Many physicians feel trapped in jobs they dread and can't easily leave. One eye surgeon found an exit he says rarely comes up in the burnout debate. Oren Fass, an ophthalmologist and cataract surgeon who sold his practice to private equity, built a solo practice where AI agents handle faxes, scheduling, and billing, so he sees one to three patients a morning. He explains how it works, who it fits, and why the safe job may be the riskier bet.
⏱️ Chapters:
0:00 Introduction
0:26 He sold to private equity, then started over solo
1:57 The burnout option that never comes up
2:46 One to three patients a morning instead of 40
3:51 An AI agent reads the fax and books the patient
4:37 Why his patients decide when the visit ends
5:43 Why leaving a bad medical job can take a year
9:29 How he taught himself agentic AI at night
10:57 Why his AI gets better every week
12:20 Could this work in primary care?
13:22 Cutting-edge AI, still running on fax
13:48 Why giant practices are the wrong fit
15:13 Why going solo isn't a total leap into the dark
17:14 Why the safe job may be the riskier bet
18:57 Take home messages
About this episode:
Oren Fass, an ophthalmologist and cataract surgeon, has held nearly every role in his field. He was an employed physician, built a multi-office practice, sold it to private equity, worked for the buyer, and then started over from scratch. He discusses his KevinMD article, "The hidden variable in the physician burnout debate," and the option he says rarely surfaces when physicians talk about burnout. In his micro practice, automation replaces staff at each station, from an AI agent that reads referral faxes and texts new patients to billing tailored by specialty. Instead of 40 patients a day, he sees one to three in a morning, and patients decide when the visit is over. He explains why physicians feel stuck, from mortgages and families to insurance and licensing changes that can take six to 12 months. He describes learning agentic AI at night, refining his systems every weekend, and why the model fits small offices better than large practices shopping for a software vendor. He closes by arguing that a career built on keyboard work may now carry more risk than ownership, and that agentic AI is already usable in medicine.
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