Primary Care Is the API for Healthcare. So Why Is Nobody Building for It? with Jefferson Health’s Dr. David Nichols

Primary care doctors spend their days stitching together a system that was never built to connect. Dr. David Nichols thinks they should be the ones to rebuild it.

In this episode of How I Doctor, Dr. Michael Hobbs sits in for Dr. Graham Walker to talk with his friend Dr. David Nichols, a family physician who finished residency in 2023 and became a medical director at Jefferson Health a year later. David co-founded a value-based care company at 23, ran its technology side through medical school and part of residency, and now leads AI work inside a large health system. He explains why primary care is the API for healthcare, the connector that fills every gap between specialists, hospitals, and patients’ lives, and why that connector is so poorly built.

From there, Michael and David get practical. David shares how clinicians can start building, what makes an AI project stick instead of stalling after phase one, and why hours saved is a risky way to measure AI when saved time can quietly become more patients on the schedule. They also dig into a billing structure that pays doctors only when patient and physician share a room, physical or digital, and never for the thinking and coordination that make care safe.

What You’ll Learn

• Why David calls primary care the API for healthcare, and why he says it is poorly written
• How to start building if you’re a frontline clinician, from finding builders in your own network to meetups and online communities
• What separates AI projects that stick from pilots that stall, and why Jefferson’s boss prefers the term phase one
• Why AI scribes may not save time but can still improve the quality of a visit
• Why doctors are not paid for coordination, asynchronous work, or cognitive thinking, and what David would change

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/

IG https://www.instagram.com/ubergraham/

Bluesky https://bsky.app/profile/drgrahamwalker.com

✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe

🟧 Follow Offcall on

LinkedIn https://www.linkedin.com/company/joinoffcall/

IG https://www.instagram.com/offcalldotcom/

TikTok https://www.tiktok.com/@offcalldotcom