Telemedicine Talks

#70 - Why ER Doctors Are Ditching the ER for Telemedicine

In this episode of Telemedicine Talks, Dr. Steven McDade joins Leo Damasco and Phoebe Gutierrez to discuss his transition from full-time emergency medicine to a flexible, primarily telemedicine-based career. After 13 years in the ER, Dr. McDade sought more time at his mountain home in Colorado and discovered telemedicine as the solution. He opens up about overcoming skepticism and imposter syndrome, the massive reach and positive impact of virtual care, building a diverse portfolio that includes medical directorships, hormone replacement therapy (HRT), weight loss medications, men’s/women’s health, and unique collaborations (including with a boutique gym and a breastfeeding NP). Dr. McDade highlights the lifestyle benefits, no commute, working from anywhere (including Portugal), schedule flexibility, reduced burnout, and renewed excitement for medicine, while still practicing some ER shifts. The conversation also covers the expanding opportunities in telehealth, AI’s role, and advice for physicians considering the transition. Top 3 Takeaways: * Lifestyle Freedom is Real: Telemedicine eliminates commutes, allows you to live where you want (mountains, travel), block time for the gym, and even work from vacation, dramatically improving work-life balance. * Bigger Reach & More Positive Impact: One physician can see thousands more patients per month in telemedicine than in the ER, shifting from reactive crisis care to preventive, wellness-focused medicine that genuinely improves lives. * Build a Diverse Portfolio: Don’t be a one-trick pony. Explore medical directorships, HRT/weight loss, niche collaborations, and entrepreneurial opportunities, telemedicine lets you learn new fields and create a fulfilling, resilient career. 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: Dr. Steven McDade is a board-certified Emergency Medicine physician with over 13 years of experience. After practicing in Colorado, he transitioned to primarily telemedicine (80/20 split) to gain flexibility and spend more time in the mountains. He serves as a medical director for a telehealth company handling 911 diversions, works in men’s/women’s health, HRT, weight loss, and various clinical collaborations. Connect with Dr. Steven McDade: You can reach out to  Dr. Steven McDade via the Telemedicine Talks team at info@telemedicinetalks.com [info@telemedicinetalks.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/ [https://www.linkedin.com/in/pkgutierrez/]   phoebe@telemedicinetalks.com   (mailto:phoebe@telemedicinetalks.com [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 [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

#69 - When AI Becomes a Doctor: Regulatory Battles in Pennsylvania & Utah

In this timely solo episode of Telemedicine Talks, Dr. Leo Damasco explores the rapidly evolving intersection of artificial intelligence and medical practice. Following last week’s conversation with Dr. Ashok Gupta on AI hallucinations, Leo examines two real-world cases making headlines in 2026. First, he dives into the Commonwealth of Pennsylvania’s lawsuit against Character.ai, where an undercover investigator exposed a chatbot persona (“Emily”) that falsely claimed to be a licensed psychiatrist, provided fake credentials, and offered therapy and medication advice. Leo also analyzes the growing tension in Utah between the Department of Commerce’s Office of Artificial Intelligence Policy and the Utah Medical Licensing Board over Doctronic’s autonomous AI platform for processing 30, 60, and 90 day prescription refills. Leo shares balanced commentary on the promise and dangers of AI in healthcare, the critical importance of physician involvement, regulatory gaps, and who should ultimately oversee AI-driven medical decisions. He discusses liability, patient safety, and the need for proper collaboration between innovators and medical boards. This episode is essential listening for clinicians, telemedicine practitioners, digital health entrepreneurs, and anyone interested in the future regulation of AI in medicine. Top 3 Takeaways: * AI Must Not Impersonate Physicians: Chatbots claiming to be licensed doctors, even under a “fictional character” disclaimer, Cross a dangerous line, especially when interacting with vulnerable patients. Clear boundaries and accountability are urgently needed. * Medical Boards Must Have a Seat at the Table: Regulatory sandbox experiments involving AI prescribing should involve state medical boards before launch, not after. Collaboration between innovation offices and practicing clinicians is essential for patient safety. * AI as a Tool, Not a Replacement (Yet): Current AI models show promise in efficiency and standardization but still make errors at rates unacceptable for independent clinical decision-making. The safest path forward is strong physician oversight combined with transparent guardrails. 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. * Connect with Leo Damasco: Email: leo@telemedicinetalks.com [leo@telemedicinetalks.com] * Website: https://www.telemedicinetalks.com [https://www.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 [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

#68 -Building Trust with Safe AI: The Future of Hybrid Virtual Physical Therapy with Dr. Ashok Gupta

What does it take to build a compliant, clinician-friendly, and patient-centered virtual care platform in a highly regulated field like physical therapy? In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Leo Damasco welcome Dr. Ashok Gupta, founder of TheraNow. Ashok shares his evolution from treating patients at the VA and in rural America to building a hybrid tele-physical therapy platform that integrates deeply with hospital systems and EHRs like Epic. The conversation explores the realities of telehealth adoption pre and post-pandemic, the importance of hybrid (omnichannel) care models, and thoughtful AI integration. Ashok provides real-world examples of safe AI use cases  including computer vision for movement tracking, context-aware ambient listening scribes, and AI-powered clinician training/feedback tools ,while stressing patient safety, avoiding hallucinations, maintaining human oversight, and building transparent, accountable systems. Listeners will gain practical insights on regulatory navigation, deep workflow integration, equity/accessibility features, and why starting with clinician and patient needs leads to better outcomes and sustainable businesses in digital health. Top 3 Takeaways: * Hybrid & Omnichannel Wins: Pure virtual models often struggle in physical medicine. Success comes from hybrid care that complements in-person services, deep EHR integrations and flexible visit options that fit patient and system needs. * Safe, Accountable AI First: AI should augment clinicians, not replace them. Use contextual prompts, real-time review, evidence-backed scoring, larger context windows, and human-in-the-loop workflows. Examples include ambient scribes with prior session context and AI feedback tools that show exact evidence instead of just scores. * Patient & Compliance Focus Pays Off: Build for equity (interpreters, ADA), accessibility, and parity with brick-and-mortar care. Deep integrations, risk-averse design, and clinician involvement from day one help navigate regulations and create scalable, trusted platforms. 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: Dr. Ashok Gupta is the founder and CEO of TheraNow, a leading virtual physical therapy platform that has supported over 70,000 patients across the US since 2021. A former VA physical therapist, he is a passionate advocate for hybrid care models and the safe, responsible integration of AI in telemedicine.  Connect with Dr Ashok Gupta on: Website: TheraNow.com [https://theranow.com] LinkedIn: Dr. Ashok Gupta [https://www.linkedin.com/in/dr-ashok-gupta-dpt-2b5a7023] 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/ [https://www.linkedin.com/in/pkgutierrez/] phoebe@telemedicinetalks.com  (mailto:phoebe@telemedicinetalks.com [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 [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

#67 - Your License at Risk: How Zealthy Used Doctors’ Names Without Their Knowledge

What happens when a telehealth founder moves from one controversy to the next, and doctors’ licenses get caught in the crossfire? In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco dive into the latest FTC/DOJ actions against Zealthy, a GLP-1 and lifestyle telehealth company led by Kyle Robertson (former CEO of Cerebral). They discuss allegations of deceptive marketing, hidden subscription charges, and most alarmingly, using physicians’ names and NPIs to issue prescriptions without the doctors’ awareness or involvement. The conversation explores broader issues in telemedicine: the lack of upfront regulatory oversight for new companies, escalation of commitment in non-compliant operations, risks to PC owners and supervising physicians, and why physicians must actively engage in clinical oversight rather than taking passive roles. Phoebe and Leo emphasize the importance of proper CPOM structures, due diligence, and building compliant operations where physicians stay in the driver’s seat. This episode provides actionable advice for clinicians considering telehealth opportunities and a reminder that compliant, well-run models can still deliver strong results when done right. Top 3 Takeaways: * Serial Issues in Telehealth Leadership: The same founder can move from one troubled company (Cerebral) to another (Zealthy) with limited personal repercussions, while clinicians and patients bear the consequences. Always research leadership and past regulatory history before joining. * Protect Your License – No Ghost Supervision: Prescriptions issued under your name/NPI without your knowledge or proper evaluation are a major red flag. As a PC owner or supervisor, you must stay actively involved. Review protocols, know the clinical team, and ensure real evaluations occur before renewals or auto-charges. * CPOM Is Your Gut Check: Corporate practice of medicine rules exist for a reason. Physicians need to drive clinical decisions, review marketing, verify money flow, and regularly check company operations. Passive roles or “one hour a month” promises often lead to compliance failures and board actions. 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/ [https://www.linkedin.com/in/pkgutierrez/]  phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com [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 [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

#66 - How Two Type 1 Diabetics Built Their Dream Telemedicine Practice

In this inspiring episode, Phoebe Gutierrez welcomes Savannah and Katie to share the raw, behind-the-scenes story of launching Type 1 Telehealth,  a telemedicine practice created by Type 1 diabetics, for Type 1 diabetics. The duo opens up about the moment they decided to break away from traditional endocrinology, the surprisingly fast timeline from idea to seeing patients, and the key lessons learned in their first two months. They discuss their unique patient-centered model including longer visits, flexible membership options, and true education, creative marketing strategies like community involvement with Breakthrough T1D, staying current with diabetes technology, and why they chose a cash-pay telemedicine approach. Savannah and Katie also share honest reflections on the challenges of wearing every hat as new practice owners, the power of true partnership, navigating a supervising physician relationship, and how their lived experience as Type 1 patients helps them deliver care that patients have been desperately seeking. This episode is packed with practical advice and motivation for any clinician dreaming of building their own telemedicine practice,  especially those passionate about a specific niche. Top 3 Takeaways: * Build What You Wish Existed for Yourself: When you create a practice rooted in your own lived experience and passion, you naturally attract the right patients and stand out in a crowded market. * Start Small, Stay Nimble, and Pivot Quickly: Be willing to wear every hat in the beginning, learn operations hands-on, and pivot fast when something isn’t working. Savannah and Katie credit their rapid progress to flexibility, constant learning, and support from communities like IPAC. * Longer, Deeper Visits and True Advocacy Win Patients: Offering unhurried consultations, comprehensive education on technology and lifestyle, and acting as fierce patient advocates leads to high conversion rates and extremely satisfied patients who finally feel heard. 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: Savannah Elkins (PA-C) and Katie Wakeland (NP) are the co-founders of Type 1 Telehealth, a Texas-based telemedicine practice specializing exclusively in Type 1 Diabetes care. Both are practicing clinicians and Type 1 diabetics themselves. Passionate about providing personalized, accessible, and comprehensive care, they left traditional endocrinology to create a practice that delivers the level of time, education, and advocacy they always wished existed for patients like them. 🔗 Connect with Type 1 Telehealth: 🌐 Website: https://www.type1telehealth.com [https://www.type1telehealth.com] 📱 Instagram: https://www.instagram.com/type1telehealth [https://www.type1telehealth.com] About the Host: * 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/ [https://www.linkedin.com/in/pkgutierrez/]  phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com [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 [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.