Andrew Sponsler, founder of Axiom, joins us this week to talk about agentic AI, personal operating systems, and why physicians should start experimenting before the tools become fully packaged for everyone else. Andrew builds AI operating systems for businesses, and in this episode, he breaks down what agentic AI means, how founders are using it now, and where it could start removing real operational pain from medical practices, from case logging to revenue cycle management. 03:04 What agentic AI is and why it matters 04:10 Andrew’s four-layer framework for understanding AI tools 07:00 How agentic AI acts beyond a single prompt 08:41 Why most people still have not engaged with AI 10:37 Should people start building now or wait for easier tools? 14:32 Why surgeons are wired to spot problems worth solving 17:44 Lucas’ case logging and billing workflow idea 22:39 Where beginners can start with Claude Code 30:29 Hardware, security, model routing, and basic setup 34:34 How Andrew helps businesses map and automate workflows 43:35 Why revenue cycle management may be the highest ROI use case Who Should Listen This episode is for physicians, surgeons, founders, operators, and medical practice owners who are curious about using AI to reduce operational friction without losing control of the work. It will especially resonate with anyone thinking about case logs, billing workflows, dashboards, communication overload, or the practical first steps of building with AI. About Andrew Sponsler Andrew Sponsler is the founder of Axiom, where he builds AI operating systems for businesses. His background is in continuous improvement and process mapping, and in the episode, he describes working with small and midsize businesses to create AI native workflows, streamline operations, and automate processes that create bottlenecks for founders and teams. He also runs Builder Weekend in Austin, a hands-on event for people building with AI at different stages. Connect with Andrew 📲 Instagram: @andrewsponsler 💼 LinkedIn: @andrewsponsler Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this conversation changed how you think about agentic AI, physician-built tools, and what it could look like to automate the parts of medical practice that slow people down, share it with a colleague who’s curious about where this is all heading. And if you’re enjoying Life of Flow, a quick review helps more physicians and builders find conversations like this.

Dr. Jacqueline Majors, MD has built her practice around one central idea: surgeons should have more control over how they care for patients, structure their lives, and build sustainable careers. In this week's episode, she talks openly about leaving high-volume practice models, building an independent multidisciplinary center in Memphis, and why she believes outpatient vascular care is changing the future of the specialty. The conversation moves far beyond business strategy into surgeon burnout, team culture, limb salvage, physician autonomy, and the realities of trying to create a practice that supports both high-level performance and a real life outside the hospital. The episode also dives into what it takes to create a physician centered system from the ground up. 04:43 Why physicians should understand the business side of medicine 09:25 Leaving high-volume practice models and protecting long-term health 11:02 How Dr. Majors met her business partner and built Zenith Vascular & Fibroid Center 21:42 Why multidisciplinary outpatient models are becoming more important 27:05 Narrowing procedural focus and building community-based vascular centers 31:08 Why hyper-specialized limb salvage centers are needed 35:02 Surgeon burnout, grind culture, and changing the future of surgical practice 41:48 Female surgeons, leadership dynamics, and evaluating practice culture 47:40 Peptides, wound healing, and innovation in independent practice Who Should Listen This episode is for vascular surgeons, interventional specialists, physicians considering independent practice, and early-career surgeons thinking about how they want to structure their careers long term. It’s also highly relevant for physicians interested in outpatient care models, limb salvage programs, team culture, and practice ownership. About Dr. Jacqueline Majors, MD Dr. Jacqueline Majors is a board-certified vascular surgeon and the owner and director of the Limb Salvage Program at Zenith Vascular & Fibroid Center in Memphis, Tennessee. She specializes in advanced limb salvage and endovascular interventions focused on restoring blood flow, wound healing, and preventing amputations. Dr. Majors co-founded a multidisciplinary outpatient vascular practice alongside an interventional radiologist partner and remains actively involved in physician advocacy, education, and private practice development. She is also the creator of Anatomy Pad, a patient education platform designed for vascular surgeons. Her background includes Division I athletics, competitive soccer coaching, and more than 25 years of surgical experience. Connect with Dr. Jacqueline Majors, MD 💼 LinkedIn: Jacqueline Majors, MD Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this conversation changed how you think about independent practice, surgeon burnout, limb salvage, and what it actually takes to build a sustainable career in medicine, share it with a colleague who’s navigating those same questions. And if you’re enjoying Life of Flow, a quick review helps more physicians find conversations like this.

Big hospital systems say “patient first,” but this episode questions what happens when incentives, bureaucracy, and corporate pressure start running medicine. Dr. Kristofer M. Charlton-Ouw, MD talks openly about the reality of building a vascular program inside a smaller hospital system, why large organizations become almost impossible to change, and how physicians end up trapped between patient care and administrative metrics. Miguel and Lucas also share their own experiences inside academic medicine, including the politics, burnout, and frustration that pushed them to rethink what kind of careers and systems they actually wanted to build. The episode also dives into what it takes to create a physician centered system from the ground up. 02:38 Building a physician centered vascular program 08:17 Creating specialized vascular OR teams 14:36 Why every patient deserves the A team 19:46 The vision behind building a new system 24:46 The hidden incentive problem inside hospitals 30:33 The billing code story that changed staffing 34:54 Speaking up against hospital leadership 42:16 When hospital systems stop being patient first 49:58 What medicine can learn from aviation safety Who Should Listen This episode is for vascular surgeons, physicians working inside large health systems, healthcare administrators, and anyone trying to build better systems of care without losing autonomy or quality of life. It is especially relevant for early and mid career physicians questioning what kind of practice environment they actually want long term. About Kristofer M. Charlton-Ouw, MD Kristofer Charlton-Ouw graduated from Vassar College with a B.A. in History before earning his M.D. from Harvard Medical School. He completed his general surgery residency at NewYork-Presbyterian Hospital and later completed his vascular surgery fellowship at Memorial Hermann Hospital and the University of Texas Health Science Center at Houston. Dr. Charlton Ouw served as Program Director for the UT Vascular Surgery Fellowship and Integrated Residency and was Director of the Memorial Hermann Heart and Vascular Institute’s Vascular Ultrasound Laboratory. His clinical and research interests include aortic aneurysm and dissection, prosthetic graft infection, hemodialysis access, peripheral arterial disease, and postoperative pain control. In 2020, he joined HCA Houston Healthcare and helped found Gulf Coast Vascular. Connect with Kristofer M. Charlton-Ouw, MD 💼 LinkedIn: Kristofer Charlton-Ouw Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this episode changed how you think about hospital systems, physician autonomy, and the incentives shaping modern medicine, share it with a colleague who’s navigating the same realities. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare professionals find conversations like this.