Dr. Leo Damasco and Phoebe Gutierrez host Dr. Cheryl Lee, a dermatologist, entrepreneur, and founder of CLMD and Zōca. Learn how she used her eczema expertise and passion for skin barrier biology to create a patented skincare line, a national teledermatology platform, and a virtual dermatology fellowship. Essential for clinicians seeking to integrate clinical skills, education, and entrepreneurship for digital care expansion.
How can dermatology and medicine as a whole—embrace digital care without compromising quality? In this episode, Dr. Cheryl Lee joins Dr. Leo Damasco and Phoebe Gutierrez to share her journey from NIH researcher to founding CLMD, a patented sensitive skincare line, and Zōca, a comprehensive telehealth platform spanning multiple specialties.
She recounts how patients across the globe sought her eczema expertise online after launching her skincare line in 2014, sparking the idea for a scalable, collaborative teledermatology ecosystem. Dr. Lee details how she built Zōca not just for dermatology but as an all-specialties, patient-centered platform complete with integrated EMRs, labs, asynchronous care, and provider collaboration tools.
Beyond tech, she discusses launching Expert Derm, a fellowship program that has already trained nearly 100 clinicians in dermatology fundamentals with a built-in telederm business—“a business in a box.” She explains how she's empowering non-derm-trained clinicians, pediatricians, family med doctors, PAs, and NPs to treat skin conditions virtually and improve patient access without needing years of formal residency.
The conversation also touches on the future of AI in medicine, the value of clinical reasoning, and how physician leadership must evolve to remain central in digital care.
1. Learn Dermatology at Scale – With a growing need for dermatologic care, clinicians from all specialties can build practical telederm proficiency through programs like Expert Derm and integrate it into virtual or hybrid practices.
2. Build a Business Around Your Expertise – Dr. Lee provides physicians with their own teledermatology platform, including malpractice coverage, EMR, virtual staff, and branding—allowing them to start practicing with minimal operational hurdles.
3. Embrace Telehealth Education and Regulation – Telemedicine success depends on understanding state laws, scope of practice, and regulatory compliance. Training programs that include telehealth law and workflow education are key for clinician confidence and success.
Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.
Dr. Cheryl Lee is a board-certified dermatologist, NIH-trained researcher, and founder of CLMD, a patented sensitive skincare line, and Zōca, a digital health platform delivering specialty care virtually. She also created Expert Derm, a teledermatology fellowship program that equips clinicians to practice derm virtually and launch their own telederm clinics. Her mission is to democratize access to specialty care and empower clinicians with the tools to do so.
🧴 Skincare Line: https://www.clmd.com
🌐 Teledermatology Platform: https://www.zoca.com
🎓 Fellowship: https://www.zoca.com/fellowship/dermatology
📸 Instagram: https://www.instagram.com/expertderm.fellowship/
Dr. Leo Damasco – Pediatrician and emergency physician turned telemedicine advocate, focused on virtual care transformation.
Phoebe Gutierrez – Former state regulator turned telehealth executive, passionate about compliance, access, and sustainable care delivery.
📧 Contact Phoebe: phoebe@telemedicinetalks.com
🔗 Connect: https://www.linkedin.com/in/pkgutierrez/
[00:00:00] Hey, welcome back folks to Telemedicine Talks. This is Leo Damascus with Phoebe Gutierrez. welcome back. happy to have you back. I am super stoked, super excited to introduce our next guest, a powerhouse I think, in the telemedicine community. this is Dr. Shirley Ever. She is a board certified dermatologist, CEO, and founder of IS Ova and CLMD.
It's her dermatology, virtual care, website. Check it out. she has expertise in skin barrier biology, and she has developed innovative hyper products to maintain skin health. Now, in terms of telemedicine, she's a serial entrepreneur, former NIH scientist, and a practicing physician. Thank you so much for joining us.
happy to be here and happy to be able to pick your mind So Thank you. Yeah. Yeah. It's fun to be here. Yeah. so looking back, you're a dermatologist, right? Board certified dermatologist. We've, said that, but, we talked about this before we actually went on.
I've talked to a, bunch of different dermatologists. [00:01:00] About telemedicine and when I was starting out, you know, talking about this to different people, there was a few dermatologists that I talked to that wasn't necessarily sold on the virtual health dermatology piece. They were like, how can I do dermatology virtually when I need to be in front of somebody physically, because it's such a, personal specialty.
So how did you get to where you're at basically? How did you get from. You know, brick and mortar dermatology to, this powerhouse in, in virtual health. Yeah. So, , so actually started in virtual health in, back in 2014. So I'm a pioneer. Okay. Yeah. And, I did a clinical research fellowship at the National Institute of Health.
And when I was there, I was focused on people who have a disease called job syndrome or hyper IgG syndrome. They have all kinds of problems. You know, there's a reason the syndrome is named after job in the Bible. but their worst problem is the worst eczema in the world. And I got to be really good at managing these really bad cases of eczema and had no good [00:02:00] products.
And I decided one day I'm gonna create the most correctly engineered skin. Barrier optimization technologies for people who have sensitive skin, and that's all humans, right? I also specialize in chemical allergies, so allergic contact dermatitis. And anyway, spent about five years developing this technology.
We just got our fifth patent on it, by the way. Wow. Congrats. And launched it in April of 2014 with a Utah Mommy Lauder. I didn't even know how to send a text message back then. Okay. Like, you know, I literally remember sitting in church one day and someone was sitting next to me showed me how to send a text message.
Right. This is back then, right? Anyway, so most of the skincare line and within three days we had people literally from all over the world emailing photos of themselves and their kids to my sales guy asking him to ask me to diagnose and treat them over the internet. And it was actually a picture of this baby from Algeria.
This little 2-year-old, probably about a 2-year-old [00:03:00] baby covered head to toe and scabs. And, you know, really severe eczema. And I was like, You know, eczema is my superpower. What if. Not only what if we could unleash my superpower, but what if, Leo, we could unleash your superpower and everybody's superpower and make it accessible to consumers.
What if we could make it so doctors and, pharmacists and patients could talk to each other? What if the psychiatrist and the primary care provider could collaborate together? What if the specialist and the primary care provider could talk to each other and get your problem resolved in seconds? Duh.
That's what we need to do. Right. And so anyway, that's where my brain was going when all these pictures were coming in and I turned to my husband . I'm like, I know we just launched a company three days ago, but we need to launch another company. And so we started working. On Zopa . he's like, no.
And I'm like, yes, we have to. It's like so good. You just have to, um, anyway, so that's, how we started. And people think, oh, you're a dermatologist then it's just teledermatology [00:04:00] that you do, and, It's a whole ecosystem. It's all specialties built around the consumer.
However, dermatology of course is my specialty, so we do a lot of super specialized stuff in derm. Mm-hmm. including, we recently launched a dermatology fellowship program and, which we've tied into the technology and it's something that's been really, really fun. Fun to do. No, and when you mentioned this earlier, definitely interesting.
And this amazed me, right? Because I, going through the telemedicine space, I was always wondering, Hey, you know, when are we gonna go to that next step and create educational pieces? . And, when you look in medical schools, do you know of any, medical schools that have a telemedicine course or teach their med students to get there?
Right. And nope. And we're obviously there, right? The need is there, there's a market, it's gonna grow. It's never going away. And this is the next obvious step. And so I was actually wondering to myself, Hey, when, is this next? And we're there, right? Zoba has [00:05:00] created there for dermatology. Yep. Tell us more about the thought behind this
And just kind of how you educate and kind of the progress of that. Sure. Yeah. Okay. So I've got my skincare line, right, and the skincare line. It's called CLMD, sensitive Skincare. And it is really protocol driven, right We have specific conditions and we've created protocols where you combine prescription compounds with the over-the-counter products for all kinds of conditions.
Mm-hmm. So atopic dermatitis, allergic contact dermatitis, peral dermatitis, sic dermatitis, hair loss, psoriasis, you know, all of these things that are really hard to treat, that we are optimizing skin barrier biology using these technologies, but I'm the only one that knows how to use 'em. And I'm like, that doesn't do anybody any good.
Okay? What if I could teach all of these other doctors these superpowers that I have? You know, it's very logic driven, and it works very, very reliably over and over and over, and your patients have amazing results. What if I could [00:06:00] share this knowledge? Right, and, I actually had a job out for my practice.
I have a brick and mortar order practice. Also, I had a job out earlier this year, looking for a dermatologist or an experienced nurse practitioner and, you know, put it up on Indeed in, within two weeks we had 150 people apply to the job and zero of them had any experience. Well, I worked in a med spa for a month.
That is not dermatology. Right? And so anyway, I was like, if I have this problem, then every single one of those 150 people who want a job in, in dermatology have this problem too, right? And how can we teach them at scale? And I'm like, well, I have a digital health technology platform with a learning management system and all of the automation and everything all really built.
So let's start a fellowship. Why not? Why not, right? And so that's what we did. So we launched it in April. we have almost a hundred fellows already now. Really? Wow. Wow. That's amazing. Yeah, we've got [00:07:00] most, mostly physicians actually. a lot of nurse practitioners and a couple of PAs.
And, it's a year long program, so if you want to learn dermatology and you know, our goal is to teach you dermatology, so you are actually proficient in dermatology. Okay, so you could go, get a job in dermatology, you know, so I, would hire one of my fellows to come work at my office. Okay. And so, anyway, our goal is to give you enough proficiency so you can go get a job in dermatology or incorporate it into your practice, but this is the digital health spin on it.
Okay. So there's a couple of digital health spins on it. We're leveraging the digital health technology, first of all, so it's like you're in clinic with us. Okay, so, you see live cases. Okay. What is this? Why do you think that? Okay, what should you do? What should you not do? but we use the application to do that so everyone in the fellowship can upload their own cases, can ask questions 24 7.
Um, [00:08:00] everybody learns from everybody, in addition to the standard training, process, right? We have, so the, fellowship is called Expert Derm, so the Expert Derm Dermatology Fellowship. Um. We also have like a standard textbook review session. You know, you have a, weekly reading assignment.
we have clinical intensives where we deep dive on, you know, all of these most common things. and then we have the list where they can upload all the cases. But the coolest thing about it is, okay, we just taught you dermatology. Now what are you gonna do with it? Well, we give you your own Teledermatology clinic and website that's branded to you with telemedicine appointments that cover the conditions that you just learned about and just got certified on and so, any, anyway, when they do that, they get their own EMR, they get their own website
we cover their malpractice. We provide virtual clinical support staff, so you just show up and see patients. You know, it's designed for you to go use with your own patients. You can obviously use that knowledge in your practice as [00:09:00] well. but it's, really touching a lot of people's lives and helping a lot of people and it's really exciting and we're just getting started.
So, no, that's amazing. That's amazing. 'cause honestly, the dermatologists were one of the hardest people. And to, convince that tone medicine is, a valid way to practice dermatology. You know when, these people come to you, what, have you found as their main kind of speed bump, as their main barrier to actually accepting.
That virtual care is a valid way. You know, I think it's amazing how you set it up, right? you've set it up where you actually learn in a virtual space and learn how to navigate that and break down those barriers, so it makes it less daunting, right? But, you know, when, people come to you, what, have you found as kind of the top barrier into adopting this or into kind of just moving forward?
You know, I don't really have a problem convincing people. It's like they come to you ready. You know, it's like, duh, okay, yeah. Sum me up. You know what I mean? Because it's, so logical, right? You know, dermatology [00:10:00] is primarily a visual specialty . Of course, we're not gonna. Cut off a mole and we're not advertising for you to come, for us to treat your moles online.
We're advertising for you the consumer, to get treatment for things that we can treat online. Mm-hmm. Obviously. Right? And so, I think that's one very important distinction, right? We're not here to treat skin cancer online. We're not doing that, okay? We're not gonna cut, your cyst out online.
We're not gonna remove your lipoma. But we will treat your acne and your eczema and your rosacea. We'll help you figure out what the heck that rash is and why you keep reacting when you use that, burst bees lip balm that you're allergic to and all of that kind of stuff, right? So, there is a huge swath of the dermatology specialty that is very appropriately treated via teledermatology.
And, you know, of course you've gotta, collect an adequate history. You've gotta collect. Photos and get the story right and be very thorough in that regard. And of course, we've checked, all those boxes. Right? We've been doing this, for a long time now. [00:11:00] Mm-hmm. Yeah. So it's a lot of fun. Leo, have you ever gotten any training in derm?
I mean, your peds emergency? Me, right? Well, I'm PS yeah, so I'm, a general pediatrician, right. And, I was a general pediatrician first before I was an emergency doctor, so I'm dual boarded, but in general peds, we see a lot of dermatology. Right. I think secondary to the dermatologist itself, I think pediatrics, you know, see the most derm in terms of that sense.
and so we got a good amount of, dermatology and it's basic, you know, like it's probably compared to the full. But yeah, so that's the training I got. And so it's funny 'cause. When you talk about the visual kind of diagnoses and that, so I was in the military before, right? And in the military, you know, parents would be all over the place, right?
I was stationed in Korea and I was a main pediatrician in Korea and I would get consults. From different areas in the peninsula, and a lot of 'em were derm. Hey, what do we do with this rash? You know, this is family medicine, doctors, [00:12:00] so forth and so on. We didn't have a dermatologist, so I was the defactor dermatologist at that time.
and so yeah, yeah, so that, was kind of my experience. Yeah. Well we found, just teaching people the basics of. we had a case in the listserv today, a 2-year-old who has severe atopic dermatitis. we gave him, our protocol. He's all clear on his body, but now he's got cracks on his feet.
Mm-hmm. Okay. So I upload the case, okay guys, what should we be thinking about? And one of the fellows said, okay, I would put glue on the cracks. No, okay, so the reason his feet are not healing is because he has shoe dermatitis. He's allergic, he has an allergic contact dermatitis.
Anyway, so it's really fun to guide these people and help them. Wait a minute. Amazing that, you know, the way you've been thinking is not the way you should be thinking, right? And giving them the skill set. to solve these things virtually, you know, it's really fun. No, this is great. 'cause you're leveraging, like you said, you're leveraging [00:13:00] your expertise where, you know, before this, right?
You know, unless you know you or in frequent contact of you, there's really no way to do that. But reaching out to literally the entire world. Now the doctors that sign up for your fellowship, are they dermatologists? Are they general practitioners? Pediatricians? what are you seeing?
And you said there's nurse practitioners, PAs as well too, right? Mm-hmm. Yeah, so it's primarily, you know, mostly physicians and nurse practitioners and a couple of PAs. but we've got family medicine, we've got emergency medicine, we've got pediatrics, we've got endocrinology, we've got psychiatry, ophthalmology, you know, people who, all of them see skin, right?
Like every single one of their patients has a skin issue, right? That currently they're like, I don't know how to help you. You know, most of them are like, I just want to have proficiency, like basic proficiency in dermatology. Right. And anyway, a lot of dermatologists are very, you know, threatened by what I'm doing, what you're gonna disrupt the whole [00:14:00] dermatology monopoly.
And I'm like, guys, we don't have a monopoly on this knowledge. Okay. And there is very much a shortage. In this service. Mm-hmm. Right? Absolutely. And you shouldn't have to wait six months to go get your acne taken care of. Right. Right. And anyway, and in reality, it is resulting in more referrals to dermatology because these doctors now know what they're dealing with Yes.
And what they can and cannot manage. Right. So it's actually beneficial for the dermatologists and the family medicine providers at the same time. Yeah, no, I was just about to say because you know, you talk to the average ER doctor at least, right. when we see a rash, it's either, hey, throw a storied at it or throw an antifungal at it, see what happens.
And in two, three weeks, if it doesn't work, throw the other thing at it. And if, see that doesn't happen. If they see us again, then they go see a dermatologist. But, you know, now it's nice to have. The knowledge of, hey, this is kind of the protocol to go through. This is what to look for, [00:15:00] you know, instead of just throwing things at rashes and see what sticks.
exactly. No, this is a valuable service. wow, this is amazing. Yeah. Well, and just to add, like, I really like that you're tying in the business side of it. Yes. Because a lot of the people that I work with, PAs, nps, different physicians, they're perfectly fine going back and doing the clinical training if you try to teach them like.
What EHR to pick? Oh my gosh. Their mind blows. And so like, you're really simplifying the process. in the tech world it's called like a business in a box model. and they don't have it for dermatology. They have it for med spas and other types of scopes, but like, nothing that's, you know, kind of like as specialized as what you're doing.
So it's really, really cool. Yeah. Well, thanks. It's been, a lot of fun. And the, business aspect of it. You said, you know, you set them up with the EMRA clinic, so forth and so on. Do you see a lot of doctors or are they having a hard time trying to get a handle of that scope?
You know, now you're introducing them [00:16:00] into the business of telemedicine nationally. Right. is there certain things, certain aspects of national virtual care that these physicians are having a hard time understanding? You know. we talk about things like, you know, the rules, each state rules, you know, compliance, so forth and so on.
Just things that you don't see necessarily in brick and mortar practice, right? Things you take for granted, right? Because while you're only in that one location, things like that, you know, what have you seen as kind of common questions for you? Yeah. So I mean, they, all will have a question, well, can I see patients in all 50 states?
No. Right. I mean, we start with the basics, but that's actually part of the fellowship is we actually have telemedicine regulation training, how you do telemedicine. It's, it is built into the fellowship. but that is one of the main questions is, okay, how do I get licensed in all these states and or how do we get more licenses and.
Can I, just go see people everywhere? And we educate them? No, you can't. Our software, you know, manually just says that automatically, see, you don't need to worry about it. [00:17:00] Right. 'cause you put your licenses in our system and you're only gonna see people in the states where you're licensed.
Yeah. but, you know, they do have a lot of like the, you know, well, how does the pharmacy work and how do you know, how does all that kind of work? but it's all, you know, it's all built in and you're right, right. PBP it is a business in a box situation. Yeah. Yeah. The compliance side is always something that just, I think it just hangs people up.
and so being able to train the, clinical brain on that, I think is something that's just really valuable, even outside of just, you know, yeah. Yeah. If you wanna scale up, it's just, it's really important to understand like even how to find the rules yourself. Yeah. Well, and we've made it like they don't even need to worry about that part, right?
Like that's all automated and built into the system by default. So, you know, it's like, of course we're not going to let you see a patient that, you know, the system is not going to let you see a patient that you legally cannot see. You know, so they don't really even need to worry about heart.
But, and then also, we manage the, can you do a video visit in that state or [00:18:00] just an asynchronous visit in that state? all that kind of. Thing, our system manages that automatically as well. So, because they don't, even know that, right? Yeah. They usually have no, you know, these, most of these people are, new to telehealth and they don't understand, oh, I can't actually do an asynchronous visit in my state.
But yeah, there's still a couple states that you can't, you know, we help take care of all that too. And, we, you're talking about zoa, correct? Yes. Yes. Yeah. Mm-hmm. No, that's amazing. And we were, talking about this too, so, we talked about this earlier. So Zo was one of the first platforms I kind of signed on, as a telemedicine doctor.
Mm-hmm. And so it's not just a dermatology platform, right. Let's, right. Yeah. Can, you mention, you were saying it, it, basically it's own environment. it's whole. Mm-hmm. What, does, you know, building that out? It's, I never knew that IVA was basically built out of this dermatology need.
'cause I always thought about it as, you know, hey, I'm able to see patients no matter what. You know, and there's a lot of different specialties under how is building that out and making that jump from, you know, brick and mortar [00:19:00] to building this big powerhouse of a telemedicine company.
Um, oh my gosh. Like, can I just tell you how many thousands and thousands of hours that is? Like, it's, it has been a lot of work, right? you know, we have an engineering firm. I threw myself into the tech. I learned tech, you know, and I had to right to, it's like to translate, okay, I need the software to do this.
Okay. So that means I have to go talk to the engineers and, Translate, you know, clinical workflows for the engineers. but yeah, I mean, what, we have done is built out a full digital health ecosystem. You know, our goal is to create a comprehensive healthcare solution for consumers where you can get all of your care in one app and where all of your providers can collaborate, communicate, share records, and really deliver the most efficient care.
we've, Become deeply involved in at-home diagnostics. you know, because you can, really push the limit of what you can do with telehealth [00:20:00] if you have lab data and if the patients are anything like me. I mean, the last time my doctor ordered lab work for me, it took me three years to go get my blood drawn.
You know, literally did. And so I'm like, okay, I'm just gonna take one of those test kids I have on the shelf. That's how I get my blood work done now. Right. So, 'cause I don't have time to go to the lab, none of us do. Right. So, but being able to integrate, you know, laboratory diagnostics into telehealth really, you know, also enables us to do this and to connect more specialties and, provide more value to the consumer.
Yeah, no, and I'm, looking at the website right now. Um, you know, you're right, this is kind of complete answer. And the at-home tests, this is very, complete . It's very inclusive. Mm-hmm. Thanks. you know, you have cardiovascular health, women's health, men's health, just all the above, and you're right.
It, took me two to three years to actually see my piece and actually get those tests. I knew what they were gonna say, they were horrible, but it was like, Hey, [00:21:00] you know, it took me a while to do that and, and get on it. So, no, this is, great. So where are you seeing, where, telemedicine can be in, terms of, you know, you're building out this fellowship, where do you want us to be in terms of not just dermatology, but telemedicine.
In, let's say a decade from now, you know, more educational programs, you know, ingrained in med school, so forth and so on. So what if you would build an ideal world and how to build this out and where, do you see us going? You know, Leo, I honestly, I mean, I was, you know, just reading online, blah, blah, blah.
Med school. Closed fellowship program. Closed residency program closed. they're losing their funding. Oh yeah. Okay. I think. Education is gonna go online. A lot of it is gonna go online. And this ability that we've built to collaborate and learn other providers, you can do it online and yeah, you can come to clinic with me if we're connected with Via video.
[00:22:00] And I'm gonna show you how I do the Kenalog in this patient's scalp and why I, you know, do it this, way and not that way. Like you can do that virtually. It's amazing. Right? And five years ago, never even thought about doing this. But now I'm like, oh my gosh, this is such a great way to learn, you know?
'cause you can learn more than just your one attending. Yeah. You can learn from, an entire group. Right. And get everyone's perspective and everyone's cases. Right. We have, we get the craziest, greatest cases. You know, like, I don't get those walking into my office, you know, 'causeI'm a practice, you know.
Just this practice, but you're seeing those patient, you know, we had one of our fellows submitted this case of acne kta, which is like the worst acne ever. Right? And you know, I'll see that very, very rarely. But here, one comes in through the app and now everybody gets to learn from that. You don't have to wait 20 years in your career to see one case.
Mm-hmm. You know? Anyway. So I think the future of. digital health, not [00:23:00] only, you know, of course we're, gonna be in integrating ai, in every way, every aspect possible. You know, diagnostics are gonna be tied into ai. Yeah. but education is also gonna be tied into ai. But I think, nothing will ever replicate having a human actually talking to you.
of course, nothing will replicate a human touching you, and we're not doing that virtually, obviously, but that's, a whole different story. but being able to have someone who, is connected and personalized, but also having a support network for, okay, I don't know how to do this. Oh, great.
I have 79 people I can ask right now and get an answer. Right. 79 experts that actually know the answer to this question. You know, that I think is part of the future. It certainly isn't all of the future, but I think it is part of what is going to make the future. Yeah, no, I agree. I think that's the power of this and, once we're able to harness this power and, able to actually just spread the accessibility of it.
I think you're right. We've, basically just touched the tip of the iceberg here and [00:24:00] once we get all on board, standardize it, protocolize it, and, just having the thought of being able to just work with each other Right. Instead of against each other. Yeah, you're right. just a able to leverage our collective knowledge across the board.
Now, did you once, COVID hit. Did you see a big jump? you know, you said, Hey, you didn't think about this five years ago, and that's around the COVID time. What, where did you see, did you, was there a transition for you there too? You know, did you see a technology boom? Was it just more acceptable?
Things like that. So we actually started out as a SaaS model and, we started building a company in 2014. We saw our first patient in June of 2015. And that's kind of an interesting thing too. I'll tell you about that in a minute. But we started as, a sas . You know, selling telehealth software and secure messaging and membership management.
You know, we have some of, the most robust membership management technologies ever. You know, 'cause we started way back then. but we, quickly [00:25:00] realized, you know, selling to a doctor is like trying to get 'em to get a new wife. He's like, I don't care about the patient experience. I'm just getting paid by the insurance company.
Why should I invest in doing something different? Right. And so that's when we pivoted to the tech enabled services model. So we started doing that in 2016. we filed some patents, so we have some patented IP on the way that we're able to create digitally connected networks. that is very, you know, really cool.
But anyway, we pivoted to tech enabled and then COVID hit and COVID was a huge pivot for us. So we ended up becoming one of the largest co test proctoring and COVID compliance management systems in the world. wow. you know, we were proctoring 15,000 tests a day, you know, so we were partnered with all the global airlines, um, Delta, Virgin WestJet.
Swoop Alaska. We were one of the health passes for Hawaii. Um, you know, we [00:26:00] would help people get out of, the Hawaii purgatory when they would get stuck because they didn't, I remember that. The COVID test in time. anyway, so, that was, a great experience on how to scale a tech company. Right.
We went from 30 employees to 645 days during the pandemic. Wow. It was insane. You know, when we launched Costco, I was on vacation, but never go on vacation, by the way. 'cause I'm a call. But anyway, I was on vacation and I remember I went to bed and I thought, I think I might have a stroke.
Like, I literally thought I might have a stroke because it was so much, connecting all the, you know, you, think you've thought of everything. Right. And then you launch it, it's like, we didn't think about that. And then fixing it as fast as you can, you know? Mm-hmm. And that's, that is totally normal with technology.
That is the evolution and the life of technology. Right. And I now know it's like, okay, that's normal. Okay. You know, you can never [00:27:00] think of everything. Anyway, I'm kind of going down a rabbit hole. but, that's kind of, been our journey, you know? Then after COVID. we went back to what we were building in the very first place.
Right? And, it was nice because then we had funding, right? We call that our equity free COVID funding round. You know, that financed what we were really trying to do, and that is to build this fully connected. Digital health ecosystems and that's built around the consumer and around the provider.
And I always very careful to say and around the provider because both parties are a hundred percent, you know, the, provider experience, user experience, and the patient's user experience. Both are equally important. Right. You know, if it's mm-hmm. if the tech doesn't work and it's a pain in the butt, the providers aren't gonna do it.
Oh, yeah. If the patients can't get the care, they're not gonna come. Right. So you've really gotta marry both sides. Actually, that's a good point. 'cause I've, been involved in companies that are either very tech and, patient forward heavy and kind of forgotten the provider experience [00:28:00] or the other way around.
Right. And it, it just doesn't work. Right. And, actually we've had prior guests. kind of making that point as well. Hey, the most successful companies are the ones that take the provider input and build it into their tech, build into their processes, and work very closely with the provider. So doctors right now trying to get in telemedicine thinking, Hey, what other things I could do?
You could be these people, product management, product, consultants to help most of these tech companies that. Yeah. Honestly, VO was built by a doctor, so it was inherently, provider driven. Yeah. But most of these companies are not inherently provider driven. Right.
They're tech driven, created by, you know, tech folks or, just entrepreneurs, not necessarily deep into medicine. So this is where you could find a role in yourself and you're very valuable doing so. Absolutely. Absolutely. You know, and, you brought up product management. You know, I never even knew what product management was before I started this company.
Right. but it's really fun. Yeah. It's like [00:29:00] one of the most fun things. And I think physicians inherently, if you're a techie physician, go look at product management because you get to create and innovate and, you know, solve problems. You know, physician brains are built that way.
You know, so anyway, but yeah, I mean, having clinical input in building digital health technologies is a must because unless you have been in the clinic seeing patients and understand the whole workflow beginning to end and all the prior authorization, and the insurance company, and the scheduling and the rescheduling and the time zones and all of those things.
If, you haven't been in, those weeds. It's not gonna work. Yeah. And what, did you have any specialized training in this? I have a self-administered PhD, like I have 10 PhDs. Right. And, it's funny 'cause we talked to a lot of different doctors and that, that's one of the major speed bumps is like, Hey, I wasn't taught this, you know, I didn't have any formal education.
You know, I don't have an MBA, so forth and so on. But yeah, [00:30:00] most of the people that we talk to is like, yeah, I've educated myself, I've gone through the trenches and you know, just like you were saying, tons of hours. And there's probably a lot of, trial and error, seeing what works, seeing what doesn't, and teach yourself the terminology, the processes, so forth and so on.
And it's funny, who's our last, guest talking about, you know, doctors transitioning to product management? Honestly, I didn't know that was a thing either until talking to our guests last, week and I had to look it up and look up kind of different kind of opportunities there and just kind of blew my mind.
It was like, yes, we are definitely, this is right up our alley. You know, this is what we do almost day in, day out. a lot of us, when we go through med school, we go through our different clinics and whatever you're at, and we're, always constantly, I think this is just who we are and how we're trained.
We're always constantly trying to. Figure out ways to do things better, right? Learn the processes, so forth and so on. And that's just what project management is just in a more, entrepreneurship scale. So that's Lou, I have a [00:31:00] question for you. Yep. I have a question for you. What do you think is going to happen to the future career of a physician?
Ooh, that's a good question. I'm usually the one answering, asking the questions. you brought that up because it's like, you know, with ai, the advent of ai. Yes. And like, man, it's, I mean, it's, that's interesting because I was thinking about this too.
You know, ai, we're taught to be thinkers, we're taught to be doers, right? But we're also inherently, you know, managers, supervisors, so forth and so on. I think AI is gonna take a lot of the mundane, a lot of those day-to-day processes that we do every day . Right. you could see that in dermatology, how AI is in dermatology, radiology, a lot of different processes, er even Right.
But I think what, as doctors and as a whole, that we need to be able to shift. We can't totally depend on [00:32:00] ai, so we need to keep that leverage, right? We need to keep the supervision over it and be able to dictate it right, and use it to make our processes better and more efficient.
But also, you're right, delving into more. Kind of project management, managing more administrative processes, which we've given up in the past, right? This is why we are no longer the heads. We are no longer the CEOs, hospitals, right? No longer, you know, the leaders in healthcare that we once were because we've given up that leverage.
But if we get that back, especially in the telemedicine space, because I think this is gonna be a larger percentage of how we practice medicine. Right. I think. Mm-hmm. the writing's on the wall right. You know, brick and mortar is, will always be around. It always has to be. But yeah, I think, the more day to day and the more, , bread and butter stuff is gonna move over to virtual care.
And if we are able to stay on top of that, stay on top of that shift and not shun away our leverage and our [00:33:00] expertise, I think, you know, we, we'll be able toss. Basically stay in the business and not, have, you know, decisions be, kind of transitioned out, if that makes sense. it's pretty crazy to think about, you know, I think, what, do you think is the end game in digital health?
I mean, you, are kind of in the same boat as I am, right? Yeah. You've been doing this a long time and you've worked for a bunch of companies and you've experienced so many workflows and. seeing so many innovations. Yeah. And, anyway, I know you're supposed to be asking me the questions, but No, this is good.
This is good. So I think end game is gonna be, the overall end game in health. Why we got into medicine For most of us, right. I'm gonna generalize is, helping others, right? Is, taking care of patients, right. Is, being able to care for patients in their ailments in whatever specialty they are.
Right. We are. And, do that. I think the telehealth end game is being able to do that in a larger scale, do [00:34:00] that, and to provide access, to populations that haven't really been accessed before, or poor access. It's really just doing that in a more accessible scale. So, and I think the, companies that I've seen have been successful in doing that is the ones that have been.
Providing access, whether it be, you see a lot of these director to consumer companies that access is very specialized access, very specialized, complaints, disease processes, but I think they're successful because yeah, the, patients are able to see a doctor, right? Get their ailments taken care of in almost a keystroke, right?
So. I dunno, what, do you think when you know, you've been doing this a lot longer than me, you're one of the OGs, right? So what's the end game you think? where are you gonna see us? So, so, many things. integrating image analytics,
You know, diagnostics, genomics, analytics, integrating them all into predictive algorithms. I [00:35:00] think ultimately physicians will do very little decision making in the future. It's, not decision making, I think physicians will do less reasoning. Yes. I should say that's it. Yeah.
'cause, ai I will, be doing like the, excuse me, the, preliminary reasoning and giving you, okay, here's the four things that you need to think about and make a decision. Right, I agree. And that I totally agree. That's, and we're seeing that now. You know, that's, what's that? And we're seeing that now, we, you know, yeah.
No, that's interesting you say that. 'cause yeah, I don't think, you're right. it's the reasoning, not the decision making. Right. Because honestly, do you think, do you think decisions will ever be taken out of the final decision making process? You know, an actual person?
I don't think so. I don't think so. Well, I think, Patients will use AI and they will rely on their physicians, physicians less frequently. I mean, I'm already seeing that and, actually, you know, being [00:36:00] in, the business meetings with the piece or the business that I, the tele medicine business that, I've been a part of, that's actually a big question.
Right. what is gonna prevent the patients from going to. chat, GPT and chat g ting their medical issues versus going to us,
right? Like why, are they gonna pay for a service when they could go to chat GPT for free? Right? I think the answer is very obvious to me. Chat GPT, you know, is great in reasoning, but you know when it comes down and you have to actually decide and, do things. then that's when we use our Precision knowledge to differentiate between what chat GT and AI has put forward.
Because, you've used ai, it's not a hundred percent right, and it could lead you down a dangerous rabbit hole if you depend on it a hundred percent , exclusively. Yeah. Well, case in point, you know, I had a patient call me today and she's like, well, I don't need my appointment anymore.
I asked Che GPT, [00:37:00] and I was like, oh. Well, what's going on? Well, I got blah, blah, blah, blah, blah, and chat. G BT told me just to use an antihistamine, and that's helping. She's like, but it is spreading all over my body though. And I'm like, right. No, exactly. It's not working out for you. Right. It's like, this is why you hired me.
Right, right. Exactly. But no, I think that concern should be on every one of our minds. It should. You're right. It should. Right. What other value can you provide to your patients? Okay. What is it that makes your service something that the patient does want to come to? No, exactly. And is it more Sure bet than going to the ai No, e exactly.
And, on that hand too, being able to leverage the AI to your advantage too, right? Because mm-hmm. Honestly, like we, see it in brick and mortar stuff too. You know, let's say you see this. This very hard case in the emergency department. Right. And we, look up things all the time. Right. [00:38:00] But if we pass it through chat chief and say, Hey, what's the top differentials?
It'll, get us closer to where we need to be faster, which is better for the patient. Absolutely. Right. So like we can't totally just deny AI as a tool, but we can't also, dependent on entirely as a correct, but also, being able to protect. the profession of a physician, right?
So, mm-hmm. Yeah. Interesting things to think about. No, this is actually a good kind of thought pathway here, because you're right. as we move along towards this end game, we're not gonna deny AI is gonna be there, right? We're not gonna deny the bigger role of AI and every single one of us, no matter what specialty you are.
And some specialties more. So radiology talking to you too, right? How are you gonna provide value and how are you gonna convince people that you know that we're not gonna totally depend on AI robots or friends and so on, right? So I think this is how we're gonna protect the [00:39:00] profession of, doctrine in the future.
So, yeah. Interesting. Yeah, I mean, I think my little two sons on it is that I think that. what you're building is gonna be more relevant than ever. I think people, again, aren't gonna go to their PCPs. You're not gonna go to your pediatrician. But if you have something, a skin rash, if you have, some, I think it's gonna be in the rise of specialty care.
And you're really gonna need, you know more now than ever, physicians who understand longevity and hormones and, Dermatology and allergies and little things. Nutrition and gut biome. Yes. And exactly. Exactly. And those topics right, are just, they're not that very well known. Right.
And, the ability for telemedicine to increase everybody's knowledge, decisions, and patients alike. Right. And have that source, I think that's an amazing tool as well. So, yeah. I think so [00:40:00] this is, great. we are getting close to time, but I do like to ask one question before we go. going back, thinking back to intern times, right day one, intern year, you're able to go back and talk to this intern person.
What would you tell your intern self on day one? July 1st say, Hey, here's some knowledge I can impart to, oh my gosh. I mean, digital health wasn't even like an inkling in my mind back then, right? I mean, I didn't do my internship here in 2000 to 2001. Oh yeah. Same. but I wish I could have come and whispered into my head, Hey, you're gonna start this massive digital health company in the future, and you're gonna become a technologist.
Okay. Like, I would've gone back and instead studied computer science. Right. That's actually interesting. Would myself to compose study is study computer science and genomics and laboratory medicine. That's what I would've [00:41:00] told myself. No, that's a How many computer science majors go into med school?
Well, I know a few. I know a few. And they are brilliant. Exactly. They're brilliant. They're made for this, right? Yeah, yeah, yeah. and that's actually an interesting Kind of taking that No, that's, great. No, I think you, but I think that combination is gonna be needed in the future.
But anyway, sorry. Go ahead. Yeah. Oh yeah. No, it's needed now. It's needed now to further, digital health. Right. Because yeah, there, is no classes on digital health and digital care, really technology whatsoever. Right. and you're right. You know when, we started, shoot.
The biggest technology I had was this big old phone that was the size of a brick. Right? And that's all I knew. I had Blackberry. I had a Blackberry. Oh my gosh. Yeah. You were way more technology driven than me. I had a phone literally the size of this microphone. awesome. But no, before I go down, it's a rabbit hole.
Um, no, thank you so much for joining us. where can we find, [00:42:00] zoa, right? Is it, how do we get in touch with you through, or. Find you companies. Is it a ova.com? Is that right? zo.com Yeah. And our fellowship program is a zo.com/fellowship/dermatology. If you're interested in the fellowship program, I'm looking into it too.
So, and we'll, put that in the, show notes. And, just to mention your other dermatology line, it is. CL md.com. That's right. That's right. it's your initials and if you haven't checked out your Instagram and please check out the doctor, your Instagram. I learned a lot about Entima while I was going through it.
Right. No, there was a lot of interesting cases about eczema and whatnot. definitely useful. I wish I found out about this when I was like a pediatrician seeing pediatric care. I was like, oh, okay. I could have used that. So, no, definitely check out. Yeah, check out your handle. And what was that again?
Sorry, I was talking over it. Cheryl Lee do eing on Instagram [00:43:00] and also Expert Derm Fellowship on Instagram and TikTok. That's awesome. Thank you so much. Phoebe, any, closing thoughts? No, no. Thank you so much for, again, I think what you're doing, and I completely agree. I think education is the future, and being able to share your wisdom and train other physicians who could also go and, you know.
Provide access because it's just such a huge issue now. I think it's amazing. Zopa is amazing. I've been on the website half the time looking at all the, specialty care that you provide, which is just, again, thank you. It's so hard to get into, those appointments and having such a robust network is super impressive.
Well, thank you. it's been a lot of work. I can tell you that. and it's gonna be a lot more in the future. So, but yes, it's been really nice to be with you guys tonight. No, we're, looking forward to see what else is, up your sleeve. Thank you so much. Okay. All right. Thanks so much, you guys.
Take care. You too. Great. Thank you.