
The ER Doc Who Quit the System - and Built His Own
From The Doctor's Lounge by The Doctor's Lounge
June 6, 2026 · 1h 2m
About this episode
Dr. Noah Kaufman discusses his transition from emergency medicine to founding a cash-pay urgent care practice.
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…
People in this episode
Hosts: Dr. Koka, Dr. DiGiorgio
Guest: Dr. Noah Kaufman
Topics covered
- emergency medicine
- direct care
- urgent care
- healthcare economics
- patient autonomy
- franchise model
Keywords
- emergency physician
- Cough Care
- urgent care
- healthcare system
- patient behavior
- direct acute care
- insurance
- billing
- franchise
Mentioned in this episode
Organizations: Cough Care, American Ninja Warrior
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