Cut & Tell

What do interviewers actually remember about you? It isn’t your answers. In this episode, plastic surgeon Dr. Liz Malphrus goes past the standard “be yourself” advice and shares what worked on the plastic surgery interview trail. She covers the wild rooms, including Operation, paper-folding tests, and a question that should never have been asked. She also explains how she prepared, which questions to ask and which to avoid, why the coordinator and the resident room matter, and how to handle the social event. Plus, a preview of a new recurring segment: First Job M&M.

Host: Liz Ma...

What if doctors ran medicine the way lawyers run law? Lawyers, accountants and dentists have kept control of their professions, while physicians have lost control of both who owns them and who pays them. Liz looks at corporate practice of medicine laws that exist on paper but not in practice, the ERISA provision that shields insurers from liability for denials that harm patients, and vertical integration from UnitedHealth/Optum. She then lays out what physicians can do to win back professional sovereignty.

Referenced: Paul Starr, The Social Transformation of American Medicine;

Zhu et al, "A...

What happens when you become the surgeon, pay off the loans, and still feel empty?

On Cut & Tell’s first guest episode, Dr. Mel Thacker (ENT, surgeon coach, and host of Surgeons with Purpose) joins me to talk about her new memoir, Scrubbing In. It covers her path from childhood neglect to surgery, the arrival fallacy, and the panic attacks in the OR that finally forced her to face it all.

We also get into how insurance incentives quietly shape clinical decisions, why Mel walked away from private practice, why residency needs coaching, and how sh...

Administrative bloat, skyrocketing CEO pay, hospital mergers, rural closures. These aren't separate problems. They're symptoms of one syndrome: financialization.

In this episode, Liz breaks down how hospitals and practices went from places that care for people to assets that exist to generate returns, and why nonprofit hospitals now behave almost exactly like for-profits. We cover the vocabulary that gets thrown around in boardrooms (marketization, corporatization, privatization), the administrator arms race between hospitals and insurers, what hospital CEOs are actually paid to optimize for, and how consolidation drives up prices without improving quality. Then we get to what...

What happens when a well-intentioned healthcare metric gets turned into a target? Nothing good — and Liz has the receipts. Before medical school, she spent two and a half years as study director for a major National Academies report on healthcare measurement. Then she went to residency, and everything she believed fell apart. This episode walks through the VA wait-time scandal, MIPS, and the Hospital Readmission Reduction Program — three cautionary tales about what happens when you attach incentives to healthcare data, and why Goodhart's Law keeps winning.

📚 Referenced: Vital Signs: Core Metrics for Health and Healthcare Progress (National Academi...

Would you send someone you love to a hospital owned by private equity? Dr. Liz Malphrus breaks down exactly how private equity works, why it's poured billions into healthcare since 2018, and what the data says about the cost, safety, and physician burnout that follow. Plus: the exact questions to ask before taking a private-equity-backed job.

Referenced: BMJ systematic review on PE and healthcare quality/cost; JAMA analysis of Medicare claims on PE hospital acquisitions and patient safety; physician satisfaction and autonomy survey data.Host: Liz Malphrus, MD

Connect with Liz: https://www.hippocratic-collective.com/members...

Every week, doctors spend 13 hours fighting insurance companies just for permission to treat their patients — and now, under a new Medicare pilot, some of those decisions are being handed to AI. In this episode, Liz digs into prior authorization: where it came from, how it quietly stripped doctors of their professional sovereignty, and why the newest version of this system might be the most alarming yet.

📚 Referenced: The Social Transformation of American Medicine by Paul Starr

Host: Liz Malphrus, MD

Connect with Liz: https://www.hippocratic-collective.com/members/liz-malphrus-md

IG: @dr.malph...

CMS is proposing a rule that could cut your pay in half just for treating more than one problem per visit — and the comment period closes September 14th. Liz breaks down the proposed change to the 25 modifier, why the "help primary care" logic doesn't hold up, and why the AMA is being sued — again — over its copyright on the CPT codes every doctor has to use. Plus: why physician Medicare pay is down 33% since 2001 while the AMA's revenue keeps climbing.

🔗 Referenced: CMS 2027 Physician Fee Schedule public comment page — [link] (open through 9/14)

Enjoyed this episode? Rate us five sta...

How does a doctor's visit actually turn into a paycheck? It's more convoluted than how a bill becomes a law — and almost nobody, including most doctors, understands it.

In this episode of Cut and Tell, Dr. Liz Malphrus (plastic surgeon, Philadelphia) breaks down the claims-based payment system that runs American healthcare: the five data points that determine every dollar a doctor is paid, why a "clearinghouse" still charges $1 per claim in 2026, and how a shadowy 32-person AMA committee called the RUC quietly decides what your appendectomy is worth.

We also go ba...

This is Episode 2 of our series on health policy and economics for doctors! This episode is about laying the historical groundwork for the rest of this season, because so many of our modern healthcare problems can be traced back to decisions made WAY in the past that set us on this course. In this episode, Dr. Liz Malphrus digs into the 19th-century roots of American medicine — from home-based house calls and bartered payments to the founding of the American Medical Association in 1847 — to explain how doctors chose to model their profession after clergy instead of lawyers, and why that choi...

What if doctors understood how the healthcare system actually works?

In the first episode of Season 2 of Cut & Tell, Dr. Liz Malphrus kicks off a new series designed to give doctors and residents the health policy knowledge they were never taught in medical school or residency.

Liz has a master's degree in public policy and spent five years working in health policy before becoming a physician. Now, after experiencing healthcare from both sides of the system, she's breaking down the forces that shape how medicine works, and why doctors are often left without the knowledge...

Choosing a medical specialty is one of the biggest and most stressful decisions in medicine.

In this season finale of Cut & Tell, newly graduated plastic surgeon Dr. Liz Malphrus reflects on her own journey from medical student to plastic surgery. Along the way, she seriously considered hospital medicine, urology, interventional specialties, and nearly changed her career path late in medical school after a single reconstructive surgery changed everything.

Rather than offering a simple checklist, this episode explores what specialty choice is really about: finding the people, work, and environment where you'll build a fulfilling career.<...

What does the first day as an attending surgeon actually look like?

After years of medical school and plastic surgery residency, Dr. Liz Malphrus officially begins her career as an attending plastic surgeon. But instead of jumping straight into the operating room, the reality is far different—and surprisingly emotional.

In this episode of Cut & Tell, Liz shares what it's really like to leave residency behind, start building a surgical practice from scratch, earn patients' trust, navigate the business side of medicine, and finally experience something many physicians rarely have: control over their own career.

Starting your first attending job means more than just showing up on day one. It means building an entire practice from the ground up.

In this episode of Cut & Tell, I take you behind the scenes of what it actually takes to launch a career as a plastic surgeon, from spending nearly $10,000 in a single day on essential equipment to building my website, planning patient workflows, setting up my office, and figuring out how to create a practice that reflects my values.

We talk about:

• The expensive equipment every plastic surgeon needs (and wh...

No one teaches physicians how to find their first job.

After years of medical school and residency, new attendings are suddenly expected to navigate networking, interviews, contracts, compensation, and career decisions, often with little guidance.

In this episode of Cut & Tell, newly graduated plastic surgeon Dr. Liz Malphrus shares everything she learned during her own physician job search. From building a professional online presence and expanding your network to evaluating job offers, negotiating contracts, and avoiding common mistakes, this is the practical guide she wishes she'd had before starting the process.

Whether you're...

After six years of surgical residency, I expected to leave with better technical skills. I didn't expect to leave without one of my defining personality traits.

In this episode of Cut & Tell, I share the story of how a formal complaint from a senior resident completely changed how I saw myself, and ultimately forced me to stop trying to make everyone happy.

We talk about:

What actually makes a great chief resident?

After finishing plastic surgery residency, Dr. Liz Malphrus reflects on one of the most important leadership roles in medical training, and the lessons no one formally teaches. From setting expectations and managing team dynamics to giving meaningful feedback and building trust, this episode is a practical guide for anyone preparing to lead in residency.

Dr. Malphrus shares the communication strategies that transformed her approach as chief resident, why vague feedback hurts more than it helps, and how supporting curiosity can create stronger teams and better physicians. Whether you're...

Starting residency can feel overwhelming. New city, new hospital, new responsibilities, and suddenly everyone expects you to know what you're doing.

In this episode of Cut & Tell, graduating plastic surgery resident Dr. Liz Malphrus shares her most requested advice for incoming interns. Drawing on six years of residency experience, she breaks down the physical, cognitive, and psychological strategies that helped her survive, and ultimately thrive, during training.

From building sustainable study habits and protecting your sleep to finding community, seeking therapy, and learning how to navigate the constant feeling of not knowing enough, this episode...

Residents today earn roughly the same inflation-adjusted salary as residents did decades ago. So why does training feel so much more financially difficult?

In this episode of Cut & Tell, plastic surgery resident Dr. Liz Malphrus explores the economic realities facing modern trainees—from exploding medical school debt and rising housing costs to childcare expenses, delayed financial independence, and the growing gap between resident compensation and the true cost of becoming a physician.

This is the second installment in the "Back in My Day" series, examining how residency has changed over time. Rather than debating which ge...

Attendings often tell stories about residency "back in the day" - more autonomy, more responsibility, more independence. But was training really better, or has the entire system changed?

In this episode of Cut & Tell, plastic surgery resident Dr. Liz Malphrus explores why modern residents often report feeling less prepared for independent practice despite performing similar case volumes to previous generations. From duty-hour debates and supervision requirements to RVU-based compensation and the growing pressure for clinical productivity, she examines the structural forces reshaping surgical education.

This isn't a conversation about whether residency is easier or harder...

What if the most important lessons of residency aren't found in a textbook?

With graduation just days away, Liz shares the three pieces of writing that most shaped her understanding of medicine, residency, and life beyond training. From the realities of surgical culture and physician burnout to the hidden history of American healthcare and the power of personal agency, these recommendations offer a framework for understanding not just residency, but your place within the system.

In this episode, Liz discusses:

- Why Surgeon on the Edge by Frances Mei Hardin is the residency...

What makes a good resident? And beyond that — what actually makes someone great?

In this episode of Cut & Tell, Dr. Liz Malphrus breaks down the unwritten skills of residency that no one formally teaches: anticipation, adaptability, reading the room, emotional resilience, communication, and learning how to survive medicine without becoming robotic in the process.

From OR etiquette and closed-loop communication to social anxiety, burnout, and the strange art of staying positive during training, this is an honest conversation about the human side of becoming a doctor.

Whether you’re a medical student, intern, resi...

Cut & Tell is where medicine gets honest.

In this episode, Dr. Liz Malphrus opens up about the failures, regrets, rejections, and detours that never make it onto a CV. From getting a C in biology at Columbia, to losing out on a White House job she thought would define her future, to walking away from a career in music — Liz reflects on the moments she once believed had ruined everything.

This is a conversation about perfectionism, identity, career pivots, rejection, and the pressure in medicine to package every setback into a clean success story. Instead of...

Cut & Tell is where medicine gets honest.

In this episode, Dr. Liz Malphrus gets real about the hidden economics of residency training, and why so many residents feel trapped, undervalued, and burned out before they ever become attendings.

With just weeks left before finishing plastic surgery residency, Liz reflects on what she wishes someone had told her on day one: know your worth.

She shares:

Cut & Tell is where medicine gets honest.

In this first episode, Dr. Liz Malphrus, a plastic surgery chief resident, opens up about what residency is actually like, beyond the polished narratives. From the hidden curriculum of training to the emotional weight of becoming a surgeon, this is a candid look at the parts of medicine that are usually left unsaid.

She shares: