Inside the Business of Healthcare: How Doctors Really Get Paid with Calvin Cajigal, MD partner at Pain Management Services

Dr. Calvin Cajigal, a first-generation physician and partner at Pain Management Services in St. Louis, joins Raj Tut for a deep dive into the realities of modern healthcare. After earning his medical degree through UMKC’s competitive six-year program and completing his anesthesia and pain management training at the University of Iowa, Dr. Cajigal has built a career balancing clinical excellence with entrepreneurial insight. His story—from overcoming adversity as a minority student to becoming a respected pain management specialist—highlights resilience, mentorship, and the pursuit of meaningful, patient-centered care.

In this episode, Calvin and Raj explore the business of medicine and what it takes to thrive as a physician today. They break down how declining reimbursements and rising overhead push doctors toward hospital employment, explain the RVU (Relative Value Unit) compensation model, and discuss how to deliver quality care amid financial constraints. Calvin also shares strategies for clinical efficiency, reflections on private equity in healthcare, and his philosophy on maintaining ethics and compassion in practice. The episode closes with his health and lifestyle advice—including sleep, fasting, cold plunges, and red-light therapy—underscoring his belief that good medicine starts with taking care of oneself.

Connect with the Host

Twitter: twitter.com/ItsRajTut

LinkedIn: https://www.linkedin.com/in/rajtut/

Instagram: instagram.com/ItsRajTut

TikTok: https://www.tiktok.com/@itsrajtut

Connect with the Guest

Dr. Calvin Cajigal

https://www.getcare.ssmhealth.com/find-a-doctor/doctor-details/calvin-g-cajigal-md

Timestamps for Key Segments

00:00 – Why private practice is struggling and the real cost of running a clinic

02:10 – Dr. Calvin Cajigal’s background: growing up in St. Louis and early adversity

05:00 – Choosing medicine, UMKC’s 6-year program, and discovering anesthesiology

08:30 – Finding his calling in pain management and learning patient-centered care

12:20 – How RVUs and hospital pay systems actually work 16:10 – Private practice vs. hospital life: balancing profits and patient outcomes

20:30 – Building an efficient medical team and avoiding “lazy medicine”

25:10 – Private equity in healthcare and its impact on care quality

30:40 – What patients should look for in a good physician 35:40 – Dr. Cajigal’s “hole-in-one” advice: taking care of your health first

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