A Physician Entrepreneur's Journey in Specialty Care Expansion - Dr. Joe Pazona, CEO of VirtuCare

The physician shortage is often discussed as a recruiting problem. Dr. Joe Pazona believes healthcare leaders need to think about it differently.

Pazona, a board-certified urologist and founder and CEO of VirtuCare, returned to *I Don't Care with Dr. Kevin Stevenson* for a conversation about physician entrepreneurship, workforce shortages, rural healthcare access and why traditional approaches to specialty care are becoming increasingly difficult to sustain.

VirtuCare has grown to 16 partnerships across eight states, beginning with urology and now exploring opportunities in other outpatient specialties. Its mission—"caring for doctors, healing communities"—reflects Pazona's belief that solving access problems requires healthcare organizations to simultaneously rethink how they use physicians.

The numbers behind the shortage

The numbers help explain the challenge. Pazona notes that there are approximately 1,100 open urology positions while only about 400 new urologists are trained annually. At the same time, many younger physicians are choosing larger practices and metropolitan markets that can provide greater economies of scale and a better quality of life. The result is a growing mismatch between where specialists want to live and where they are most needed.

That mismatch helped shape VirtuCare.

A path to entrepreneurship shaped by adversity

Pazona's path to entrepreneurship was anything but planned. After beginning his career in rural Washington, he experienced firsthand the limitations that smaller communities face in providing specialty care. A subsequent move to Alabama for what appeared to be a major physician leadership opportunity ended badly when the position failed to match what had been promised and Pazona was ultimately terminated. The experience became a turning point, leading him to decide that he needed greater control over both his professional future and the kind of healthcare he wanted to help create.

After moving to Nashville and gaining firsthand exposure to the business side of private practice, Pazona began recognizing a larger opportunity. Specialists might want or need to live in cities such as Nashville, while patients in Appalachia, Kentucky, Southern Illinois and other underserved markets still desperately need their expertise. VirtuCare evolved as a way to bridge that gap through a hybrid, team-based model combining remote physicians, fractional on-site care and clinicians practicing at the top of their licenses.

Physicians and administrators: rethinking the relationship

The conversation goes well beyond VirtuCare. Stevenson and Pazona explore one of healthcare's most persistent tensions: the relationship between physicians and administrators.

Both acknowledge the pressures on each side. Physicians face declining autonomy, increasing administrative burdens and growing expectations. Hospital executives operate within complex regulatory environments while trying to sustain organizations that often function on razor-thin margins.

That requires more than better communication. It requires healthcare organizations to challenge longstanding assumptions about how care must be delivered.

Challenging the risk of doing nothing

Rather than continuing to rely exclusively on traditional recruitment, locum tenens coverage and organizational structures developed for another era, health systems should consider models that extend scarce physician expertise, create meaningful roles for advanced practice providers and allow specialists to serve communities without requiring them to permanently relocate.

Lessons for physician entrepreneurs

For physicians considering entrepreneurship, Pazona offers another lesson from his own experience: entrepreneurship is not simply about starting a company. It is about identifying an existing problem and being willing to take action to solve it. His journey included mistakes, financial uncertainty, sleepless nights and repeated adjustments, but it also gave him the opportunity to build a model around the problems he had experienced personally.

The episode ultimately returns to a simple idea. Physicians and healthcare executives may occupy very different seats, but neither can solve healthcare's workforce, access and financial challenges alone. Sustainable change will require collaboration, a willingness to question traditional models and the courage to act when the old way of doing things no longer works.