leadership experience17:57 The costly mistakes founders make when they build on untested assumptions22:54 The real stages of hardware development from MVP to manufacturing32:54 What first-time founders get wrong about fundraising and why the right people matter40:07 Why ego, power dynamics, and poor feedback can put a company at riskWho Should ListenFounders, engineers, and operators building products, especially in hardware or deep tech, along with early-stage entrepreneurs trying to validate ideas, raise capital, and avoid costly mistakes.About Omer HaciomerogluOmer Haciomeroglu is a Turkish-born designer, entrepreneur, and creative technology leader based in Austin, Texas, best known for operating at the intersection of design, engineering, and applied artificial intelligence. As a co-founder and chief design officer, he has led the development of AI-driven computer vision systems focused on real-world, high-stakes applications, including safety, automation, and human-centered decision making. His work spans product design, robotics, and advanced prototyping, grounded in a philosophy that prioritizes clarity, sustainability, and practical impact over speculative futurism. Across startups and innovation ecosystems, he is recognized for translating complex technical systems into coherent products that can move from concept to deployment without losing ethical or human considerations.Connect with Omer💼 LinkedIn: Omer Haciomeroglu📲 Instagram: @omerh.coFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode changed how you think about validating ideas, building products without over-relying on assumptions, and the role of feedback and accountability in a founder’s journey, share it with someone building something of their own. And if you’re enjoying Life of Flow, a quick review helps more people find conversations like this.

Desde una formación clásica en negocios hasta la meditación y la escritura creativa, en este episodio de Life of Flow Amy Sandler explora cómo habilidades aparentemente “blandas” terminan siendo críticas para liderar, comunicar y trabajar mejor en equipo. En esta conversación, el foco se desplaza hacia un tema incómodo pero inevitable: cómo dar y recibir feedback sin romper relaciones. A través de ejemplos reales y errores propios, Amy aterriza qué significa realmente practicar la franqueza radical en contextos de alta presión y dinámicas de poder.01:18 Qué es Radical Candor y por qué importa en el trabajo03:01 Problema real del feedback en evaluaciones formales03:32 Reencuadre del feedback como construcción de relaciones14:05 Primer paso del líder: pedir feedback para reducir la brecha de poder20:10 Tipos de feedback: comportamiento vs resultado del trabajo27:20 Por qué la franqueza radical aplica a todos los niveles29:07 Modelo CORE: contexto, observación, resultado y siguiente paso31:08 La franqueza se mide en quien escucha, no en quien habla¿Quién debería escuchar este episodio?Líderes de equipos, médicos, profesionales en entornos de alta exigencia y cualquier persona que gestione relaciones laborales donde el feedback impacta directamente en el rendimiento y la confianza.Sobre Amy SandlerAmy Sandler tiene formación en negocios con un MBA de Harvard y posteriormente realizó estudios en escritura de guiones. Es instructora de mindfulness y ha enseñado inteligencia emocional en el entorno laboral durante más de una década. Ha trabajado en Radical Candor durante los últimos años, enfocándose en formación ejecutiva y desarrollo de liderazgo basado en relaciones, feedback y comunicación efectiva.💼 LinkedIn: Amy SandlerSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre dar y recibir feedback, construir relaciones de confianza en entornos exigentes y el impacto que tiene la forma en que te comunicas como líder, compártela con un colega que esté navegando esos mismos desafíos. Una reseña rápida también ayuda a que más profesionales encuentren conversaciones como esta.

In this episode of Life of Flow, we sit down with Dr. Mario Alejandro Fabiani to explore a question that directly impacts clinical decision-making: what does a “no option” patient mean?From that starting point, Dr. Fabiani leads an international consensus aimed at bringing structure to a definition that currently varies depending on the physician, their experience, and their clinical context. The conversation also highlights how patient profiles have shifted over time, why commonly cited percentages may not reflect today’s reality, and how these assumptions influence decisions such as attempting revascularization or proceeding with amputation. Toward the end, the focus turns to the need to validate and adopt this consensus in real-world practice.03:32 From critique to action: building evidence04:00 Forming an international Delphi consensus05:09 What a Delphi is and how it works08:51 Why the “no option” definition needs to change12:23 The debate around the 15% “no option” figure14:51 How patient profiles have changed over time17:26 Geographic variation in cases and decision-making20:22 Presentation of the Delphi consensus39:53 Real-world amputation outcomes in Latin AmericaWho Should ListenVascular surgeons, trainees, and clinicians managing complex patients who want to better understand how the definition of “no option” impacts real-world decision-making.About Dr. Mario Alejandro FabianiDr. Mario Alejandro Fabiani is a physician trained at the National University of La Plata (Argentina). He completed his residency in General Surgery and served as Chief Resident at CEMIC in Buenos Aires. He then pursued a second specialty in Vascular Surgery and Transplant through a joint program between CEMIC and the Hospital de Clínicas at the University of Buenos Aires. He received scholarships from the Bunge y Born Foundation to attend Yale University and from the Argentine Association of Angiology to train at the Vascular Surgery Service at NYU Medical Center.He later joined the Vascular Surgery and Transplant Service at CEMIC, where he was involved in teaching until 2013. Since then, he has been a full-time professor at Tecnológico de Monterrey. He is Director of the Vascular Medicine Center at Sociedad Académica Temperantia, has participated in hundreds of national and international conferences, pioneered endovascular techniques, and trained dozens of specialists.He is an honorary professor at the University of Valladolid, an honorary member of medical societies in Colombia and Ecuador, and a Level I member of Mexico’s National System of Researchers. With over 25 years of experience, he is one of the most experienced specialists in Mexico in the management of aortic, carotid, and peripheral arterial disease.This episode references the international consensus led by Dr. Fabiani to redefine the “no option” patient. You can access the full document here: academic.oup.com/bjs/advance-article-abstract/doi/10.1093/bjs/znag040/8606833Connect with Dr. Mario Alejandro Fabiani💼 LinkedIn: Mario Alejandro Fabiani🔗 Website: drfabiani.comFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about what it really means for a patient to be “no option,” the decisions made before recommending amputation, and the importance of questioning long-held assumptions in clinical practice, share it with a colleague who would benefit from it. A quick review also helps more physicians and interventionists discover conversations like this.

En este episodio de Life of Flow, la Dra. Karen Barnard, MBBCh, MPH, habla desde la experiencia de haber dejado la práctica clínica para dedicarse a acompañar a otros médicos en ese mismo proceso. La conversación se centra en algo muy concreto: cuándo empieza realmente esa inquietud por cambiar de rumbo, cómo se ve ese proceso en la práctica y qué señales suelen aparecer mucho antes de que alguien tome la decisión. También aborda lo que pasa cuando el cambio no sale como se esperaba, y por qué eso no necesariamente es un error, sino parte del recorrido.02:13 Primeras señales de que “algo no estaba bien”03:29 Transición hacia el coaching y salida de la práctica clínica04:22 Tipos de transiciones que buscan los médicos06:48 Momento en que reconoce la necesidad de cambiar09:20 Conflicto de valores como detonante principal12:30 Miedo al riesgo y cómo tomar decisiones graduales16:23 Qué buscan los médicos cuando llegan al coaching20:21 Estructura del proceso para rediseñar la carrera24:41 Habilidades transferibles que los médicos no reconocen29:42 Momentos clave en la carrera donde surge la insatisfacción¿Quién debería escuchar este episodio?Médicos en etapa media o avanzada de su carrera que están cuestionando su rumbo profesional o explorando alternativas fuera de la práctica clínica.Sobre Karen Barnard, MBBCh, MPHLa Dra. Karen Barnard es médica especializada en medicina interna y endocrinología, con más de 30 años de experiencia clínica y roles de liderazgo. Tras dejar la práctica, se formó como coach profesional y hoy trabaja acompañando a médicos en procesos de cambio de carrera, ayudándolos a identificar sus intereses, habilidades y próximos pasos, tanto a nivel estratégico como práctico.💼 LinkedIn: Dr. Karen BarnardSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre el momento de replantear tu carrera, las señales que indican que algo no está bien y cómo abordar un cambio profesional sin tomar decisiones impulsivas, compártela con un colega que esté pasando por lo mismo. Una reseña rápida también ayuda a que más médicos encuentren conversaciones como esta.

A conversation that starts with one set of “normal” labs and quickly turns into a deeper question: what does “healthy” mean? In this week’s episode, Lauren Colletti walks through how she evaluates patients beyond standard ranges, why so few people are truly metabolically healthy, and how tools like peptides, continuous glucose monitoring, and advanced labs are being used in practice today. The episode moves between clinical reasoning and real-world experimentation, including what changed when Lucas became the patient.04:30 Why “normal” labs may not mean optimal health04:54 Only 12% of people are metabolically healthy06:44 What peptides are and how they work10:32 Curiosity, self-experimentation, and patient empowerment17:08 Case breakdown: labs, symptoms, and treatment plan23:12 Immediate changes in sleep, recovery, and performance28:35 What technology can’t replace: human connection in care33:15 Is ChatGPT your new doctor? 46:00 Innovation, risk, and pushing beyond traditional models55:00 Lauren’s clinic and Soul Women initiativeWho Should ListenPhysicians, clinicians, and healthcare professionals who are thinking about prevention, metabolic health, or integrating newer tools into patient care.About Lauren CollettiLauren Colletti is a board-certified Nurse Practitioner in functional medicine and anti-aging medicine. She has been working in the space for about 15 years, focusing on identifying root causes of health issues and integrating advanced testing and therapies into patient care. She is the co-founder of Alive and Well, a clinic with multiple locations, and the founder of Sol Women, a program focused on helping women navigate midlife through functional medicine, coaching, and community.Connect with Lauren💼 LinkedIn: Lauren Colletti📲 Instagram: @laurencolletti_fnpFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode changed how you think about prevention, metabolic health, and what it means to optimize your own physiology as a clinician, share it with a colleague who’s navigating the same questions. And if you’re enjoying Life of Flow, a quick review helps other physicians find conversations like this.

En este episodio de Life of Flow, conversamos con Ryan Blasko, vicepresidente en The Mullings Group, en donde explica cómo se construyen carreras y equipos dentro del ecosistema MedTech, y qué ocurre realmente detrás de las oportunidades que muchos médicos ni siquiera saben que existen. La conversación se centra en cómo se conecta el talento clínico con startups y empresas en crecimiento, qué buscan estas compañías en un médico y cómo evaluar si una oportunidad vale tu tiempo. También profundizan en el mundo de los roles fraccionales, el riesgo en startups y cómo tomar decisiones más estratégicas fuera de la práctica clínica tradicional.❗️Este episodio fue originalmente grabado en inglés y ahora lo traemos doblado al español para nuestra comunidad hispanohablante.English Version of the Episode 👉 youtube.com/watch?v=_vSoXpR2LII06:13 Cuándo tiene sentido dejar la práctica clínica10:51 Habilidades clave para roles en industria15:12 Qué son los roles fraccionales y cómo funcionan19:26 Cómo evaluar compensación y equity en startups23:40 Riesgo real de trabajar con startups26:59 Cómo decidir si una oportunidad vale tu tiempo27:17 Qué preguntas hacen los mejores candidatos29:34 Cómo evaluar una empresa: mercado, equipo, visión y producto43:02 MBA vs experiencia real en negocios¿Quién debería escuchar este episodio?Médicos que están considerando oportunidades fuera de la clínica, profesionales interesados en startups de salud y cualquier persona explorando roles en la industria MedTech.Sobre Ryan BlaskoRyan Blasko es vicepresidente en The Mullings Group, donde trabaja conectando talento con empresas dentro del sector MedTech. Con más de dos décadas de experiencia en ventas y liderazgo ejecutivo en compañías como Cintas, Boston Scientific, Cardiovascular Systems Inc. y Ambu USA, ha construido y liderado equipos, además de colaborar con empresas respaldadas por venture capital y private equity. Es graduado en Comunicaciones por Indiana University.💼 LinkedIn: Ryan BlaskoSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠Si esta conversación cambió cómo piensas sobre las oportunidades fuera de la práctica clínica, cómo evaluar el riesgo en startups y qué hace realmente valiosa una propuesta más allá del salario, compártela con un colega que la aproveche. Una reseña rápida también ayuda a que más médicos y profesionales del sector encuentren conversaciones como esta.

This week’s episode features Dr. Anahita Dua, MD, MBA, Associate Professor of Surgery at Massachusetts General Hospital and Harvard Medical School, and Director of the Peripheral Artery Disease Center at MGH. She joins us for a detailed conversation on below-the-knee disease, why recoil after POBA remains a real limitation, and how a retrievable stent platform like Reflow Medical's Spur System is designed to disrupt plaque in a controlled way without leaving a permanent implant. Dr. Dua walks through the clinical rationale behind plaque modification, drug penetration, durability data from early studies through FDA clearance, and how she evaluates outcomes in her own patients through duplex follow-up and wound healing.This episode centers on Dr. Dua’s clinical perspective on tibial interventions and how newer device concepts are influencing real-world decision-making.03:35 The evolution of complex below-the-knee disease05:09 Why balloon angioplasty alone often leads to recoil24:44 FDA endpoints versus clinical durability25:41 Histologic plaque disruption and controlled microchannels28:16 Temporary scaffold concept and billing without leaving a stent30:27 Retrievable stent design and drug penetration strategy31:34 First-in-human experience and multicenter durability data33:12 Restenosis and the importance of long-term follow-up49:51 Duplex stability and wound healing as meaningful outcomes Who Should ListenVascular surgeons, interventionalists, PAD-focused clinicians, and MedTech leaders who are evaluating durability, restenosis, and how device design translates into real-world outcomes.About Dr. Anahita DuaDr. Anahita Dua is an Associate Professor of Surgery at Massachusetts General Hospital and Harvard Medical School. She serves as Director of the Peripheral Artery Disease Center, Associate Director of the Wound Center, Clinical Director of Research, and Director of the Sub-Internship in Vascular Surgery. Dr. Dua completed her vascular surgery fellowship at Stanford University Hospital, general surgery residency at the Medical College of Wisconsin, and her medical school in the United Kingdom. She has also completed a master's degree (MS) in trauma sciences and a master's in business administration (MBA) in health care management.Dr. Dua is double board-certified in vascular surgery and general surgery. She is also boarded in advanced wound care and management.Connect with Dr. Anahita💼 LinkedIn: Anahita DuaAbout Reflow Medical Inc.Reflow Medical, Inc. is a privately held medical device company based in San Clemente, California, and a leading developer of innovative medical devices focused on complex cardiovascular disease.A core element of Reflow Medical’s approach is the close collaboration between physicians and engineers, enabling rapid iteration from clinical insight to device design and real-world application.The company’s portfolio includes coronary and peripheral microcatheters, crossing catheters, and the Spur® Stent System, which enables Retrievable Scaffold Therapy (RST), a temporary scaffolding approach designed to modify lesions, reduce recoil, and leave nothing behind.Reflow Medical is committed to improving endovascular therapy outcomes for patients with complex lesions through clinically driven innovation.Learn more about Reflow Medical 🌐 Website: reflowmedical.com/💙 Spur: reflowmedical.com/spur/Follow Life of Flow📲 Instagram: @LifeofFlowPodcast👍 Facebook: Life of Flow Podcast💼 LinkedIn: Life of Flow Podcast🐦 X: @VascularPodcastIf this episode clarified how you think about below-the-knee disease and durability, share it with a colleague who would value the discussion. And if you’re enjoying Life of Flow, a quick review helps other physicians find conversations like this.

En este episodio de Life of Flow revisamos un caso clínico que nos pareció particularmente interesante: una arterialización venosa realizada para tratar una herida grave en el talón. Partimos de la evolución del paciente y analizamos qué ocurre cuando una arterialización que inicialmente funciona termina ocluyéndose a los pocos meses. A lo largo del episodio compartimos cómo evaluamos el caso, qué encontramos en la angiografía y cómo decidimos reabrir el sistema, comentando las decisiones técnicas que tomamos durante el procedimiento. 04:05 Oclusión de la arterialización y decisión de reintervenir13:03 Evaluación angiográfica y estrategia para manejar el trombo23:47 Colocación de stents en el tracto de salida y manejo del material residual26:18 Flujo restaurado y cierre del acceso con dispositivo SELT💡¿Quién debería escuchar este episodio?Cirujanos vasculares, intervencionistas endovasculares y médicos que trabajan en preservación de extremidades y tratamiento de heridas complejas del pie.Sigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this week's episode, we sit down with Timotej Vitez, who leads business development and the US market at MESI Medical, to explore what it looks like to simplify care at the point of practice. The conversation moves from the origin of a one-minute automated ABI device to a broader vision of integrating multiple diagnostics into a single workflow, reducing the time clinicians spend on administrative tasks. We also get into what it takes to scale a medical company across different healthcare systems, and why even strong tools only matter if they fit into how medicine is practiced day to day.This episode focuses on how integrated diagnostics and automation can simplify clinical workflows, reduce administrative burden, and support better decision-making in real-world practice.02:10 The origin of automated ABI and how MESI started07:32 Bringing arterial assessment into primary care09:42 The idea of a one-surgeon clinic and automation in practice12:16 Integrated diagnostics and combining multiple tests into one device15:23 Expanding access to care through mobile and home-based solutions17:10 The problem with referrals and delays in decision-making23:37 Lessons from expanding across different healthcare markets30:35 Building a global vision for integrated diagnostics in every clinicWho Should ListenPhysicians, MedTech founders, and operators building or scaling healthcare solutions, especially those focused on workflow, diagnostics, and clinical efficiency.About Timotej VitezTimotej Vitez is responsible for business development and leading the US market at MESI Medical. He has been part of the MESI story for the last 7 years, being responsible for various European markets, and for the last 6 years, also the growth of the US market. He has led the global sales operations team and handled many different aspects of sales, from key account management, business development, sales process, compliance in the sales department, and helped form operations in MESI branch offices in Europe. In 2025, he spent 3 months in the US, located in Denver, Colorado, and travelled across the country to onboard and train regional sales representatives, a new national sales manager for the US, located in Arizona, and a customer success manager located in North Carolina.Connect with Timotej💼 LinkedIn: Timotej VitezAbout MESI MedicalMESI is a European manufacturer of integrated diagnostic solutions focused on simplifying how clinicians assess patients in everyday practice. Its technology is designed to help healthcare professionals detect and manage chronic conditions more efficiently, while reducing the complexity of clinical workflows.The company is a European market leader in arterial assessment, with a focus on enabling earlier detection of peripheral arterial disease through fast, automated testing.MESI entered the US market in 2017 as an OEM provider, followed by a direct launch of its one-minute automated ABI device, MESI ABPI MD. This was later expanded with the introduction of the MESI mTABLET platform, including ABI, TBI, and ECG modules, with additional modules such as SPIRO and VITALS continuing to expand the portfolio.Today, MESI supports healthcare professionals across wound care, cardiology, and primary care settings throughout the US.Learn more about MESI🌐 Website: mesimedical.comFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode changed how you think about workflow, diagnostics, and the role of automation in everyday practice, share it with a colleague who’s navigating these same challenges. And if you’re enjoying Life of Flow, a quick review helps other physicians find conversations like this.

En este episodio de Life of Flow conversamos con Stuart Baugher, abogado del sector salud que trabaja en estrategia, compensación y diseño organizacional dentro de uno de los sistemas de salud sin fines de lucro más grandes de Estados Unidos. La conversación gira en torno a un momento crítico en la carrera de muchos médicos: el momento de firmar su primer contrato laboral.Stuart explica por qué los contratos médicos pueden ser mucho más complejos de lo que parecen, cómo funcionan conceptos como el valor justo de mercado, y qué aspectos contractuales pueden afectar decisiones profesionales durante años. También comparte ejemplos reales de errores comunes que ocurren cuando se firman acuerdos sin comprender completamente sus implicaciones financieras y legales.09:01 Conceptos básicos que aparecen en los contratos médicos11:34 Qué significa realmente el valor justo de mercado12:10 Cómo encontrar datos salariales para negociar un contrato16:08 Por qué el salario no debería ser el único factor al elegir un primer empleo16:57 Ejemplo real de un acuerdo salarial que termina convirtiéndose en deuda17:27 Qué entender sobre los modelos de compensación y productividad21:55 Cómo funcionan los pagos basados en unidades de valor relativo de trabajo24:40 Qué preguntas hacer durante una entrevista sobre productividad y expectativas27:30 Cómo influyen los rangos académicos en la compensación médica💡¿Quién debería escuchar este episodio?Médicos en formación, especialistas que están negociando su primer contrato laboral y profesionales de la salud que quieren entender mejor cómo funcionan los acuerdos de empleo dentro de los sistemas hospitalarios.Sobre Stuart BaugherStuart Baugher es abogado especializado en el sector salud y ejecutivo enfocado en estrategia, compensación y diseño organizacional dentro de sistemas hospitalarios. Ha trabajado en estrategia, finanzas y operaciones dentro del ámbito sanitario y actualmente participa en la supervisión de modelos de compensación y estrategias de retención para médicos y proveedores dentro de un sistema de salud sin fines de lucro de gran escala en Estados Unidos.Cuenta con formación avanzada en derecho y administración de empresas. Es miembro del Florida Bar y vive en Dallas, Texas con su esposa y sus tres hijos.💼 LinkedIn: Stuart BaugherSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this episode of Life of Flow, we sit down with transformational coach, founder, and musician Jenna Phillips Ballard for a conversation that moves far beyond the usual medical discussions. Jenna shares how her path from celebrity fitness coach in Los Angeles to emotional intelligence training and leadership development reshaped the way she sees purpose, identity, and personal responsibility.The conversation explores why more people seem to be questioning the systems they operate inside, what happens when high-performing professionals begin confronting their own internal conflicts, and why doctors and leaders alike may eventually face moments that force them to reevaluate who they really are and what they’re here to do.02:33 Jenna’s early career in fitness and discovering her purpose to motivate people14:20 Self-doubt, proving yourself, and navigating male-dominated professional environments16:07 Leaving a career path and stepping into transformational training and personal development21:30 Internal conflict and how personal work influences the broader world26:28 The idea that human awareness and consciousness are expanding30:13 Creativity, purpose, and questioning the identity we build around our professions29:00 Following curiosity and small actions that lead people toward change29:37 Why doctors may experience their own awakening about purpose and the systems they work within41:02 Real-Life Lesson: Jenna survived a coma at 17Who Should ListenPhysicians, surgeons, and healthcare professionals navigating burnout, identity shifts, or questions about purpose, along with leaders interested in emotional intelligence, personal development, and transformational coaching.About Jenna Phillips BallardJenna Phillips Ballard is a visionary leader, transformational coach, artist, and founder of I•▲M, a global movement dedicated to helping people embody their highest selves and live in alignment with purpose, prosperity, and love.In 2011, Jenna discovered emotional intelligence and somatic healing, igniting a deeper mission to awaken the leaders of the new era. She immersed herself in leadership trainings and transformational coaching, helping top executives and influencers access their highest potential and create legacies rooted in integrity and impact.In 2016, Jenna and her husband, Brad Ballard, co-founded Ascension Leadership Academy (ALA), a premier emotional intelligence training company that has transformed thousands of lives, helped businesses 10x their growth, and raised over $4MM for charity.Now based in Austin, Jenna continues to mentor high-level leaders, founders, and creators while expanding her I•▲M ecosystem, which includes her transformational book I•▲M Her Now, the ADMIT IT podcast, her signature affirmation deck, and a line of intentional lifestyle products.In 2024, Jenna stepped into a lifelong dream and launched her career as a recording artist. Through her pop-EDM fusion of coaching and music, she brings empowerment to every beat, proving that it’s never too late to say yes to your biggest calling.Her proudest title, however, is boy mom to Jax and Jett, raising the next generation of conscious, heart-centered men.Connect with Jenna📲 Instagram: jennaphillipsballard 🎵 Spotify: Jenna Phillips Ballard🔗 Website: jennaphillipsballard.comFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this conversation made you reflect on how purpose, identity, and personal responsibility shape the way we show up as physicians and leaders, share it with a colleague who might be navigating similar questions. A quick review also helps more people discover conversations like this.

En este episodio de Life of Flow, conversamos con Jill Sommerset, RVT, FSVU, tecnóloga vascular con 25 años de experiencia en ultrasonido vascular avanzado y creadora del Pedal Acceleration Time (PAT), y con el Dr. Brian D. Lepow, D.P.M., podólogo a cargo de las operaciones clínicas en HOPE Vascular & Podiatry en Houston. Este es el cuarto desahogo del podcast sobre arterialización venosa profunda, y en esta conversación, abordamos lo que ocurre después del procedimiento: cómo interpretar los volúmenes de flujo en sala de recuperación, cuándo y cómo intervenir quirúrgicamente en el pie, y por qué esperar semanas con tejido necrótico visible puede ser la decisión clínica más difícil y al mismo tiempo la más correcta.03:20 La fase PACU: por qué actuar de inmediato en recuperación marca la diferencia 05:00 El técnico de ultrasonido en quirófano: cómo construir esa relación y por qué importa07:15 Dolor en reposo postoperatorio: cómo reconocerlo y qué significa cuando aparece 10:43 Lección clave: no salir del quirófano sin verificar los volúmenes de flujo 13:00 Perspectiva podológica: qué cambia en el manejo de una DVA frente a una revascularización estándar 14:43 La incomodidad de esperar con un pie necrótico: confianza del equipo y comunicación con el paciente 18:44 Amputaciones en guillotina y por qué dejar la herida abierta cambia los resultados 20:01 TMA temprana: por qué puede acortar la trayectoria de recuperación de forma predecible 28:22 El registro de Alkmar y el origen del período de espera de cuatro a seis semanas💡¿Quién debería escuchar este episodio?Podólogos, cirujanos vasculares, técnicos de ultrasonido vascular y profesionales de salud involucrados en el manejo postoperatorio de pacientes con arterialización venosa profunda, especialmente quienes están comenzando a realizar estos procedimientos y necesitan entender por qué el protocolo difiere radicalmente del manejo vascular convencional.Sobre los invitadosJill Sommerset, RVT, FSVU, es tecnóloga vascular con 25 años de experiencia en ultrasonido vascular avanzado y preservación de extremidades. Es directora de ultrasonido en Advanced Vascular Centers y HOPE Vascular & Podiatry, y directora de Educación Clínica y Formación en Aveera Medical. Es la creadora del Pedal Acceleration Time (PAT) y ponente internacional reconocida por sus contribuciones al ultrasonido vascular y la mejora de resultados en pacientes.💼 LinkedIn: Jill Sommerset RVT, FSVUDr. Brian D. Lepow, D.P.M., es podólogo con amplia trayectoria en cirugía y medicina podológica. Dirige las operaciones clínicas en HOPE Vascular & Podiatry en Houston, Texas, donde también ha ocupado el cargo de Jefe de Podología. Ha ejercido como profesor asistente en el Departamento de Cirugía Michael E. DeBakey, División de Cirugía Vascular y Terapia Endovascular.💼 LinkedIn: Brian D. LepowSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

El Dr. Mariano Palena, MD, es un radiólogo intervencionista especializado en revascularización de extremidades en estadios avanzados, con base en Italia y actividad clínica regular en España, Bulgaria, Hungría y Abu Dhabi. En este episodio de Life Of Flow, cuenta cómo construyó su carrera desde Rosario, Argentina, hasta convertirse en uno de los referentes europeos en el tratamiento endovascular del pie, trabajando durante casi una década junto al Dr. Marco Manzi en el Policlínico de Abano Terme, donde llegaron a realizar más de 1.000 procedimientos anuales. Lo que hace que esta conversación valga la pena no es solo el recorrido técnico, sino la honestidad con la que Mariano habla sobre lo que realmente falta en los centros que visita: no equipamiento, sino cultura clínica, curiosidad y trabajo en equipo alrededor del paciente.03:47 El encuentro con Marco Manzi y el inicio de un proyecto pionero06:55 Hacer más de 1.000 angioplastias al año y lo que eso enseña10:14 El primer acceso metatarsiano: el momento que lo marcó13:39 Por qué empezó a viajar y cómo nació el modelo de consultoría internacional18:21 La brecha más grande en los centros: lo que pasa antes y después de la revascularización22:01 Los errores más comunes de los intervencionistas cuando llegan a esta especialidad24:01 El valor del acceso ecoguiado y la resistencia cultural que encuentra en distintos países29:26 Hacia dónde va la especialidad 36:44 Uno de los casos más dificiles de Mariano43:50 Por qué el factor que diferencia a los mejores no es la habilidad sino la curiosidad¿Quién debería escuchar este episodio?Médicos intervencionistas, cirujanos vasculares y cardiólogos hemodinamistas que traten o quieran tratar pacientes con isquemia crónica de miembros inferiores, así como profesionales en etapas tempranas de su carrera que estén pensando en cómo especializarse o en qué tipo de formación tiene más impacto real.Sobre Dr. Mariano Palena, MDEl Dr. Mariano Palena, MD, es un radiólogo intervencionista y especialista endovascular italiano reconocido internacionalmente, centrado en técnicas avanzadas de salvamento de extremidades para la isquemia crónica que amenaza las extremidades y la enfermedad del pie diabético. Es consultor y líder clínico en los principales centros vasculares de Italia, España y Bulgaria, y cofundador y director de iniciativas educativas como CLI-Courses para promover la investigación, la formación y las estrategias de tratamiento mínimamente invasivas para la enfermedad arterial periférica grave.💼 LinkedIn: Mariano Palena🔗 Website: marianopalena.comFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastSi esta conversación cambió cómo piensas sobre lo que significa tratar una extremidad en riesgo, el trabajo que ocurre antes y después de la revascularización, o la diferencia que hace la curiosidad clínica frente a la experiencia acumulada, compártela con un colega que la aproveche. Una reseña rápida también ayuda a que más médicos e intervencionistas encuentren conversaciones como esta.

En este episodio de Life of Flow, conversamos con Aaron Thweatt, CHPC, coach ejecutivo que asesora a profesionales en conversaciones críticas de carrera como entrevistas laborales, negociación salarial y toma de decisiones profesionales. Aaron explica cómo se estructuran realmente las negociaciones laborales, por qué muchas personas se posicionan mal desde la primera llamada con un reclutador y qué significa aprender a manejar conversaciones que definen el rumbo de una carrera.La conversación también explora temas como presencia ejecutiva, preparación para entrevistas, cultura organizacional y cómo identificar talento cuando se está construyendo un equipo. 05:42 Cómo comienzan realmente las negociaciones salariales en tecnología11:12 Comprender la compensación total: salario, bonos y equity18:45 Preparación antes de una negociación y cómo entender tu valor de mercado25:02 Cómo responder cuando un rango salarial parece demasiado bajo30:18 Por qué entrevistar bien es la base de cualquier negociación36:10 El concepto de presencia ejecutiva y cómo se desarrolla44:05 Desafíos comunes que enfrentan los candidatos durante entrevistas51:27 Inteligencia artificial y cómo podría cambiar el mercado laboral58:43 Cómo construir equipos fuertes y evaluar los intangibles en candidatos💡¿Quién debería escuchar este episodio?Profesionales que están atravesando procesos de entrevista o negociación laboral, especialmente médicos, residentes, profesionales de tecnología o personas en mitad de carrera que buscan cambiar de rol o mejorar sus condiciones laborales.Sobre Aaron Thweatt, CHPCAaron Thweatt es coach ejecutivo especializado en ayudar a profesionales a navegar conversaciones clave de carrera, incluyendo entrevistas laborales, negociación salarial y toma de decisiones profesionales. Pasó once años trabajando en el área de compensación dentro del sector tecnológico, donde participó en la definición de estructuras salariales y políticas de remuneración en empresas como SpaceX, Activision Blizzard y DoorDash. A partir de esa experiencia, hoy asesora a personas para entender su valor en el mercado, prepararse para procesos de entrevista y negociar de forma más efectiva.💼 LinkedIn: Aaron Thweatt, CHPCSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this week’s episode, we sit down with Jan Sloves, RVT, RCS, FASE, a nationally recognized vascular imaging expert and educator who has spent decades working at the intersection of ultrasound, clinical decision making, and physician training.The conversation explores the real-world gaps he sees in vascular imaging labs, from inconsistent studies and communication breakdowns between physicians and sonographers to operational challenges that affect diagnostic accuracy and patient care.Jan also shares how he built Ultrasound Unlocked, a global education platform where he publishes weekly vascular case discussions and training resources for clinicians worldwide. Throughout the episode, he explains how he works directly with practices to improve imaging performance, why physicians need to stay closely involved in their labs, and what it actually takes to produce scans clinicians can trust when making treatment decisions.04:02 The mission behind Ultrasound Unlocked and building a global education community07:34 Communication gaps between physicians and sonographers in vascular imaging09:36 Developing a lower extremity arterial protocol and improving diagnostic workflows13:58 How Jan evaluates practices and approaches lab training19:55 Why physicians must actively teach and review scans with their staff22:54 The importance of detailed scans to avoid procedural surprises38:02 Why the overall standard of vascular imaging needs improvement39:43 The real cost of turnover and why investing in staff improves patient careWho Should ListenVascular surgeons, interventional physicians, sonographers, and clinicians involved in vascular imaging who want to understand how ultrasound quality, lab culture, and physician engagement impact clinical decision making.About Jan Sloves, RVT, RCS, FASEJan Sloves is a nationally recognized vascular imaging expert and educator with more than 30 years of experience advancing ultrasound techniques and training healthcare professionals. He founded Ultrasound Unlocked to help clinicians elevate their skill sets by mastering the techniques that turn good scans into great diagnostics. Through the platform, he has built a global community dedicated to collaboration and excellence in vascular imaging. Whether you are a physician or an RVT, this training sharpens technical and interpretive skills, builds confidence, and elevates patient care.Connect with Jan💼 LinkedIn: Jan Sloves RVT RCS FASE🔗 Website: UltrasoundUnlocked.comFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about the role of ultrasound in clinical decision making, the culture inside imaging labs, or the responsibility that comes with interpreting a scan, share it with a colleague who would appreciate it. A quick review also helps more physicians and sonographers discover conversations like this.

En este episodio de Life of Flow, conversamos con la Dra. Elaine Chan, MD, FACS, cirujana de trauma y especialista en cuidados intensivos quirúrgicos, sobre un camino profesional que terminó tomando una dirección muy distinta a la que muchos médicos imaginan. Elaine comparte cómo pasó de una carrera académica tradicional en cirugía a rediseñar su vida profesional para poder viajar, trabajar en diferentes lugares y explorar nuevas formas de ejercer la medicina.La conversación recorre su infancia como hija de inmigrantes chinos que crecieron en extrema pobreza, sus años trabajando en el restaurante familiar desde niña, y el momento en que comenzó a cuestionar el ritmo de trabajo que llevaba dentro del sistema hospitalario. También habla sobre el estrés que experimentó durante su carrera académica, la decisión de dejar ese modelo para hacer locums, y cómo viajar por el mundo cambió completamente su perspectiva sobre el trabajo, el éxito y la vida.05:02 Formación médica y cómo llegó a la cirugía de trauma11:38 El momento que la llevó a cuestionar su carrera y tomar un descanso16:55 Viajar por el mundo y trabajar con organizaciones de vida silvestre22:07 Infancia como hija de inmigrantes y trabajar en el restaurante familiar31:42 Presión profesional, ambición y agotamiento en la medicina académica40:10 El impacto del estrés y el momento que la obligó a detenerse45:28 Decidir dejar el modelo tradicional y comenzar a trabajar como locum💡¿Quién debería escuchar este episodio?Médicos, cirujanos en formación, profesionales de la salud y cualquier persona que esté cuestionando el equilibrio entre carrera, propósito personal y estilo de vida.Sobre Elaine Chan, MD, FACSLa Dra. Elaine Chan, MD, FACS, está certificada por el American Board of Surgery en Cirugía General y Cuidados Críticos Quirúrgicos. Realizó sus estudios de grado en New York University y cursó la carrera de medicina en State University of New York Downstate Medical Center.Completó su internado y residencia en cirugía general en St. Luke’s Roosevelt Hospital en la ciudad de Nueva York. Posteriormente realizó una fellowship en cirugía de trauma en Emory University – Grady Memorial Hospital en Atlanta, Georgia, y una fellowship en cuidados críticos quirúrgicos en Jackson Memorial Hospital – Ryder Trauma Medical Center en Miami, Florida.Luego se desempeñó como profesora asistente de cirugía en Temple University Hospital, antes de dedicarse durante varios años al trabajo como médica locum. Actualmente es profesora adjunta de cirugía en Mission Hospital en Asheville, Carolina del Norte, donde también se desempeña como Directora de Bienestar para los residentes de cirugía de MAHEC y directora de rotación clínica para los estudiantes de tercer año de medicina de UNC School of Medicine en el programa de Asheville.Sigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

This week’s episode moves from dating apps into something far less superficial. What begins as a conversation about modern romance turns into a deeper examination of loneliness, ego after surgical training, trauma bonding in hospitals, and whether connection can quite literally influence survival.Joel Monteleone joins us to talk about why dating apps feel like a lottery, why authenticity is rare, and why high-performing professionals often struggle in relationships after years of identity built around status and performance. The discussion moves through cardiomyopathy linked to heartbreak, a dialysis patient who outlived expectations after finding love, the psychological effects of eleven years of surgical training, casual sex versus commitment, polarity and leadership in relationships, trauma bonding in medicine, and why vulnerability is often the moment real connection finally begins.02:27 Dating apps, gamification, and why swiping disconnects people09:39 The dating app lottery and why real-world presence changes the game11:13 Stop trying to win Hinge and start leading in real life14:50 The dialysis center love story and living longer than expected18:38 Eleven years of surgical training and identity distortion20:16 Casual fun versus commitment and getting clear on what you actually want31:05 Trauma bonding, hospital culture, and why healthcare dating gets chaoticWho Should ListenSurgeons, physicians, and high-performing professionals navigate dating after intense training. Anyone in medicine who has built success externally but feels disconnected internally will recognize themselves in this conversation.About Joel MonteleoneJoel Monteleone is a Relationship Abundance Coach helping ambitious people stop overthinking dating and build real connections in real life. He is based in Austin, Texas, and hosts Hot Takes, Hot Dates, a live singles event focused on bringing fun, authenticity, and vulnerability back into modern dating.Connect with Joel📲 Instagram: @joel_monteleone🔗 Website: joelmonteleone.comFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this conversation changed how you think about loneliness, leadership in relationships, or the cost of hiding behind identity, share it with someone who might need to hear it. A quick review also helps more physicians find conversations like this.

En este episodio de Life of Flow, nos sentamos con Pam Jordan, fundadora de Pivot Business Group, para hablar sobre lo que realmente implica abrir y escalar un spa médico o un negocio de sueroterapia (sin rodeos) siendo médico.La conversación gira en torno a errores frecuentes en precios, desorden contable, mala estructura fiscal y falta de claridad en objetivos que terminan convirtiendo una “fuente de ingresos extra” en un foco de estrés. Pam explica cómo diagnostica problemas financieros, cómo ayudar a que un negocio sea rentable en menos de un año y qué se necesita para pensar en una eventual venta.Este episodio aborda qué tan viable es este sector competitivo, cómo estructurarlo desde el inicio y qué decisiones financieras marcan la diferencia entre crecer con orden o perder dinero durante años.04:38 Problemas comunes de médicos al emprender y rol del equipo adecuado07:36 Tipo de clientes que atiende y cuándo puede generar mayor impacto09:49 Herramienta de análisis financiero para detectar fallas en el negocio12:44 Primer paso antes de abrir: definir el objetivo del emprendimiento16:09 Estructura legal, contable y errores frecuentes en precios19:34 Competencia, capital constante y preocupación por la rentabilidad23:03 Diferenciación mediante acumulación de servicios25:19 Franquicias, masterminds y no empezar desde cero30:05 Pasos prácticos al trabajar con su equipo y orden contable34:06 Modelo de honorarios y estrategia fiscal basada en ahorro real💡¿Quién debería escuchar este episodio?Médicos, enfermeros y profesionales de la salud que estén considerando abrir un spa médico, un negocio de sueroterapia o diversificar ingresos fuera del modelo hospitalario tradicional.Sobre Pam JordanPam Jordan es fundadora de Pivot Business Group. Trabaja con emprendedores del sector salud, incluyendo médicos y proveedores de salud integrativa, ayudándolos a estructurar sus finanzas, optimizar su estrategia fiscal y escalar sus negocios. Ofrece servicios de contabilidad, dirección financiera fraccionada y estrategia fiscal, y ha trabajado con clínicas que facturan desde medio millón hasta más de veinte millones de dólares anuales.💼 LinkedIn: ⁠Pam Jordan⁠Sigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

This week’s episode lives in the gray space most physicians don’t talk about publicly. Not clinical technique or policy, but what happens internally after years of performance, pressure, and building a life that looks successful on paper, then realizing that might not be the whole story. Dr. Priya Rao Kothapalli, MD, FACC, FSCAI, joins us to reflect on training, depression in fellowship, moral injury in early practice, leaving a job less than a year in, and learning to trust intuition in and out of the cath lab. The discussion moves through suffering, ego, art in medicine, fasting, spirituality, risk, and what success actually means when you strip away titles and status.04:56 Quitting the job and questioning who you are10:27 Pressure, intuition, and preparing for life-and-death decisions18:07 Fasting, presence, and testing your limits23:21 Academia, ego, and realizing misalignment27:55 Taking risks and trusting when life whispers33:36 Material safety 44:14 How to become more intuitive49:44 Rest, regulation, and showing up as a better physicianWho Should ListenPhysicians, surgeons, and interventionalists navigating identity shifts, burnout, or career inflection points. Anyone in medicine who feels the tension between performance and alignment will recognize themselves in this conversation.About Dr. Priya KothapalliDr. Priya Rao Kothapalli, MD, FACC, FSCAI is a Houston-based, quadruple board-certified interventional cardiologist specializing in coronary and structural heart disease who combines high-stakes procedural expertise with media and education initiatives as founder of the Open Heart podcast and storytelling platform bridging medicine and broader cultural inquiry. Connect with Dr. Priya💼 LinkedIn: Priya Rao Kothapalli, MD, FACC, FSCAI🎙️ Podcast: Open Heart PodcastFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this conversation reshaped how you think about identity in medicine, intuition in the cath lab, or the risks of stepping outside a traditional path, share it with a colleague who’s quietly questioning their next move. A quick review also helps more physicians find conversations like this.

En este episodio de Life of Flow, el Dr. Jerry Kim, MD, cirujano vascular formado en Baylor College of Medicine, conversa abiertamente sobre su decisión de abandonar un grupo médico y construir una práctica privada completamente independiente en una zona desatendida del condado de Los Ángeles. Explica por qué priorizó la autonomía, cómo utilizó la geografía y los patrones de referencia a su favor, y qué implicó negociar contratos con aseguradoras desde cero. También detalla los errores, riesgos financieros y lecciones concretas sobre gestión del ciclo de ingresos que pueden determinar el éxito o el fracaso de una práctica individual.05:15 Mudanza a California y elección de Pomona como zona desatendida06:42 Estrategia inicial dentro del grupo médico y plan a tres años12020 Negociaciones con aseguradoras y obstáculos con HMO e IPAs12:45 Construcción del patrón de referencias hospitalarias y ambulatorias16:10 Transición a práctica totalmente independiente en 202218:00 Reserva financiera necesaria y reducción del estilo de vida36:30 Estrategia “lean” al iniciar la consulta y control de costos40:50 Desarrollo del OBL y rechazo a consultoras externas💡¿Quién debería escuchar este episodio?Cirujanos vasculares y otros médicos especialistas que estén considerando pasar de empleo asalariado a práctica privada independiente, especialmente en mercados con dinámicas complejas de aseguradoras y contratos.Sobre Dr. Jerry Kim, MD,El Dr. Jerry Kim nació y creció en el sur de California. Obtuvo su licenciatura en biología molecular en UCLA. Realizó la escuela de medicina en Baylor College of Medicine en Houston, su residencia en cirugía general en Harbor UCLA en Torrance, y completó su fellowship en cirugía vascular nuevamente en Baylor College of Medicine en Houston. Actualmente ejerce en el sur de California y atiende pacientes con enfermedades vasculares.Sus áreas de enfoque incluyen estenosis carotídea, aneurisma y disección de aorta abdominal, isquemia mesentérica, hipertensión renovascular, enfermedad arterial periférica, enfermedad venosa incluyendo flemasia y síndrome de May Thurner, y accesos vasculares y de diálisis.👤 Profile: Allied Pacific IPASigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this episode, we sit down with Dr. Ronen Elefant, MD, MBA, MSEng, FACS, double-board-certified general surgeon and surgical intensivist. He shares how his early experience with locums work, aviation, and operating across different hospital systems evolved into a national direct surgical care model built on transparent pricing and surgeon autonomy. We discuss why he believes insurance is the central driver of rising healthcare costs and physician burnout, how ACES functions as a virtual surgical practice partnering with ambulatory surgery centers, and why restoring a direct doctor-patient financial relationship matters for both surgeons and employers.🎧 This episode examines how insurance structures, administrative burden, and employer-sponsored healthcare drive costs up while pulling physicians away from true patient care, and why understanding basic economics may be just as important as clinical training.02:18 From Israel to biomedical engineering to medicine05:04 Residency in New York vs Temple and trauma experience11:42 The origin of ACES and early locums work18:17 Flying to perform outpatient surgery and batching cases19:52 Cash pay surgery and the Surgery Center of Oklahoma model22:04 Building a virtual national surgical practice26:53 Chief grand rounds on healthcare economics and big government29:26 Insurance, administrative burden, and physician burnout24:28 Entrepreneurship, team building, and surgeon independenceWho Should ListenThis episode is for surgeons, physicians, and healthcare professionals thinking about autonomy, alternative payment models, or building outside traditional hospital employment. It is also relevant for employers and healthcare leaders exploring direct care and cash pay systems.About Dr. Ronen Elefant, MD, MBA, MSEng, FACSDr. Ronen Elefant, MD, MBA, MSEng, FACS is a double-board-certified general surgeon and surgical intensivist, founder and CEO of the ACES National Surgical Team where he drives a model of direct surgical care emphasizing transparency, surgeon autonomy, and high-quality outcomes; he serves as Trauma Medical Director and Chief of Acute Care Surgery at a regional Pennsylvania hospital, holds advanced training in biomedical engineering and business, and applies multidisciplinary expertise in trauma surgery, emergency general surgery, and surgical critical care. Connect with Dr. Ronen💼 LinkedIn: Ronen Elefant, MD, MBA, FACS🔗 Website: ACES National Surgical TeamFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this conversation reshaped how you think about insurance, burnout, or building a more autonomous surgical practice, share it with a colleague exploring alternative models. A quick review also helps more physicians find discussions like this.

En este episodio de Life of Flow, conversamos con los Drs. Bret Wiechmann y Fadi Saab sobre la evolución del modelo ambulatorio en el tratamiento de la enfermedad vascular periférica y la isquemia crítica de las extremidades. La conversación profundiza en los desafíos estructurales del entorno hospitalario, las amenazas financieras al modelo ambulatorio, la necesidad de estándares claros para los operadores y el verdadero significado de “éxito” clínico cuando el objetivo es preservar función, independencia y supervivencia libre de amputación.Se analizan temas como la fragmentación de la atención, la falta de evaluación vascular previa a amputaciones mayores, la importancia de registros clínicos robustos y el rol de la OEIS en la defensa del modelo no hospitalario. El debate también aborda escenarios clínicos reales donde la decisión de amputar no es binaria y depende del contexto funcional individual del paciente.04:33 Recortes de reembolso y amenaza existencial al modelo ambulatorio07:44 Dificultad de desarrollarse como clínico dentro del hospital10:41 Necesidad de estándares y definición de operadores en el modelo ambulatorio17:33 Riesgo de sobre regular y crear cuellos de botella en el acceso a atención24:28 Qué es OEIS y por qué se creó para defender el modelo no hospitalario28:30 Registro con más de 40.000 pacientes y generación de evidencia en entorno ambulatorio30:46 Amputación mayor, supervivencia libre de amputación y definición de éxito💡¿Quién debería escuchar este episodio?Cirujanos vasculares, cardiólogos intervencionistas, radiólogos intervencionistas y médicos que tratan enfermedad vascular periférica e isquemia crítica de las extremidades, especialmente quienes trabajan en modelos ambulatorios o evalúan la descentralización como estrategia de atención.Sobre los invitadosDr. Bret WiechmannEl Dr. Bret Wiechmann, MD, es especialista en Radiología Vascular e Intervencionista en Gainesville, Florida, con más de 30 años de experiencia. Se graduó de la Facultad de Medicina de la Universidad de Florida en 1991 y está afiliado a Lake City Medical Center y North Florida Regional Medical Center. Ha sido presidente de la Outpatient Endovascular and Interventional Society (OEIS), organización creada en 2013 por especialistas de radiología intervencionista, cardiología y cirugía vascular para defender y promover el modelo ambulatorio no hospitalario, establecer procesos de acreditación y desarrollar un registro clínico que actualmente incluye más de 40.000 pacientes en su módulo arterial periférico.💼 LinkedIn: Bret N. WiechmannDr. Fadi A. SaabFadi A. Saab, MD, FACC, FSCAI, FASE, es cardiólogo certificado en medicina cardiovascular e intervencionista. Se especializa en revascularización endovascular de enfermedad vascular periférica e isquemia crítica de las extremidades. Completó su residencia en medicina interna en Detroit Medical Center-Sinai Grace Hospital y múltiples fellowships en cardiología y cardiología intervencionista. Es Profesor Clínico Asociado de Medicina en Michigan State University College of Human Medicine, Director Médico de Terapia Endovascular y de Investigación Cardiovascular en Dearborn Cardiology y Michigan Outpatient Vascular Institute. Participa activamente en investigación clínica, publica sobre isquemia crítica y salvamento de extremidades, y ocupa roles de liderazgo en sociedades relacionadas con el ámbito endovascular ambulatorio.💼 LinkedIn: Fadi Saab, MD, FACC, FSCAI, FASESigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this episode, we sit down with Mark F. Weiss, JD, an attorney who has spent decades advising physicians on the business and legal realities shaping medical practice. Mark explains how hospitals gained economic and structural power over physicians, why patient costs rise after hospital acquisitions, and how fear quietly became a tool that keeps many physicians from leaving systems that no longer serve them. The conversation moves from history to responsibility, ending with a blunt question about what individual physicians can do instead of continuing to complain.🎧 This episode explores how physicians lose autonomy through reimbursement policy, consolidation, and fear-based decision-making, and why understanding the business and legal structures around medicine matters as much as clinical skill.02:45 From janitor to lawyer and how early jobs shaped his thinking04:17 Moving from real estate law into physician and hospital deals07:17 The original physician hospital relationship and how it changed14:02 How reimbursement policy pushed physicians out of independence13:37 “You didn’t go to medical school to run a business” and why that line stuck33:28 Fear, employment, and why starting a practice feels impossible37:14 The mid-career breaking point many physicians hit49:53 Awareness, responsibility, and why complaining is not a strategy Who Should ListenThis episode is for practicing physicians, residents, and mid-career doctors who feel stuck in hospital employment, as well as anyone trying to understand how economics, fear, and policy shape modern medical practice.About Mark F. Weiss, JDMark F. Weiss is an attorney specializing in the business and legal issues affecting physicians, medical groups, and physician-owned ventures on a national basis.From 2002 through 2013, Mark held an appointment as a clinical assistant professor of anesthesiology at USC’s Keck School of Medicine, at which he developed and taught a seminar course for anesthesia residents on the business and legal issues affecting anesthesia practice.He's a frequent speaker on topics of interest to providers and professional advisors in the healthcare industry, and is the author of multiple books and hundreds of articles on medical practice legal and business issues.Mark practices law with The Mark F. Weiss Law Firm, with offices in Dallas, Los Angeles and Santa Barbara, representing clients across the country.Connect with Mark💼 LinkedIn: Mark Weiss🔗 Website: weisspc.com🎙️ YouTube: Mark F. Weiss📘 Book: The Impending Death Of Hospitals: Why You Must Plan Your Medical Practice's Survival Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode helped clarify how hospital economics, consolidation, and personal responsibility shape physician autonomy, consider sharing it with someone navigating similar pressures. A quick review also helps others find conversations like this.

En este episodio de Life of Flow, conversamos con los Dr. Mark Davies y Dr. Andro Herrera-Mendoza sobre cómo el cuidado vascular y el manejo de heridas se fragmentaron en sistemas separados y qué ocurre cuando esa desconexión rompe la continuidad del paciente. A lo largo de la conversación, analizan por qué los modelos actuales priorizan episodios agudos sobre seguimiento longitudinal, cómo los incentivos financieros influyen en las decisiones clínicas y qué desafíos reales aparecen cuando los pacientes se mueven entre hospitales, centros postagudos y atención domiciliaria. El foco no está en una técnica puntual, sino en cómo diseñar sistemas que puedan sostenerse en el tiempo sin perder de vista al paciente.❗️Este episodio fue originalmente grabado en inglés y ahora lo traemos doblado al español para nuestra comunidad hispanohablante.English Version of the Episode 👉 youtube.com/watch?v=mr-8DgebKcA03:40 Integración horizontal y vertical del cuidado del paciente10:18 Rol del cirujano vascular en el entorno agudo y postagudo17:07 Debate sobre atención multidisciplinaria versus un único proveedor26:34 Fragmentación del sistema postagudo y pérdida de continuidad30:10 Perspectiva desde la atención crónica y la gestión de poblaciones36:02 Concentración de servicios y especialización por mercado42:15 Incentivos financieros y modelos de atención ambulatoria48:30 Limitaciones de los modelos de pago actuales y atención basada en valor💡¿Quién debería escuchar este episodio?Profesionales de cirugía vascular, médicos que trabajan con pacientes crónicos complejos, líderes clínicos involucrados en gestión de sistemas de salud y responsables de modelos de atención postaguda y ambulatoria.Sobre los invitadosDr. Mark DaviesCirujano vascular con experiencia en el manejo integral de pacientes a lo largo de entornos agudos y postagudos. Durante el episodio comparte su trabajo en distintos modelos de atención en Estados Unidos, incluyendo el desarrollo de sistemas que conectan hospitales, centros ambulatorios y cuidado de heridas, así como su visión sobre incentivos financieros, fragmentación del sistema y continuidad del cuidado.💼 LinkedIn: Mark G DaviesDr. Andro Herrera-MendozaMédico con rol de liderazgo en PAM Health, enfocado en atención crónica y postaguda. En la conversación aporta su perspectiva sobre la gestión de poblaciones, la creación de ecosistemas de atención que abarcan desde hospitales de cuidados prolongados hasta atención domiciliaria, y los desafíos de coordinar servicios clínicos dentro de sistemas altamente fragmentados.💼 LinkedIn: Andro Herrera-Mendoza, FACHESigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this episode of the Life of Flow podcast, Dr. Pedro Martinez-Clark returns to talk through the less visible side of running an independent medical practice. He walks through moments where growth outpaced infrastructure, how poor systems quietly drained revenue, and why discipline, restraint, and operational clarity matter just as much as ambition. The conversation focuses on decision-making under pressure, learning when to slow down, and building systems that support both performance and sustainability over time.🎧 This episode explores how physicians and other high-responsibility professionals manage pressure, decision fatigue, and constant operational demands, and why building structure and control outside the clinical setting is essential to maintaining focus and performance inside it.04:04 The structure of a multi-division cardiovascular practice06:13 Why proof of concept must come before scaling08:20 Expanding too fast and the cost of operational waste09:54 Closing locations to regain efficiency and control13:15 Growth expectations in mature practices21:31 Revenue cycle management and money left on the table37:41 Hiring mistakes and why firing fast mattersWho Should ListenThis episode is for physicians considering independent practice, practice owners navigating growth decisions, and operators responsible for hiring, cash flow, and operational systems in healthcare.About Dr. Pedro Martinez ClarkDr. Pedro Martinez-Clark, MD is a physician originally from Colombia; he earned his medical degree at Universidad del Norte in Barranquilla, Colombia. He completed his postgraduate training in Internal Medicine at Case Western Reserve University (Ohio). He then obtained a clinical fellowship in Cardiovascular Disease at Beth Israel Deaconess Medical Center / Harvard Medical School, including additional fellowship training in Interventional Cardiology, Endovascular Therapies, and Vascular Medicine.He founded Amavita Health, which offers state-of-the-art, minimally invasive, outpatient cardiovascular and vascular care. Their services include management of coronary artery disease, arrhythmias, peripheral vascular disease, chronic venous insufficiency, and related conditions. The practice partners with prominent hospitals in Miami-Dade County, such as Mercy Hospital (Miami), but remains independent, allowing a patient-first model focused on advanced cardiovascular care.Beyond patient care, Martinez-Clark has been active in medical innovation: co-founding ventures such as a health-tech incubator (for medical technologies) and a contract research organization supporting early-stage life-sciences startups. He has authored multiple peer-reviewed publications and contributed academically, including a textbook chapter on systems of care for primary angioplasty. He has been recognized for excellence: in 2014 he won a “best research award” at a meeting of the Society for Cardiovascular Angiography and Interventions (SCAI).In 2023 he was honored by South Florida Business & Wealth with an Apogee Award for Excellence in Healthcare, acknowledging his leadership and vision in the cardiovascular field.As of 2025, his practice remains active and continues to emphasize community outreach, promoting awareness about heart disease prevention, vascular health, and diabetes risk to the South Florida populationConnect with Dr. Martinez-Clark📲 Instagram: @drmartinezclark💼 LinkedIn: Pedro Martinez-Clark, M.D.🐦 X: @drmartinezclark🔗 Website: amavita.healthFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode helped clarify how operational awareness, systems, and deliberate decision-making can reduce stress and prevent costly mistakes, consider sharing it with someone navigating similar demands. A quick review also helps others find conversations like this.

En este episodio de Life of Flow, Jill Sommerset, RVT, FSVU, Directora de Ultrasonido en HOPE Vascular & Podiatry, se suma a una conversación extensa y técnica sobre el uso real del ultrasonido en pacientes sin opciones de revascularización arterial. A lo largo del episodio, Jill discute de forma directa cómo el mapeo venoso preoperatorio puede cambiar decisiones quirúrgicas, qué información considera crítica antes de una arterialización venosa y por qué muchos estudios actuales se quedan cortos. La conversación se mueve entre la práctica diaria, los límites reales del ultrasonido, la toma de decisiones intraoperatorias y las preguntas que aún no tienen respuesta clara.❗️Este episodio fue originalmente grabado en inglés y ahora lo traemos doblado al español para nuestra comunidad hispanohablante.English Version of the Episode 👉 youtube.com/watch?v=BOGS74PDBEA06:45 Por qué el ultrasonido suele infrautilizarse en la planificación preoperatoria13:30 Qué información busca Jill en un mapeo venoso antes de una arterialización22:10 Identificación de patrones de enfermedad en pacientes con CLTI31:40 Evaluación del sistema venoso profundo y superficial del pie41:55 Limitaciones del venograma frente al ultrasonido detallado52:30 Cómo el mapeo venoso puede cambiar por completo el plan quirúrgico01:03:15 Selección de venas objetivo y dificultades anatómicas reales01:16:20 Discusión sobre flujos, formas de onda y mediciones intraoperatorias01:31:40 Seguimiento postoperatorio y preguntas abiertas sin respuesta clara💡¿Quién debería escuchar este episodio?Este episodio está dirigido principalmente a cirujanos vasculares, especialistas en imagen vascular, técnicos en ultrasonido y equipos clínicos involucrados en el manejo de pacientes con isquemia crítica de miembros inferiores y procedimientos complejos.Sobre Jill Sommerset, RVT, FSVUJill Sommerset, RVT, FSVU, es Directora de Ultrasonido en HOPE Vascular & Podiatry y cuenta con más de 20 años de experiencia en ultrasonido vascular. Durante el episodio, comparte su enfoque práctico sobre el mapeo venoso, la evaluación detallada del sistema venoso del pie y la importancia de comprender la anatomía real antes de procedimientos de arterialización. Jill es reconocida por haber desarrollado la técnica Pedal Acceleration Time (PAT) y por su trabajo continuo en mejorar la planificación y los resultados en pacientes complejos.Connect with Jill💼 LinkedIn: Jill Sommerset RVT, FSVUSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this week’s episode of the Life of Flow podcast, physical therapist and BreathLab & Yoga Studio founder Kattia Lohmann joins the conversation to share how breath became the turning point in her own experience with anxiety, panic, and burnout.She reflects on moving from clinical work and years in the vascular medical device industry into a deeper exploration of breathing, awareness, and regulation. Grounded in lived experience, the discussion connects physiology, stress, and attention in a way that speaks directly to the realities of high-performing professionals.🎧 This episode is a conversation about how physicians and high-stress professionals experience pressure, stillness, and regulation, and why learning to access calm and focus outside of the operating room matters as much as performance inside it.02:49 Kattia’s background in physical therapy and early interest in healing05:09 Anxiety, panic attacks, and discovering breath as a starting point09:10 Different styles of breathwork and first discussion of holotropic breathwork21:59 How to assess your own breathing patterns and build awareness27:02 When breathwork can worsen anxiety and why awareness comes first29:04 Nasal breathing, nitric oxide, and circulation32:00 Coherent breathing and regulating the nervous system37:10 Breath, intuition, and accessing flow states43:45 Stillness in surgery versus stillness outside the operating room55:10 Quick grounding tools for high-stress moments Who Should ListenThis episode is for physicians, surgeons, and other high-stress professionals who operate in intense environments and want practical ways to regulate stress and attention. It will also resonate with healthcare and MedTech professionals interested in how physiology, awareness, and performance intersect.About Kattia LohmannKattia Lohmann is a Physical Therapist and founder of BreathLab & Yoga Studio, where science meets soul through conscious breathwork and embodied healing. She bridges her background in rehabilitation and physiology with mindfulness and yoga to help people restore balance, vitality, and inner peace. Kattia has an MBA and over a decade of experience in the vascular medical device industry, a background that fuels her mission at BreathLab to merge science, mindfulness, and movement for whole-body health.Connect with Kattia Lohmann💼 LinkedIn: Kattia Lohmann📲 Instagram: @breathlab_yogastudioFollow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode helped clarify how breath awareness can support focus, regulation, and decision-making under stress, consider sharing it with someone navigating similar demands. A quick review also helps others find conversations like this.

En este episodio de Life of Flow, el Dr. James Jim Coleman recorre, con un nivel de detalle poco habitual, su transición desde la formación quirúrgica en Irlanda hasta el desarrollo de tecnologías de cierre vascular. La conversación se centra en cómo su interés temprano por la ingeniería, la investigación académica, y su paso por la industria farmacéutica y de dispositivos influyeron directamente en las decisiones que marcaron su camino profesional. A lo largo del episodio, Jim describe de forma concreta los aciertos, los fracasos y las presiones humanas que acompañaron el paso de la práctica clínica al emprendimiento.❗️Este episodio fue originalmente grabado en inglés y ahora lo traemos doblado al español para nuestra comunidad hispanohablante.06:15 Rotación quirúrgica y decisión de dedicarse a la cirugía vascular 7:40 Beca de investigación en Estados Unidos y trabajo con hidrogeles 10:30 Primer contacto con innovación y procedimientos basados en catéter 13:10 Regreso a Europa, práctica clínica y revolución laparoscópica 16:20 Transición a la industria y rol como director médico internacional 20:05 Decisión de dejar la práctica clínica y dedicarse al emprendimiento 26:40 Primer intento fallido de dispositivo de cierre y aprendizajes clave 29:15 Origen del nuevo concepto de cierre vascular y desarrollo del diseño 30:30 Ensayos clínicos iniciales, marcado CE y experiencia en Europa 💡¿Quién debería escuchar este episodio?Cirujanos vasculares, médicos en formación o adjuntos interesados en innovación, profesionales de la industria de dispositivos médicos y médicos que evalúan una transición desde la práctica clínica hacia la investigación o el emprendimiento.Sobre Dr. James “Jim” Coleman El Dr. James Coleman se formó como médico y cirujano en el Royal College of Surgeons de Irlanda, donde inició su especialización en cirugía vascular. Durante su carrera combinó práctica clínica, investigación académica y trabajo en la industria, incluyendo su paso por centros de investigación en Estados Unidos y roles directivos en empresas multinacionales. A lo largo del episodio relata su participación en el desarrollo de tecnologías de cierre vascular, su experiencia fundando empresas, y el proceso personal y profesional que lo llevó a dedicarse de lleno al emprendimiento en dispositivos médicos.Sigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this week's episode of Life of Flow, Dutch Rojas joins us for a candid conversation about why independent physicians are being systematically pushed out of American healthcare. Drawing on decades spent building surgery centers, working inside insurance and policy structures, and watching consolidation unfold firsthand, Dutch explains why the system is not broken, but functioning exactly as designed.We talk through CMS priorities, hospital lobbying, and the growing gap between how medicine is practiced and how physicians are trained to work.🎧 This episode continues our ongoing conversation about physician autonomy, institutional power, and what it feels like to practice medicine inside systems that control decision-making, reimbursement, and voice.05:40 The moment consolidation became impossible to ignore08:09 CMS priorities and why hospitals come first11:58 How payment structures work against independent doctors13:42 Why physicians lack political leverage21:46 What it feels like to practice without autonomy22:24 The fear of speaking out inside institutional medicine22:41 Why autonomy is the number one complaint from physicians31:12 Certificate of need laws and blocked physician ownership40:12 Signs consolidation may be slowing and what comes nextWho Should ListenThis episode is for physicians navigating hospital employment, private practice, or consolidation pressures, as well as healthcare operators and investors trying to understand how policy, incentives, and institutional power shape modern medical practice.About Dutch RojasDutch Rojas is a healthcare entrepreneur who has spent over two decades building, operating, and exiting physician-focused businesses. He is the founder of MedMerge, co-founder of PhyCap Fund, and serves on the board of Physician Led Healthcare for America. Dutch invented surgery futures and options and built and sold ambulatory surgery centers and surgical practices. His exits include Sano Surgery and Everyone Health.Dutch is the creator of The Rojas Report, a reader-supported Substack publication focused on exposing the hidden power structures in American healthcare, and host of The Physicians Edge podcast. His forthcoming book, Too Big To Care: How Nonprofit Health Systems Hijacked Healthcare, launches in early 2026. He is a Marine veteran. Connect with Dutch📰 Substack: dutchrojas.substack.com💼 LinkedIn: Dutch Rojas🐦 X: @DutchRojasFollow Life of Flow📲 Instagram: ⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠👍 Facebook: ⁠⁠⁠Life of Flow Podcast⁠⁠⁠💼 LinkedIn: ⁠⁠⁠Life of Flow Podcast⁠⁠⁠🐦 X: ⁠⁠⁠@VascularPodcastIf this episode clarified how consolidation, policy, and institutional incentives affect physician autonomy, consider sharing it with someone navigating the same pressures. A quick review also helps others find conversations like this.

El Dr. Jan Skowronski, MD y el Dr. Robert Beasley, MD se unen a Life of Flow para una conversación sobre cómo está cambiando la forma en que los médicos consumen educación y por qué el modelo tradicional de congresos ya no responde a las necesidades reales de los operadores.A lo largo de la charla, discuten la fatiga de las reuniones clásicas, la brecha entre formación teórica y habilidad práctica, y la necesidad de espacios educativos más directos, accesibles y honestos. La conversación gira en torno a Pegasus Endovascular, una conferencia diseñada para priorizar casos reales, debate abierto y confrontación profesional sin guion.04:32 Cómo cambió la forma de aprender de las nuevas generaciones08:15 Educación basada en casos versus educación orientada a exámenes13:40 A quién está dirigida realmente la educación médica continua18:55 El origen y objetivo de Pegasus Endovascular24:10 Debate abierto, controversia y conversaciones sin guion31:05 El rol de la industria y la dificultad de financiar eventos globales38:42 Educación gratuita, acceso global y consumo bajo demanda40:30 Disparidad en la atención médica y ausencia de un estándar real45:20 Controversia pública, periodismo y la necesidad de discutir como comunidad médica💡¿Quién debería escuchar este episodio?Médicos intervencionistas, cirujanos vasculares, radiólogos intervencionistas y profesionales de la salud interesados en educación médica continua, especialmente aquellos que cuestionan los modelos tradicionales de formación y congresos.Sobre los invitadosDr. Jan Skowronski, MDEl Dr. Jan Skowronski es cardiólogo intervencionista y ha ejercido la medicina en Estados Unidos durante 25 años. A lo largo del episodio, comparte su experiencia organizando conferencias médicas y su visión sobre la necesidad de transformar la educación hacia formatos más dinámicos, accesibles y basados en casos reales. Defiende un enfoque educativo centrado en formar operadores sólidos más que en repetir datos o resultados a largo plazo.💼 LinkedIn: Jan SkowronskiDr. Robert Beasley, MDEl Dr. Robert Beasley es radiólogo vascular e intervencionista certificado. En la conversación, aporta su experiencia clínica, su participación en múltiples ensayos clínicos y su perspectiva sobre la disparidad en la atención médica según regiones, hospitales y operadores. Enfatiza la importancia de discutir abiertamente prácticas controvertidas, compartir experiencias reales y crear espacios donde distintas especialidades puedan confrontar ideas con respeto profesional.💼 LinkedIn: Robert BeasleySigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.

In this episode of Life of Flow, Courtney Johnson returns for a wide-ranging conversation on why personal brand is not optional, regardless of role, title, or career path, and how visibility, influence, and professional identity are shaped both inside and outside medicine. The discussion explores how repetition builds trust, why people become top of mind through exposure rather than intention, and how professionals who allow institutions to define them relinquish long-term agency. For physicians in particular, the episode draws a clear distinction between expertise and influence, and why visibility determines who is remembered, referred to, and trusted over time.🎧 This episode builds on the conversation around physician identity and visibility, examining how personal brand shapes trust, recognition, and long-term agency in medical careers.01:40 Top-of-mind awareness and why repetition predicts behavior02:44 Why propaganda and programming are neutral tools07:43 Association as a shortcut to trust and credibility11:02 Why 99% of long-term leverage comes from personal brand11:45 Why humans connect faster with people than organizations16:12 The lie of “put your head down and work hard”16:47 Why no one will find you unless you put yourself out first22:12 Finding purpose through what people ask you for Who Should ListenThis episode is for physicians, surgeons, and healthcare professionals navigating hospital systems, private practice, or career transitions. It is especially relevant for doctors thinking about referrals, reputation, visibility, and long-term autonomy within medicine.About Courtney JohnsonCourtney Johnson is a personal brand strategist, host of Slay The Gatekeeper Podcast, and content creator whose work centers on visibility, influence, and personal brand development. She helps professionals understand how perception is formed over time, how trust is built through repetition, and why personal brand is a long-term asset that extends beyond any single role, company, or institution.Through her work, Courtney focuses on helping individuals take ownership of their professional identity, particularly in environments where hierarchy and systems often define visibility by default. Her approach emphasizes intentional messaging, consistency, and human connection, with a strong belief that influence is shaped through presence and clarity rather than credentials alone. Courtney’s perspective is rooted in self-authorship, agency, and the idea that personal brand is not about promotion, but about being recognizable, trusted, and remembered for the value you provide.Connect with Courtney📧 Contact: [email protected]👍 Instagram: @slaythegatekeeper🎙️ Podcast: Slay The Gatekeeper👍 Instagram: @courtlynnjohnson 💼 LinkedIn: Courtney Johnson🎶 TikTok: @courtney..johnsonFollow Life of Flow📲 Instagram: ⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠👍 Facebook: ⁠⁠⁠Life of Flow Podcast⁠⁠⁠💼 LinkedIn: ⁠⁠⁠Life of Flow Podcast⁠⁠⁠🐦 X: ⁠⁠⁠@VascularPodcastIf this episode sharpened how you think about personal brand and visibility in medicine, share it with someone who would benefit from the conversation. And if you’re enjoying Life of Flow, a quick review helps others find these discussions.

Amy J. Goldberg, MD, FACS, se une a Life of Flow para una conversación honesta sobre liderazgo médico, formación quirúrgica y las tensiones reales que existen entre exigencia, cultura y humanidad dentro de la medicina académica.A lo largo del episodio, reflexiona sobre cómo han cambiado las residencias quirúrgicas, qué significa liderar desde la responsabilidad con el paciente y cómo se aprende a ejercer autoridad sin perder autoconciencia. Desde su experiencia como cirujana de trauma y decana, Goldberg habla sin adornos sobre fracaso, carácter, agotamiento, vocación y el peso emocional de ocupar roles de poder.05:10 Cómo ha cambiado la cultura de la residencia quirúrgica con el tiempo09:25 Por qué nunca planeó ser líder y cómo siguió su vocación en Temple16:20 Liderar sin un plan estratégico y ejercer liderazgo sin título20:55 Introversión, agotamiento y el costo emocional de ser decana27:40 Salud mental, rutinas personales y la necesidad de recargar energía34:50 Fracaso como condición necesaria para aprender y liderar mejor41:30 Carácter fuerte, feedback duro y aprendizaje relacional52:10 Cultura de excelencia, misión compartida y trabajo en equipo01:05:30 Tecnología, inteligencia artificial y el futuro de la medicina💡¿Quién debería escuchar este episodio?Médicos en formación, cirujanos, líderes académicos, profesionales de la salud en roles de gestión y cualquier persona interesada en liderazgo dentro de sistemas complejos y de alta exigencia.Sobre Amy J. Goldberg, MD, FACS, MAMSEAmy J. Goldberg, MD, FACS es cirujana de trauma y educadora con más de treinta años de trayectoria en Temple University. En el episodio relata su recorrido desde la residencia hasta convertirse en decana de la Lewis Katz School of Medicine, rol que asumió tras ocupar posiciones como directora de residencia, jefa de trauma y presidenta de departamento. A lo largo de la conversación comparte su visión sobre liderazgo, responsabilidad con el paciente, formación médica, cultura institucional y los desafíos personales que implica sostener roles de alta exposición y exigencia.💼 LinkedIn: Amy Goldberg, MD, FACS👤 ACS: Academy Fireside ChatSigue a Life of Flow📲 Instagram: ⁠⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠⁠@VascularPodcast⁠¿Conoces a alguien que debería escuchar esta conversación?🎧 Envíale este episodio y ayúdanos a que más personas accedan a estas historias y aprendizajes.