The Treatment Plan with David Usher, M.D.

Jack and Dave unpack a recent healthcare AI essay from the venture capital firm 8VC and use it as a jumping-off point to examine why costs keep rising, why wages stay flat, and why the doctor–patient experience feels so broken. They dig into Medicare incentives, AMA-driven reimbursement structures, physician burnout, and the regulatory barriers that make meaningful innovation difficult. The conver...

In this episode, Jack and Dave discuss the complexities of healthcare funding in the U.S., focusing on the Individual Coverage Health Reimbursement Arrangement (ICHRA) and its implications for employers and employees. The discussion highlights the challenges posed by the Affordable Care Act, the political dynamics surrounding healthcare funding, and the potential for ICRA to disrupt traditional he...

In this episode, Jack and Dave break down recent headlines showing the largest jump in employer health insurance costs in 15 years. They explain what’s really driving those increases—from CMS reimbursement structures and GLP-1 drugs to the perverse incentives baked into insurance commissions—and why Obamacare locked small businesses into an unsustainable system. The conversation explores how regul...

In this conversation, Dave and Jack discuss the many responses Dave got on his viral LinkedIn post stating his belief that excess carbohydrate consumption is the primary driver of the obesity crisis ( this post ). They discuss the importance of simplicity in nutrition and fitness, emphasizing low-carb diets and their effectiveness for weight management. They explore evidence from elite athletes on...

Jack and Dave break down some of the most misunderstood areas of weight loss: the real role of exercise, why “calories in, calories out” oversimplifies the problem, and how satiety, especially from protein, drives sustainable results. (00:00) Intro Setting up today’s topics: exercise, calories, satiety, and fiber. (01:15) Exercise and Weight Loss Why exercise is essential for health but overrated...

In this episode, Jack and Dave dive deep into the obesity crisis, exploring why rates have soared in the U.S. and globally, and what that means for public health and healthcare costs. Dave shares his clinical perspective on carbohydrates as the central driver of obesity, why traditional dietary guidelines may have backfired, and how his patients respond to low-carb and carnivore-style intervention...

In this episode, Jack and Dave discuss the launch and very early days of Dave's direct pay practice. TOPICS Opening/intro The Medical Economics magazine moment Business planning phase The E-Myth discussion Non-compete agreement navigation Location selection and setup Early marketing efforts First year challenges/successes Lessons learned/closing thoughts He shares the pivotal moment when a Med...

In this episode, Jack and Dave dive into the economics, culture, and structure of primary care in America. They unpack why so few medical students choose family medicine, how RVUs shape physician incentives, and the burnout that stems from misaligned systems. Dave shares why he left a major health system to launch a direct pay primary care clinic and what he’d tell other physicians who feel stuck....

Nearly half of all Americans get their health insurance through work. But most employers don’t realize they’re running a second business: healthcare. In this episode, Jack and Dave discuss how employer-sponsored insurance actually works—from fully funded plans to self-funded strategies—and why so many companies are bleeding cash without realizing it. They talk about the hidden role of PBMs, the ri...

In this episode, Jack and Dave discuss the implications of the One Big Beautiful Bill, healthcare policy, particularly in relation to direct primary care and health savings accounts (HSAs). They explore the changes that allow HSAs to be used for direct primary care memberships and the significance of on-site employee clinics. The discussion also touches on the broader implications of government in...