Internal medicine-pediatrics physician, educator, and Panacea Financial co-founder Dr. Michael Jerkins joins us as a guest to share his journey through medicine. From his early days in Memphis to residency in Cincinnati, Dr. Jerkins experienced firsthand the pressures of medical education, ballooning student debt, and the emotional toll of ICU rotations.

But what if the system could be different? What if medical school were shorter, more affordable, and designed for how we actually learn today? In this episode, Dr. Jerkins opens up about the parts of his training that now feel obsolete, the lessons hidden inside six-figure student loans, and why AI might just be the assistant doctors didn’t know they needed.

How do you stay human in a system that sometimes forgets you are one? What would you change if you had a magic wand—and what does ska music have to do with any of it? Dr. Jerkins shares honest reflections, practical ideas, and plenty of humor in a conversation that reminds us why medicine needs both heart and reform. Tune in for a thoughtful look at what it takes to practice with intention in a world that’s constantly evolving.

Here are five takeaways from Michael and Ned’s discussion:

1. Medical Education Needs Reform
Dr. Jerkins argues that med school could be shorter, more affordable, and better aligned with how people learn today. He proposes a three-year model with reduced tuition and less emphasis on outdated board prep content.

2. AI as a Clinical and Educational Partner
AI has the potential to transform both how doctors learn and how they practice—by summarizing research, tailoring education, and streamlining documentation. But it still needs human oversight and judgment.

3. The Hidden Cost of Student Debt
Dr. Jerkins shares his personal journey with over $300K in student loans and reflects on how debt shapes career choices, burnout, and access to care. He supports proposals for interest-free forbearance during residency.

4. Doctors Are Human Too
One of the most underappreciated truths, according to Dr. Jerkins, is that physicians are people first. Building human connections with patients—especially in outpatient care—can improve both experience and outcomes.

5. Ska, Stanley Cups, and Self-Reflection
In a lighter moment, Dr. Jerkins admits to rediscovering ska music and embracing the Stanley Cup trend. He also shares a cringeworthy ICU memory that taught him the value of emotional regulation under pressure.

Transcript

Michael Jerkins:

Do I need to know how to use a microscope? I’m serious, do you think I need to?

Ned Palmer:

No, no, I think when you asked me that, my answer for obsolescence was something to do with histology and microscope slides.

Hey everyone, and welcome to The Podcast for Doctors by Doctors. I’m really excited about our guest today because he’s living proof that you can be an excellent doctor and a savvy financial expert all at the same time. I’m of course talking with none other than our very own Dr. Michael Jerkins, who I desperately hope we leave in here facepalming right now because he hates compliments about himself.

Prior to starting his medical career, he received a master’s in education from Arizona State University while working with Teach for America. Dr. Jerkins then went on to the University of Tennessee for medical school and completed internal medicine and pediatrics training at the University of Cincinnati and Cincinnati Children’s Hospital. Since completing residency, he’s been an outpatient med-peds doctor and currently works at a clinic in Arkansas seeing patients of all ages—truly a Renaissance man. Not only does Dr. Jerkins care for patients as a med-peds physician, but he also saw a big problem in how traditional banks serve customers—or more accurately, didn’t serve them. That led him to co-found Panacea Financial, a bank built for doctors by doctors.

If you’ve ever felt overwhelmed by student loan debt, confused about physician finances, or just want to get smarter about your money in medicine, this episode is for you. Let’s dive in with Dr. Michael Jerkins. Dr. Jerkins, welcome to The Podcast for Doctors by Doctors. I’m excited to have you here today as a guest and the subject of this interview. How are you feeling about it?

MJ:

I can’t wait for it to be over.

NP:

I mean, you certainly had a lot of glee when you turned the spotlight on me, so why don’t you feel that way having it reflected back on you now?

MJ:

I think it’s because I’m probably a hypocrite, and I don’t really want to have other people ask me questions. It was way more fun asking you questions—especially ones that you didn’t know I was going to ask. But I guess it’s my turn.

NP:

It is. I think we’re going to dive into this, but your history as a teacher certainly makes some sense—you’d rather be at the front of the classroom than sitting in a seat, right?

So let’s pop right into it. What is something about doctors that most people get wrong?

MJ:

I think that most people probably underappreciate how human we actually are. That sounds stupid, but you’ve experienced this—where people see you outside of the hospital or clinic and it’s like, “You’re a real person.” Like, yeah, I also shop at the grocery store.

And why I think that matters is because patients are the subject of the visit or encounter, and sometimes the doctor can feel like a cold technician there to fix the patient. But doctors bring their humanness to the situation as well, which affects how patients receive care and how doctors choose to give it. That’s probably underappreciated by the public.

I don’t know how that translates into actionable next steps, but it’s obviously a dumb thing to say “doctors aren’t human”—everyone knows we are—but to understand that? I think non-doctors underappreciate it.

NP:

Yeah, I’ve recently found myself struggling with that, even with our own son’s pediatrician. It’s funny that you bring this up—trying to reinforce that humanity in the clinical encounter. So how do you work on it as a doctor? How do you make sure patients see you as more than just a mechanic fixing a problem?

MJ:

I try to start patient encounters as a normal human being. Most of the time in daily life, we don’t meet someone and immediately say, “What do you want and why are you talking to me?” That’s not normal. It’s more normal to greet someone, ask how their day is going, make small talk—find ways to connect, human to human.

Fortunately, in outpatient settings, you might have met someone a few times before, so you have things to call back on and reconnect over. That’s harder in inpatient settings. So I do recognize that outpatient medicine gives us the luxury of building longitudinal relationships. It feels less transactional and more like a conversation.

NP:

Yeah, the time definitely helps with relationship building, especially for you as a primary care provider compared to specialists who may offer more episodic care.

But let’s pivot—I want to hear more about your medical education journey. What parts of it now feel obsolete?

MJ:

I guess if I have to.

NP:

You do. Those are the rules of the podcast.

MJ:

Right. I’m contractually obligated.

I went to the University of Tennessee Health Science Center—UTHSC—for med school. Excellent training and strong clinical experience. Fun fact: my brother was in the same med school class, so that added a dynamic.

Then I went to the University of Cincinnati for med-peds—internal medicine and pediatrics. As far as what feels obsolete… what do you mean by obsolete, exactly? I’m asking you a question now.

NP:

I should’ve known you’d try to turn this around. Okay—who did better on Step 1, you or your brother?

MJ:

We didn’t do that kind of thing.

NP:

Really? I would’ve thought that would’ve been a natural competition.

MJ:

No, we were more mature than that, Ned. Okay?

NP:

Very impressed. So back to the question: you go through four years of med school trying to pack thousands of years of study into a few years to create a good day-one intern. What parts of that do you think weren’t necessary?

MJ:

I think in its purest form, med school is meant to produce someone who can continue learning during residency. But the reality is, we also have to pass USMLE exams. So part of it becomes: what can we teach to ensure students pass boards?

So much of it was basic science—rare genetic diseases or molecular biology—that doesn’t translate well to actual clinical care. I remember going through four-inch stacks of printed PowerPoint slides, flipping four slides at a time, learning things I honestly couldn’t recall now. And yet, I turned out okay.

What they taught 25, 30, 50 years ago is different than what they teach now. Medicine evolves. But it’s wild how much research is generated each year that doctors can’t possibly keep up with.

Where I think AI becomes useful is consolidating that data—peer-reviewed, verified information—into digestible insights that we can actually apply. We can’t read every journal published last week, but a robot could summarize it for us. So rather than memorizing everything all the time, maybe the future is more about synthesizing and applying it.

I don’t know if that answered your question or if I just answered it how I wanted to—but it felt right.

NP:

That might be as good as we’re gonna get. You’re already skipping ahead to one of my later questions, but I won’t let you derail this entirely.

It’s an interesting argument—are we training doctors to use the tools to do the job, or to become the tools? Like long division—we all learned it, but we use calculators for life. Isn’t there value in learning it anyway? A fallback?

MJ:

Do I need to know how to use a microscope? I’m serious—do you think I need to?

NP:

No. When you asked me that, my answer for obsolescence was exactly that—histology and microscope slides. I not only don’t need to know how to use one, I don’t need to know what I’m looking at either.

MJ:

Do you think gross anatomy and cadaver dissection are obsolete?

NP:

I think it depends on the goals. For me, it taught a respect for the human body that I didn’t have before. My school emphasized the anatomic gift and respecting bodily autonomy—how easily you can move from consent to violation. I learned far more about that than I did about nerve bundles or vascular beds or muscle groups.

MJ:

Really?

NP:

I learned more about the human body. Absolutely.

MJ:

Interesting. Okay.

NP:

We did a thing when we started—you know, “ceremonies” is too rigid a word—but we did a thank-you for the anatomic gift. At the end, we did another thank-you. It was very much about honoring that gift. I think we learned more about respecting the human body than we did from the actual cutting and dissecting.

MJ:

That is very noble and admirable. But take that away—do you think it helped you learn anatomy?

NP:

No. No, I would’ve done way better with what’s available today—3D models, putting on glasses and diving into the human body virtually, seeing systems and structures in a far more lifelike way. What we had was a devitalized, formalin-filled body—everything was pale yellow. It’s not what it actually looks like. So there are far better learning tools available.

MJ:

I don’t know how I feel about that.

NP:

Now, I didn’t go into a… I’m not a cutter, though. I don’t know.

MJ:

You know what I did? I had a group—amazing people—and they all wanted to be the leader, to do the dissection. And I thought, there’s only one body to learn on here. I’m not going to sit and wait and wait and wait. Instead, I let them lead, and I went around to all the other bodies every single day. I’d learn from all the dissections going on around the room. I think it worked out better that way for everyone.

NP:

Did your group go into surgical subspecialties? Any selection bias there?

MJ:

You know what? No. Family medicine, peds, IM—I think internal medicine. So no surgeons in our group.

NP:

Not even proceduralists?

Another funny thing—some of the people who excelled most at anatomy didn’t end up going into procedural specialties. So that whole “surgeons will crush it” idea? Not really accurate.

MJ:

Common recruiting myth, whatever.

NP:

Yeah, no real correlation between anatomy performance and surgical aptitude. So it’s not even a good selection tool—which goes back to your original point on obsolescence. So are you saying gross anatomy may be trending toward obsolete?

MJ:

I’ve heard people say that. I don’t know if it’s just me holding on to tradition. There’s got to be some value—it’s lasted this long as a core part of med ed. But maybe not. Maybe with today’s technology, there are better ways to teach it. It’s an interesting question. Anatomy lab feels like one of those untouchable parts of medical education that people just haven’t questioned much. I don’t know how I feel about it, honestly.

NP:

I actually thought you were going to bring up that front-page story in the New York Times—about the sketchy anatomic gift program and how they were bringing bodies into Ivy League med schools.

MJ:

No, I didn’t know that. I missed it.

NP:

That’s probably for the best. You didn’t need to read about it—it doesn’t help this conversation anyway.

So, I want to transition a bit. Med school is expensive—was expensive. I’m sure having two brothers in school at once didn’t help. I doubt you guys combined your debt, but it’s easily one of the most expensive professional degrees out there.

MJ:

Okay, okay.

NP:

I want to see if you’ll be open with us. Will you share how much debt you accumulated during med school, and what happened to it during residency?

MJ:

Yeah. It was around $250,000. It’s no laughing matter, Ned—that’s a lot of money. During residency, I was on an income-driven repayment plan—IDR—and interest kept accumulating. By the time I was done with training, I had a little over $300,000 in student debt when I started my first attending job.

NP:

Wow, that’s a lot of ballooning interest. And unfortunately, with where the SAVE plan seems to be heading, we may be going back to this world of interest accumulation during training.

MJ:

You know what’s interesting? And I know this podcast has a shelf life—but this is probably a different episode—we’re going to record a whole thing on student loans.

But there’s a proposal on the table to allow interest-free forbearance for medical residents. The government—taxpayers—would cover the interest.

NP:

Who pays for it? CMS? Department of Ed? A tax subsidy?

MJ:

It would need to be passed by Congress—part of a set of modifications to PSLF and repayment plans. Clearly, someone talked to lawmakers about this, because it’s in a proposal. I don’t think it’s out of committee yet. Maybe by the time this goes live, it’ll be signed into law. But as of now, there’s at least a possibility of interest-free forbearance during residency.

NP:

Interesting. That would be really exciting.

MJ:

But the counterbalance is that time wouldn’t count toward PSLF. So, say you did med-peds for four years—that time wouldn’t count toward the 10 years required for forgiveness. But if you opted for forbearance, no interest would accrue. That’s how I read it.

NP:

Yeah, okay. We’ll see. I mean, in the last 10 years, they also talked about making residents pay for residency, so I’m not holding my breath just yet.

But still—a little over $300,000 of debt to become the doctor you are. What amount of debt would have been too much? You said you graduated with about $250K—did you even think about the debt when deciding to go into medicine?

MJ:

I didn’t really think about it going in, quite frankly. But if I had the knowledge I have now?

This is going to be a crazy number—I’ve never thought about this—but maybe $600,000. If I knew I’d end up with $600K, I think I would’ve said no.

NP:

At graduation?

MJ:

Yeah. $600,000 by the time I started making attending-level money—that would be too much. I don’t know why I picked that number. Totally emotional. But that’s my answer.

NP:

Yeah, and it’s honestly not that hard to reach that number.

MJ:

It’s true.

NP:

If you went to a private undergrad and then one of the newer private DO schools—which tend to have the highest tuitions—you could hit $600K even before interest accumulates.

MJ:

Same goes for dental specialists, right? Private undergrad, dental school, then pay for residency. Interest accruing the whole time. It’s easy to hit $500K or $600K.

NP:

Easily. And that’s not even the biggest number we’ve seen, which is wild.

You’re an educator—we mentioned that in your bio. You were a teacher before becoming a doctor, and you still think like an educator. I appreciate that about you. So if you had the power to change medical education with the wave of a wand—what’s the Jerkins Plan?

MJ:

I would lower tuition. I’d consider making med school three years instead of four—go year-round. And I’d detach education from board exams. We talked earlier about how much time is wasted on outdated or irrelevant material just to pass boards.

If you cut out a year, you could reduce tuition by 25%. That means students graduate with less debt. Med schools would probably become more efficient, with less bureaucratic bloat. And because students would have less debt, they’d be able to practice in ways more aligned with what they actually want to do.

You and I both know doctors who feel trapped—by where they have to practice, how much they have to work, and how they practice—because they’ve got student loans to pay. If doctors had less debt, maybe they wouldn’t work full-time. Maybe they’d work 60%, but do a better job because they’re not burnt out and can treat patients the way they want to.

I think we’d all benefit from that.

Of course, there’s an argument: if fewer doctors work full-time, that worsens the doctor shortage. But some people—smarter than me—argue that there isn’t a physician shortage. There’s a maldistribution of doctors.

If we made medical education cheaper, we might be able to better recruit doctors from the communities that are currently underserved. Most grads want to go where other doctors are—nice schools, good lifestyle, strong referral networks.

But if we could reduce debt and recruit from places that need doctors, we could better distribute the workforce. That might improve efficiency across the board.

NP:

I like it. So solve the distribution issue—start at the top, start with schooling. Make it cheaper, make it more accessible by making it three years—just a shorter time commitment. Then work on the maldistribution issue and improve access to healthcare.

MJ:

Yeah, I mean, I think that relies on a great residency network. Can you shave off 25% of med school and still go into residency and really learn the art of being a great clinician? Some people strongly disagree and think that’s a terrible idea. But hey—it’s my interview, so I’m giving my answer.

NP:

I gave you the magic wand. So this is the Jerkins Plan. And I appreciate the optimism. It’s nice—you’re not designing to the lowest common denominator, which is how you actually evolve a system.

MJ:

You sound surprised, Ned.

NP:

Yeah, you’re not the most optimistic person in my life.

MJ:

Hmm, okay.

NP:

You’re not. Everything’s a spectrum, you know—and you’re on one end of it. I’ll let the listeners decide which end. So what’s one thing from your medical training that still makes you cringe? Are you ready to share it?

MJ:

Mm-mm.

I don’t know… this doesn’t feel like a safe space. I was in an ICU as a resident and got four or five transfers into the unit all at once. I was an intern. The senior resident basically transferred in four or five patients in a row. It wasn’t even on the same call—it was like: here’s one. Five minutes later—another one. Five minutes later—another one.

I was very stressed, and the senior was clearly frustrated with me. They felt like I was dragging my feet and we didn’t have enough beds. Anyway, I didn’t handle the situation in the nicest way—let’s just put it that way.

The senior talked to me. The attending talked to me. People listening to this are probably thinking, “That’s it? That’s not that bad.” I’m leaving out some details on purpose. Let’s just say I think about it, I cringe, and I wish I had handled it differently. And maybe some people still don’t like me because of that interaction.

It was stress-induced. I’ll blame it on the stress, the lack of sleep, and probably too much Diet Mountain Dew and cheese crackers—basically all I had for six meals leading up to that point.

NP:

And probably some three-day-old Chinese food out of the residency fridge—or some other absolutely toxic soup.

MJ:

No, I couldn’t eat that. All the med students would’ve eaten it before I even got there—because I was never on time.

NP:

Because you were too busy dealing with all the admits. That’s right.

No, I think that’s a good self-reflective moment. When people are asked if they think about the things that happened to them in training, they often just brush it off. But this is a good example of: “What were you disappointed in? What did you learn?” And I think you did—because I don’t think I saw you respond emotionally like that again during residency. So it was just the one and done, right?

MJ:

Totally. That was it. I haven’t responded emotionally since. Ever.

NP:

Speaking of AI—let’s transition into that.

MJ:

Great. This is perfect.

NP:

All right, Robo-Michael. You are, unequivocally, the biggest user of AI in my professional and social circles. How do you think AI will impact medical practice? You started touching on education earlier, but what about clinical care?

MJ:

I think it will continue to push how much doctors are expected to know.

The principle I learned in residency—and I still believe—is that the point of residency or training isn’t to learn everything, because you can’t. It’s to learn how to learn what you need to know. And that principle still holds.

We have this ever-growing body of evidence around disease processes, treatments, prevention—more than any human can stay on top of. But now we have a tool—AI—that can consolidate and summarize that information for us. It’s already happening. There are platforms that are HIPAA-compliant and CME-accredited that do this. That’s going to continue to evolve.

And because of that, patients will be more educated. They’ll have access to really good information about their symptoms. Maybe not quite yet, but eventually they’ll come in with better information than “Dr. Google.” So that keeps doctors on our toes. We have to be up to date and also understand the tools our patients are using.

And then I think AI will also help us treat patients differently. This is where your basic science brain would use better words than mine—but we’re already seeing advances in treating genetically linked diseases. AI is helping model conditions and identify better treatments in ways we couldn’t before.

If I keep talking, I’ll start sounding like an idiot, so I’ll stop there. But from what I read and understand, that’s going to be another big change—and that’s just short-term.

Lastly, on a practical level—I really hope AI improves doctors’ lives by making documentation more efficient. Right now, we’re glorified billers—just typing into giant EHRs all day. AI has the potential to reduce that burden so we can focus more on clinical care.

NP:

My fear is—starting with your last point—is that we’ll end up with AI-augmented billing fighting AI-augmented denials from insurance companies. You’ll have a little AI parrot on your shoulder saying, “Hey, don’t forget to ask if they smoke—we can bill more for that,” or “Don’t forget to ask about XYZ.” Some of that might be helpful, but the motivation still feels like it’s ultimately about billables.

That’s a concern coming from the inpatient world I work in. We still get questions kicked back from billing all the time, like, “They have a kidney—did you ask them about it?” Like… yeah, I did. It was there.

MJ:

You didn’t ask them about their kidney—for their rash?

NP:

Yeah, I should’ve. Should’ve asked about their kidney. Look, AI is imperfect. I’m very excited, though, about the modeling component you talked about earlier—evolving genomics, proteomics, things that have just needed more computing power.

MJ:

See, those are the words I was trying to remember. I didn’t even know how to pronounce them—so thank you.

NP:

I got you. That’s why we’re a good team.

MJ:

Also—I’ve never said “obsolescence” out loud before.

NP:

Well, now you have.

MJ:

That was my first time.

NP:

And you got through it really well!

MJ:

Thanks. I heard you say it three times already.

NP:

I could see you clapping just off-screen—keeping the syllable count together. But yeah, genomics and proteomics have had fascinating ideas behind them for decades—they just needed the computing horsepower. I think AI could really unlock some of that.

But I want to go back to your earlier point about using AI in clinical care. A lot of people have written about AI being like having a really smart intern—hardworking, fast. Maybe today it’s a smart intern. Tomorrow it’s a second-year resident. Later, maybe a third-year. But the issue is still: trust, delegation, and ultimate decision-making. That’s challenging.

I’ve gotten back some really bad answers to what I thought were basic clinical questions. Just like asking a confused intern.

MJ:

Switch models.

NP:

Right—there’s a medical-specific one I’ve played around with—OpenEvidence. I thought it was pretty good. They’re really good at citations, which I appreciate.

MJ:

OpenEvidence? It’s CME-accredited, too. Not a commercial—we don’t have a financial relationship or anything.

NP:

We definitely do not. No affiliation. But where do you see the line of oversight? Is that the physician’s role—to take in the AI’s information, identify hallucinations, and make the final call?

MJ:

Yeah, I think about it like this: Sure, AI might replace some jobs. But in cognitive-heavy specialties—especially ones involving direct patient interaction during really vulnerable moments—AI is more of a partner.

So yes, the AI can aggregate, synthesize, and communicate information really well. But it still needs a human to interpret, edit, and execute. That applies to doctors and probably many other knowledge-based fields. AI is a tool, not a one-to-one replacement.

That tool can make us more efficient. For example, some practices use history-taking modules while patients are in the waiting room. The AI summarizes it, and the doctor checks it—just like you would with an intern or med student.

NP:

Yeah, exactly. Or a med student.

MJ:

Right. That saves time, and the patient still feels heard. They can even see their own chart now and say, “Hey, that’s not what I said.” So maybe it helps us see more patients more effectively. But it’s not a replacement.

NP:

No, and something I’ve been thinking about a lot lately—we don’t have as much diagnostic or therapeutic uncertainty as people assume. It’s not like House—the mystery-diagnosis show—where nothing makes sense.

In reality, a lot of cases are relatively clear. We’re trained to follow a series of logical, stepwise evaluations. So I don’t know if AI’s best use case is feeding in symptoms and getting a diagnosis back. I think it’s stronger at suggesting the best possible treatment plan—adhering to guidelines and current evidence.

MJ:

I agree with that. But I also think you might be a little biased—because in the inpatient world, things are often more clear-cut. By the time someone gets admitted for fatigue, for example, you can usually figure out what’s going on.

NP:

Fair. There’s a selection bias there.

MJ:

Yeah—fatigue in the outpatient setting is way harder. Just a thought.

NP:

No, I think that’s a great counterpoint. And I love that there are different use cases for AI at every stage in the clinical process. So let’s talk about how AI folds into medical education. Right now, there’s this tension: AI can pass the USMLE, students can feed it questions, and it gives the right answers. So… what are they actually learning? And what should they learn if AI is part of the toolset?

MJ:

Totally making this up, but I think AI could be used to better tailor education to the learner. Based on their performance, it could give students more relevant cases, content, or assessments.

You could actually target learning gaps more precisely. Assuming we’re feeding the system good data, you’d know what students already understand—and focus on what they don’t.

The clinical scenarios AI generates are already pretty impressive. You and I remember Step 3—it was like multiple choice on floppy disk. It felt like playing Oregon Trail. Now, it’s closer to Grand Theft Auto in terms of complexity.

That shift—more personalized, immersive, robust case-based learning—could lift learners up and make training way more efficient. And I know some programs are already doing this well.

NP:

That’s a great use case. What’s the last clinical question you asked AI?

MJ:

Let me check…

NP:

Do you have it set to save your questions?

MJ:

No, but I used OpenEvidence again. Shoot—I just gave them another commercial.

NP:

They’re not sponsoring this episode. We promise.

MJ:

Okay, here it is: I asked about drugs indicated for osteopenia—any recent updates.

NP:

What’d you find out?

MJ:

There was a 2023 New England Journal review it summarized pretty well. I didn’t change my management because of it—but technically, that’s what I asked most recently.

NP:

Fair enough. Have you tried re-asking the same question in different ways—just to see if the responses change? That whole prompt engineering idea?

MJ:

Yeah, across different models.

NP:

Right—between different AI models. Got it.

MJ:

Yeah, and honestly, a lot of the models today still act like interns who don’t know how to say, “I don’t know.” So they just make something up that sounds confident. You hear them and go, “Wow, those are real words,” but once you evaluate it, you realize—nope, this is nonsense.

That’s why I like asking, “Can you cite that for me?” And sometimes they go, “Actually… it’s blah blah blah,” and you realize—they just lied. They made it up.

NP:

Yeah, the lying part is wild.

There was a post from Graham Walker about this—on deception in AI models. He pointed out how some models actually hide their answers or “learn” to obfuscate their internal logic. It’s almost like they’re trying to pass a Turing Test by being deceptive. That’s both fascinating and a little scary.

MJ:

Totally agree. Super interesting—and we’re really just at the beginning.

MJ:

Now who’s being optimistic?

NP:

Me? Continuously. That’s why I live on an off-grid farm. That’s where I’m at right now.

MJ:

Is that where you’re at right now? With the flight map over your right shoulder?

NP:

Yeah, and fluorescent lighting. It’s… really poorly off-grid. All right—if you had to do it all over again, would you still be a doctor?

MJ:

Yes.

NP:

OK, that was easy. Would you take the same path?

MJ:

Yes.

NP:

Perfect. Great transition into our rapid-fire questions.

NP:

Best Tennessee sports team?

MJ:

The University of Memphis Tigers.

NP:

Best non-Tennessee sports team?

MJ:

That’s a tough one… I don’t really have one. Maybe the U.S. National Team—for both women’s and men’s soccer.

NP:

All right, we’ll go with that. That’s a good one.

MJ:

Technically includes Tennessee… but yeah. I’m bad at this game.

NP:

Are there any Tennesseans on either team?

MJ:

There have been—yep.

NP:

Best AI model for medical inquiries?

MJ:

I think we’ve covered that—OpenEvidence. I like that it gives citations. Makes me feel like it’s not lying.

NP:

Best AI for non-medical questions?

MJ:

I think Claude versus GPT-4o right now.

NP:

Favorite chief complaint when a patient pops up on your Epic board?

MJ:

Honestly, probably the more nebulous ones. That’s maybe why I like outpatient medicine. There’s more room to grow the doctor–patient relationship. More communication. Those tend to be satisfying over time.

NP:

So like fatigue, shortness of breath…

MJ:

Yeah, even mental health diagnoses. They open the door for deeper conversation.

NP:

All right—you’re a Southerner. What’s the best state for barbecue?

MJ:

Is that a real question?

NP:

Of course. It stokes controversy. Not everyone agrees with you.

MJ:

It’s not a whole state—it’s part of one state. West Tennessee, west of the Tennessee River. That’s where the best barbecue is.

NP:

Interesting. People will have to go check it out.

MJ:

You thought the western border of Tennessee was the river, didn’t you? For a second there, you doubted me. But you don’t know your geography, Ned.

NP:

This is extra embarrassing. And my map doesn’t even label the Tennessee River.

MJ:

That map looks like a child drew it. Don’t tell me it’s for aviation. It’s not helping your case.

NP:

I’ll give you that one. Though I will say—food-wise, Louisiana may have the most diverse offerings.

MJ:

Totally agree. Best food overall.

NP:

Least favorite drug to prescribe?

MJ:

I don’t actually prescribe it anymore, but—Fioricet.

NP:

Really? Why?

MJ:

Rebound headaches.

NP:

Yeah, that tracks. From a functionality standpoint, any drug that requires a prior auth is frustrating. Maxalt, triptans…

MJ:

Yeah… fair point.

NP:

Well, you can’t change your answer. Fioricet it is. OK—favorite co-resident and favorite podcast co-host?

MJ:

Favorite co-resident: Sarah Ehrman. Favorite podcast host: Conan O’Brien.

NP:

Conan’s a good one. I’ll change this to Ned Needs a Friend.

MJ:

You and Conan have the same height, same hair. It fits.

NP:

Volume and temperament too. Fair enough. Last question—we ask this of all our guests. What’s one thing you’ve changed your mind about recently?

MJ:

You know, I didn’t come prepared. And I’m the one who wrote this question in the first place.

NP:

Zero percent surprised.

MJ:

Can we edit out this pause?

NP:

Absolutely not.

MJ:

OK—Stanley cups. I used to think Stanleys were overrated. But I got a blue one for Father’s Day, and I actually like it a lot.

So, after this deep, meaningful conversation, I’ll end on a shallow note about a popular thermos.

NP:

Do we get any financial compensation from Stanley?

MJ:

We’ve endorsed a lot of products today… without a single ad deal.

NP:

Yeah, not doing great there. But honestly, good answer. They were mocked a lot—but there’s some real value to them.

MJ:

OK, one more. You thought I was done.

NP:

Oh no—is this a better answer?

MJ:

Worse. Way worse. I think I’ve started to like ska again.

NP:

Wow. OK—same bands? Is ska even making a comeback?

MJ:

I don’t think so. Maybe we’re ushering in a terrible new ska era. I’m not saying it’s amazing. I’m just saying—it’s gone from funny to genuinely enjoyable. A little ska now and then never hurt anybody.

NP:

Helps blow off some energy.

MJ:

Yeah. I’m talking like… one or two songs.

NP:

OK—not going full ska with the studded belts and wild dancing?

MJ:

Nope. The dancing’s weird. But I respect the passion. I love that they loved it so much. That’s what I appreciate.

NP:

Respect the passion. I get that. So—ska and Stanley cups. This is how you’re sprinting into adulthood.

MJ:

Yes. Absolutely.

NP:

With a product marketed to 22-year-olds and music from 30 years ago. That tracks. Dr. Michael Jerkins, thank you for being on For Doctors, By Doctors. You can find the podcast on all major platforms.

MJ:

Thank you, Dr. Palmer. Appreciate it. Glad it’s over.

NP:

Thanks for joining us. If you enjoyed this episode or learned something new, please leave a rating and subscribe so you never miss an episode. As always, thank you for listening—and next time you see a doctor, maybe prescribe this podcast. See you next time.

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