Podcast
Telemedicine Talks
Hosted by Phoebe Gutierrez, Dr. Leo Damasco, Doctor Podcast Network · EN
Telemedicine isn’t the future—it’s happening now. But for physicians and startups, it’s a world filled with unanswered questions, regulatory landmines, and a steep learning curve.
Welcome to Telemedicine Talks, where we cut through the chaos and give you the real story behind digital healthcare.
Hosted by Dr. Leo Damasco, a pediatrician and emergency medicine doctor who built his career in telemedicine, and Phoebe Gutierrez, a former state regulator turned startup strategist, this podcast explores what works, what doesn’t, and what no one else is talking about.
🚀 How do you build a sustainable telemedicine career?
⚖️ What legal and compliance risks are lurking beneath the surface?
💡 How can startups and physicians work together without burning out—or blowing up?
We don’t sugarcoat. We don’t do corporate jargon. We bring you real stories, hard-earned lessons, and expert insights from the front lines of telemedicine.
If you're ready to navigate this space with confidence—whether you’re a physician looking for flexibility or a startup founder scaling your vision—this is the podcast for you.
🔹 No fluff.
🔹 No hype.
🔹 Just the raw, unfiltered truth about making telemedicine work.
Welcome to Telemedicine Talks—let's get into it.
44episodes
Episodes
Newest firstAll episodes
#63 - Convenience Over Care: My Wake-Up Call with Asynchronous HRT
Mar 3100:23:13Tap to summarizeWhat if the ultra-convenient telemedicine experience you signed up for actually put your health at risk because no one ever spoke to you? In this candid episode of Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco dive into the consumer side of trendy wellness treatments in telemedicine. Phoebe recounts her recent experience as a 38-year-old woman seeking hormone replacement therapy (HRT) through a major asynchronous telemedicine platform. She filled out a dynamic questionnaire, selected her preferred treatment, and received estradiol patches shipped to her door after a quick physician review, with no live consultation required. Phoebe and Leo explore the broader tensions in telemedicine wellness, the pressure of competitive marketing, the rise of self-directed care, asynchronous “store-and-forward” models, and the fine line between patient convenience and responsible medicine. They discuss how some platforms disincentivize thorough follow-up or pushback from providers, the predatory nature of wellness marketing targeting perimenopausal women, and why even highly compliant companies can still fall short when human conversation is removed from the process. The episode stresses that while telemedicine offers incredible access, patients, especially those pursuing hormones, peptides, or longevity treatments, must be cautious about what “convenience” really costs. Three Actionable Takeaways: Demand more than convenience. Insist on personalized care: As a patient, don’t assume a quick questionnaire and fast shipping equals good medicine. Ask whether you’ll have a live consultation, proper dosing education, and follow-up support before starting hormone therapy or similar treatments. Providers and platforms must prioritize clinical judgment over speed: Asynchronous models should include robust, dynamic protocols with age-appropriate starting doses, step therapy options, and clear pathways for live discussion when needed. Physicians should never feel penalized for refusing to prescribe or requesting more information. Beware of wellness marketing that skips the human element: Social media and direct-to-consumer ads often push quick fixes for perimenopause, weight loss, or longevity. Take time to understand your options, get labs, and speak with a qualified clinician rather than self-directing complex treatments. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#62 -Peptides in Telemedicine: Gray Areas, Regulations, and the Wellness Boom
Mar 2400:26:32Tap to summarizeWhat if the peptides you're injecting for wellness, recovery, or anti-aging came from a shady overseas lab with zero oversight, would you still take them? In this candid episode of Telemedicine Talks, Hosts Phoebe Gutierrez and Leo Damasco unpack the realities behind the hype. They explore: The recent HHS Secretary RFK Jr. announcement (late Feb 2026) signaling intent to move ~14 of 19 restricted peptides back to Category 1, potentially allowing licensed 503A compounding pharmacies to produce them legally under prescription which is still pending full FDA implementation. Why the industry feels "gray": Many peptides were previously Category 2, restricted from routine compounding due to safety concerns, leading to black-market "research only" sales. Risks of unregulated sources: Potential impurities, toxicity, and patient harm from poor-quality compounding or non-pharma-grade products, and shady marketing tactics on social media. Telemedicine pitfalls: Providers approached for "medical director" roles with minimal oversight, asynchronous prescribing, or protocols that skip deep history and labs, versus compliant models requiring thorough evaluations. The bigger picture: Wellness trends driven by social media, unmet patient needs, and access bypassing traditional care, balanced against real safety, compliance, and ethical concerns. Whether you're a provider considering peptides or a patient exploring options, this episode stresses caution, research, and compliant infrastructure in a space that's heating up and getting more regulated. Three Actionable Takeaways: Ask the hard questions on sourcing: For providers or patients, always verify where peptides come from, licensed U.S. compounding pharmacies? Human-grade? Avoid anything with vague "research only" labels or overseas origins that skip quality controls. Prioritize thorough evaluations: Don't jump to peptides for fatigue, recovery, or performance, require detailed history, labs, and rule out organic issues first. Compliant models involve longer consults and ongoing monitoring, not quick sign-offs. Stay updated on regulations: Check FDA warning letters, HHS/FDA announcements (like the ongoing peptide reclassification), and recent actions, the "wild west" of telehealth compounding is shrinking fast, with real enforcement risks. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#61 | One Year of Telemedicine Talks: Lessons from 58 Episodes
Mar 1700:34:06Tap to summarizeWhat does it take to launch and sustain a healthcare podcast? In this special one-year anniversary episode of Telemedicine Talks, Phoebe Gutierrez and Dr. Leo Damasco reflect on the journey from a simple idea to 58 episodes featuring clinicians, founders, and healthcare innovators. They discuss the behind-the-scenes realities of podcasting—from finding the right co-host and booking guests to balancing busy careers while producing weekly episodes. Along the way, the show has become a platform for honest conversations about telemedicine, entrepreneurship, compliance, and the evolving healthcare landscape. Phoebe and Leo share lessons for clinicians interested in podcasting, including the importance of knowing your audience, staying authentic, and building the right support systems. Looking ahead, they preview upcoming conversations on AI, compliance, new models of care, and the real journeys of healthcare professionals building businesses in telemedicine.Three Actionable Takeaways: Find the right podcast partner: A co-host with a different background or perspective can create better conversations and make episodes more dynamic and engaging. Know your audience before you start: Whether your podcast targets patients, clinicians, or entrepreneurs, understanding your audience helps shape the topics, format, and frequency of your episodes. Outsource the technical work when possible: Editing, production, and distribution can quickly become overwhelming. Using a podcast network or production team allows hosts to focus on conversations and content. About the Show Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Hosts Dr. Leo Damasco – Pediatrician and emergency medicine physician turned telemedicine advocate, helping clinicians explore new models of digital healthcare. Phoebe Gutierrez – Former state regulator turned telehealth executive specializing in compliance, healthcare regulation, and sustainable virtual care models. Connect with Phoebe Gutierrez LinkedIn:https://www.linkedin.com/in/pkgutierrez/ Email: phoebe@telemedicinetalks.com The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#60 - Building Compliant Health Tech: Why Compliance Drives Revenue and Growth
Mar 1000:29:15Tap to summarizeWhat if prioritizing compliance in your health tech startup could unlock contracts, funding, and growth instead of hindering it? In this episode, Phoebe Gutierrez and Dr. Leo Damasco explain how compliance, often delegated from federal rules to states, contractors, and companies, impacts health tech founders aiming to sell to hospitals, insurers, or consumers. She emphasizes building around certifications like HITRUST for privacy and security, which can take 7-12 months and involve audits, interviews, and demos, warning that skipping it leads to rework (up to 70% of a product) and lost opportunities. For telemedicine services selling peptides or GLP-1s, LegitScript certification is essential for Meta ads and Stripe payments, preventing suppression or payment issues. Phoebe highlights that even direct-to-consumer models evolve toward B2B, where HITRUST, SOC 2, FedRAMP, or PCI compliance become mandatory for series funding or government contracts. She advises starting with checklists, mapping workflows early, and understanding buyer contracts to avoid negative optics or pipeline shutdowns, noting offshore dev teams may miss healthcare standards. They share real-world examples of certification delays and costs, underscoring the need for informed decisions from the MVP stage. Three Actionable Takeaways: Review certification checklists early: Download HITRUST or LegitScript requirements and incorporate them into your roadmap, like user roles and permissions, to avoid costly rework later. Understand your buyers' contracts: Get sample obligations from target clients (e.g., hospitals, payers) to identify needed certifications like SOC 2 or PCI, ensuring you meet them before pitching. Plan for audits and timelines: Budget 7-12 months for certifications, prepare policies/procedures, and demo functionalities to pass third-party assessments without delays. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#59 - How to Master PC MSO Structures in Telemedicine: Busting Myths and Scaling Smart
Mar 300:31:05Tap to summarizeConfused about PC MSO setups in telemedicine? You're not alone. Many physicians jump in without knowing the full picture. In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Leo Damasco dive into the realities of Professional Corporation (PC) and Management Services Organization (MSO) structures for telemedicine practices. Drawing from personal experiences, Leo as a PC owner plugged into existing setups. They debunk myths like the "one-size-fits-all" friendly PC model for nationwide scalability. They discuss Corporate Practice of Medicine (CPOM) rules, state-by-state variations, and why solo physicians might not need an MSO if they're not hiring others or taking investors. Key insights include the high costs (up to $150K–$200K) of a full 50-state rollout, including legal fees, registrations, DEA, and malpractice; the misconception that you must start big to avoid missing opportunities; and strategies for bootstrapping in 1–3 states first to validate and expand based on demand. They emphasize starting small, avoiding FOMO-driven overexpansion, and competing with giants like Hims & Hers through personalized, local services. The conversation also touches on operational hurdles, regulatory shifts, and the mindset shift for risk-averse physicians to embrace entrepreneurship. Whether you're a burnt-out doctor eyeing telehealth independence or scaling an existing practice, this episode offers practical advice on compliance, funding, and building sustainably, and a shoutout to their spot on the Doctor's Podcast Network. Three Actionable Takeaways: Assess Your Needs Before Committing to PC MSO: If you're a solo physician providing care independently without hiring providers or taking non-physician investors, skip the MSO, form a simple PC in your practice states and outsource basics like credentialing; consult a healthcare law firm to confirm CPOM compliance and avoid unnecessary structures. Start Small and Scale Smart: Bootstrap in 1–3 high-potential states to prove your concept and collect patient data via intake forms; expand only as demand grows, saving on upfront costs like $150K–$200K for a 50-state setup, and focus on referrals over broad marketing. Embrace an Entrepreneurial Mindset: Overcome risk aversion by viewing practice-building as a journey, not a destination. Connect with peers for collaboration, prioritize personalized services to differentiate from big platforms, and involve your legal team early for tailored recommendations on operations and finances. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#58 - How Getting Sued Ignited a PA's Ruthless Rise in Medical-Legal Domination: With Christopher Cannell
Feb 2400:36:22Tap to summarizeEver wondered how a lawsuit could launch a thriving consulting career? In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco sits down with Christopher Cannell, as he shares his path from bedside clinician to nationally recognized medical-legal expert, starting with a malpractice suit he won due to his preparation and poise as a witness. He explains how attorneys seek thorough, credible experts who understand standard of care from multiple angles, and how his diverse experience allows him to opine on cases across specialties. The discussion covers building a consulting business through word-of-mouth, mentoring via his Healthcare Hub community, and teaching as a full-time professor. Chris highlights the value of humility, networking, and learning from mentors; the role of PAs in legal medicine; and upcoming talks on dissecting malpractice cases and AI risks at the AAPA conference. He emphasizes preventing errors through education, creating better systems for patients and providers, and embracing entrepreneurship, offering insights for clinicians eyeing side gigs or career shifts in telemedicine and beyond. Three Actionable Takeaways: Prepare Thoroughly for Legal Roles: Hone expertise through certifications, teaching, and diverse clinical experience; review cases prospectively from all perspectives (provider, nurse, patient) and back opinions with literature, attorneys value professionalism and resilience under scrutiny for repeat business. Build a Consulting Side Gig: Start with word-of-mouth from successful cases; create educational resources like masterclasses or communities (e.g., via Kajabi) to mentor others; network in running groups, professional orgs, or conferences for entrepreneurial advice and humility in learning from mistakes. Mitigate Risks Proactively: Join orgs like PAs in Legal Medicine for standards and support; focus on preventing errors through system improvements and education—explore AI's med-legal implications and aim for work-life balance by dropping to part-time clinical hours while scaling consulting. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Guest Christopher Cannell is a seasoned physician assistant with over 22 years in emergency medicine, orthopedics, critical care, and internal medicine. A medical-legal expert, he turned a malpractice lawsuit into a consulting career, providing witness services, risk mitigation, and education. As president of PAs in Legal Medicine and a full-time professor, he mentors via his Healthcare Hub community. Email: chris@theapcconsultant.com Websites : theapcconsultant.mykajabi.com https://www.theapcconsultant.com About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#57 - Revolutionizing Health Insurance for Independent Providers: Insights from Wyatt Stokesberry
Feb 1700:42:51Tap to summarizeAs 2026 unfolds with looming subsidy cliffs and rising uninsured rates, hosts Phoebe Gutierrez and Dr. Leo Damasco revisit Episode 35, featuring Wyatt Stokesberry. Growing up around business owners and ditching a corporate path, Wyatt shares his pivot from aspiring chef to health insurance innovator, emphasizing the thrill of breaking norms, embracing discomfort, and betting on yourself amid uncertainty.Drawing from his experience building self-funded plans for small employers, Wyatt demystifies the fragmented insurance ecosystem, unbundling pharmacy, TPAs, stop-loss, networks, and brokers for cost savings. He spotlights the ACA marketplace's stagnation and launches Molly as a transparent, member-owned alternative for solopreneurs: AI tools for cost predictions, in-network checks, and personalized health insights, all while capping at 1,000 members to prioritize quality.The episode dives into eye-opening realities: cash-pay rates slashing MRI costs by 60-70% (e.g., $300 vs. $2,000 deductible), negotiating bills like pros, and why frequent users need high-deductible catastrophic coverage. Wyatt warns of misaligned incentives, carriers profiting from confusion, and champions AI for empowerment, not denial, bridging wearables data to better risk profiles. Amid fears of AI overreach, the trio stresses ethical uses like navigation and transparency to rebuild trust.For burnt-out W2 clinicians eyeing 1099 freedom, this rewind equips you with entrepreneurial mindsets, practical hacks, and hope: Molly's waitlist opens soon, proving innovation can outpace chaos and deliver care on your terms.Three Actionable Takeaways:Always Ask for Cash-Pay Discounts: Before any procedure, inquire about uninsured rates. They're often 60-70% lower than insured costs (e.g., MRIs under $300 via sites like Green Imaging). Negotiate further, as providers prefer quick cash over chasing 30 cents on the dollar from insurers.Assess Your Utilization Before Buying Insurance: Tally expected doctor visits, meds, and big-ticket items, if low (e.g., occasional primary care), skip high premiums/deductibles for catastrophic coverage plus cash-pay. High utilizers? Opt for low-deductible plans to maximize benefits.Leverage AI for Transparency and Savings: Use tools like ChatGPT to estimate costs or self-advocate, and join innovative plans like Molly for predictions on MRIs or premiums. Track sleep/exercise via wearables to inform better decisions, transparency empowers, don't fear the tech.About the Show:Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.About the Guest: Wyatt Stokesberry, CEO and co-founder of Molly, a transparent health plan launching in Q1 2026 for 1099 freelancers, has over five years of health insurance expertise. A risk-taking entrepreneur who rejected corporate life, he leverages AI for efficiency and aims to rebuild trust in insurance. Website: https://mollyhealth.comEmail: wyatt@mollyhealth.com.About the Hosts:Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health.Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models.Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#56 - Physician Assistants in Telemedicine: Breaking Barriers and Building Businesses
Feb 1000:50:09Tap to summarizeWhy are so few Physician Assistants (PAs) entering the telemedicine space, and how can they overcome the barriers to start their own practices?In this episode of Telemedicine Talks, Phoebe Gutierrez and Dr. Leo Damasco are joined by a panel of innovative providers: Ashlyn Smith, Christina Davis, Savannah Elgins, and Katie Wakeland. Together, they share their journeys from traditional clinic settings to telemedicine entrepreneurship, highlighting the frustrations with the broken healthcare system, insurance challenges, and the shift to cash-pay models.The group discusses state-specific regulations like corporate practice of medicine (CPOM), the differences between supervising and collaborating physicians, and business structures such as PLLCs, PC-MSOs, and LLCs. They emphasize the importance of finding your "why," building community through groups like the Independent PA Collective (IPAC), and embracing an entrepreneurial mindset—including learning from mistakes, pivoting, and overcoming imposter syndrome. From addressing care gaps in rural areas to leveraging telemedicine for flexible, patient-centered care, this episode offers practical insights for PAs (and NPs) looking to disrupt healthcare and scale their impact nationwide.Three Actionable Takeaways:Know Your State Laws and Build the Right Structure: PAs face unique regulatory hurdles like CPOM and supervision requirements—research your state's rules on collaboration vs. supervision, and consider structures like PLLCs or PC-MSOs to enable ownership while partnering with physicians.Find Your "Why" and Join a Supportive Community: Clarify your mission to stay motivated through challenges; seek out groups like the Independent PA Collective (IPAC) for mentorship, shared knowledge, and encouragement from peers who've navigated similar paths.Embrace Mistakes and Prioritize Balance: Shift from a risk-averse clinical mindset to an entrepreneurial one—expect pivots, learn from failures, and remember to set boundaries, as you're irreplaceable only to your loved ones, not your job.About the Show:Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.About the Guests:Ashlyn Smith is an endocrine PA based in Arizona with 15 years of experience, passionate about whole-person care in endocrinology. She's certified in lifestyle medicine and advanced diabetes management, and runs her own telemedicine practice focused on bridging care gaps.Christina Davis is a PA in Florida's Panhandle specializing in developmental behavioral pediatrics with a functional medicine approach. She operates a hybrid telemedicine practice to serve underserved families nationwide.Savannah Elgins is a PA with over 20 years living with type 1 diabetes and an endocrinology background. She's co-founder of a telemedicine practice dedicated to specialized type 1 diabetes care.Katie Wakeland is a nurse practitioner with an endocrinology focus and type 1 diabetes experience. She partners with Savannah Elgins to provide patient-centered, tech-savvy care outside traditional systems.About the Hosts:Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health.Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models.Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#55 - How to Build Your Telemedicine Practice: PC MSO Structures, Compliance, and Entrepreneurial Mindsets
Feb 300:35:49Tap to summarizeThinking about launching your own telemedicine or digital health practice but overwhelmed by the logistics? In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco break down the essential steps for clinicians, PAs, NPs, and entrepreneurs to build compliant, scalable practices.They explore PC MSO structures and variations like professional associations or PLLCs across all 50 states, emphasizing that anyone can own a medical practice with the right setup. Phoebe shares practical advice on researching state regulations via Google and business registration rules, avoiding costly attorney fees upfront, and deciding whether to align structures across states or customize for risk and efficiency. The conversation covers key buckets: crafting a targeted business plan, focusing on niche audiences like Spanish-speaking populations, transitioning from a clinical to entrepreneurial mindset, speaking in layman's terms, embracing calculated risks, and essential costs (from $300 entity fees to $4,000 annual insurance and $300/month tech stacks).They also discuss overcoming imposter syndrome, hiring VAs for support, the value of partnerships for accountability, and why private practice could combat healthcare burnout by empowering providers to deliver care on their terms, often cash-pay to bypass insurance hassles. Drawing from real client successes, this episode offers encouragement and actionable insights for anyone tired of big systems and ready to innovate in telemedicine.Three Actionable Takeaways:Research State-Specific Structures First: Before diving in, Google your state's business registration regulations to determine required entity types (e.g., PC MSO, PA, or PLLC) and ownership rules (100% clinician-owned vs. 51/49 splits). This ensures compliance without immediate high attorney costs and helps pick startup-friendly states like Alabama.Build a Niche-Focused Business Plan: Target a hyper-specific audience (e.g., a specialized population in one language) rather than "everyone." Outline patient acquisition via marketing, website design, and layman's language to attract non-clinicians. Remember, the larger the market, the harder it is to stand out.Budget Smart and Delegate Early: Start with essentials: $300–500 for entity setup, $4,000/year for insurance (malpractice, cyber, professional liability), and $300/month for tech (EHR, domain). Hire a VA under $1,000/month to handle non-clinical tasks like marketing or admin, freeing you to focus on care and growth.About the Show:Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.About the Hosts:Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health.Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models.Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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#54 - January 2026 Telemedicine Recap: Federal Flexibilities, Data Disputes, Rural Health Grants, and Emerging Trends
Feb 100:38:46Tap to summarizeKicking off 2026 with a bang: telemedicine is navigating government uncertainties, tech-driven oversight, and fresh funding avenues. In this January recap on Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco dive into key developments: flat Medicare rates for 2027 causing stock market ripples, potential extensions of telemedicine flexibilities through 2027 amid shutdown risks, and how the AI-first administration could ease fraud monitoring with real-time audits. They explore ongoing litigation in the EHR space, including Epic's lawsuits against companies like Health Gorilla over data access, contract breaches, and oversight failures, highlighting the fight for patient data ownership and network integrations. The episode also covers a $50 billion rural health grant over five years, aimed at underserved communities, and how telemedicine entrepreneurs can position themselves through proposals, compliance focus, and value-based metrics. Looking ahead, Phoebe and Leo discuss expectations for innovative niche startups (beyond GLP-1s), AI's potential bubble, deeper healthcare integration (like Utah's prescription AI), mergers/acquisitions in mental health and primary care, and the race to the bottom in GLP-1 pricing versus concierge value. This episode encourages listeners to reach out for collaboration or advice on building telemedicine ventures, emphasizing the altruistic potential of reaching underserved patients while embracing entrepreneurial opportunities. Three Actionable Takeaways: Monitor Federal Flexibilities Closely: Track bills extending telemedicine waivers through 2027, prepare for potential government shutdown disruptions, and leverage AI tools for compliance like real-time audits to align with the administration's tech focus, start by checking CMS updates weekly. Explore Rural Health Grant Opportunities: Research your state's rural health office or telemedicine proposals to pitch value-based programs; focus on KPIs like quality score improvements and compliance officer roles to access the $50B fund—begin with a sweat equity commitment to build proposals targeting underserved communities. Stay Ahead of Data and AI Trends: Audit your EHR integrations for contract compliance to avoid Epic-style disputes; evaluate AI's role in your practice (e.g., repeat prescriptions) while watching for an "AI bubble" network with emerging physician-CEOs via info@telemedicinetalks.com to collaborate on niche, innovative models beyond GLP-1s. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez:https://www.linkedIn.com/in/pkgutierrez/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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