# The ER Doc Who Quit the System  - and Built His Own

Page: https://stenobird.com/podcast/the-doctor-s-lounge-7442524/the-er-doc-who-quit-the-system-and-built-his-own
Text version: https://stenobird.com/podcast/the-doctor-s-lounge-7442524/the-er-doc-who-quit-the-system-and-built-his-own.md
Podcast: [The Doctor's Lounge](https://stenobird.com/podcast/the-doctor-s-lounge-7442524)
Published: 2026-06-06T12:00:00+00:00
Episode link: https://api.riverside.com/hosting-analytics/media/3cc7fc41d450062716f516ac5be958ce64adb82fde0c7fef058a747935aad7b8/eyJlcGlzb2RlSWQiOiIxNzUwMDJjYy00NTZiLTQwM2QtOGRkOS1hYzcyN2M0YjE3YjUiLCJwb2RjYXN0SWQiOiI1OTUwMWY1OS1hY2E0LTRkZWYtYmQ5OS1hMDQzYTY4MDIyNjMiLCJhY2NvdW50SWQiOiI2OTJmNTE0YTZlYjA1ZDMyNzdmZTA2OWQiLCJwYXRoIjoibWVkaWEvY2xpcHMvNmEyMjg3YzYzMDc0ZGNkZWEyMDE4YjExL2RvY3RvcnMtbG91bmdlcy1zdHVkaW8tY29tcG9zZXItMjAyNi02LTVfXzEwLTI0LTM4Lm1wMyJ9.mp3
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JSON: https://stenobird.com/v1/public/podcasts/the-doctor-s-lounge-7442524/episodes/the-er-doc-who-quit-the-system-and-built-his-own
Duration seconds: 3736

## Resource

Episode Summary Dr. Noah Kaufman - board-certified emergency physician with 20 years in the ER, seven seasons on American Ninja Warrior, and a new direct acute care practice in Denver - joins Drs. Koka and DiGiorgio to talk about why he walked away from the employed medicine model and built Cough Care, a cash-pay, fully transparent urgent care. The conversation covers the broken economics of emergency billing, why most urgent care is a race to the bottom, how price signals change both patient and physician behavior, and what a parallel direct care system could look like at scale -including the franchise model Kaufman is already planning. Chapter Markers 00:00 Introduction — Meet Dr. Noah Kaufman 02:12 What led to leaving the ER after 20 years 04:53 Becoming the patient — the moment everything clicked 09:33 What is Cough Care and where it sits between urgent care and the ER 13:54 Why he doesn't take insurance 16:30 How ER billing actually works — the 2.6 cm laceration rule 19:49 Can urgent care be shopped? The free market argument 21:17 One month in — what he's actually seeing 41:00 Does cost-consciousness lead to undertreating? 43:39 The culture of over-treatment and the evidence behind it 45:48 Longevity, peptides, and the gray market 54:25 Patient autonomy vs. clinical responsibility 1:01:36 What happens if every burned-out ER doc does this? 1:07:33 The franchise vision — scaling direct acute care nationwide Co-Host Handles @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod

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## Transcript

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