In this episode of The Rojas Report, Dutch sits down with Dr. Ali, physician, technologist, designer, and fierce defender of physician autonomy, for one of the most unfiltered conversations you will ever hear about the real forces shaping American healthcare.

Most people blame one another for the system’s failures. Doctors blame insurers. Insurers blame hospitals. Politicians blame everyone.

But Ali and Dutch go upstream, to the incentives, structures, and quiet policy decisions that created the middleman economy now dominating medicine.

Dr. Ali breaks down:

• How physicians accidentally empowered intermediaries
• Why insurance CEOs earn more than entire clinical departments
• Why UX, design thinking, and hospitality matter more in medicine than anyone admits
• How “nonprofit” health systems became the most profitable corporations in healthcare
• The true impact of the Affordable Care Act and who wrote the rules
• Why burnout is a symptom of lost agency, not workload
• Why independent medicine is the only sustainable future

Dutch pushes further, into Medicare overpayments, the pricing distortions created by consolidation, the illusion of “virtue” in large health systems, and why the American medical economy rewards opacity instead of outcomes.

This episode is philosophical, technical, and deeply practical.

Dr. Ali explains why he built his own EMR, how surgeons should reclaim the patient experience, and what happens when capital, policy, and medicine collide.

If you’re a physician, policymaker, founder, or anyone trying to understand why American healthcare became a corporate labyrinth, and how to escape it, this conversation is essential.

Dr. Ali: https://www.evofoot.com/

Dutch Rojas: https://www.bliksemhealth.com/

Topics covered include:

middlemen, incentives, pricing, UX design, physician independence, Medicare pricing, ACA politics, burnout, workflow engineering, and the future of doctor-led healthcare.

The Rojas Report is built for people who want the truth without the spin — and who refuse to accept a system where the middlemen own the doctors.

Listen, share, and join the physician-led movement to rebuild American medicine.

Support the show

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