Health policy isn’t background noise, it’s the operating system of healthcare. In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco dive into the nuts and bolts of starting a telemedicine practice, from PC MSO setups and state regulations to business planning, marketing, and overcoming clinician burnout.
Thinking 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.
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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:
Leo: [00:00:00] Hey everybody. Welcome back to another exciting episode of Telemedicine Talks. this is your host, Phoebe Gutierrez, and, the co-host Leo Damas. It's just us this time around talking about us.
Take a deeper dive into what you've helped other businesses do. Right. You know, you've mentioned it before and it begs to be repeated. You've helped a bunch of startups start up. And also, you know, with me personally as well, you've helped connect a bunch of physicians with nurse practitioners, with PAs and startup collaborations and whatnot.
you've also, helped build PC MSO structures, so forth and so on. And it'd be helpful to know how the hell did you actually do that? You know, I take it for granted, when I walk into these kind of relationships, I'm like, oh, okay, it's set up, but there's actually some work behind it, obviously.
Right. But so yeah, walk us through kind of how you've done this and what we need to pay attention to. [00:01:00] You know, what are the steps, like, how do you do it?
Phoebe: Yeah. I think it's an interesting topic. I kind of also have glazed over it over the years of just, working on all of these.
Different practices and getting to kind of learn from each client that I get to support. But, it's been interesting, you know, the start of this year, I've had so many different people reach out and they're all kind of asking the same questions. And the big question of course is always, can I do this in my state?
so if it's a. Physician, for example, who wants to do a telemedicine company or if it's, a pa who's, looking to start something in Texas. the rule of thumb that I tell everybody, even before looking at anything, is there's a way for anyone to own a medical practice in the United States, and the easiest thing to look at is look at a HIMSS and hers.
Look at any telemedicine platform out there. Most of them are not owned [00:02:00] by physicians and they're still somehow functioning in providing clinical care. So in all 50 states, there is a way it's the P-C-M-S-O structure in which we've all talked about. Now, if you don't have to have that structure or there's different options 'cause you're a clinician or a doctor, whatever.
You wanna explore that because it's cheaper and it could save you some hassle. But, the first thing that I always tell people is figure out, what structure you have to have in your state. And make sure that you're not just saying it's A-P-C-M-S-O because in a lot of states it's not.
It could be a. Professional association. It could be a PLC, I'm not gonna bore everybody with it, but there's so many different things. And the big thing for that is, again, it's like they just wanna make sure that a clinician is having the independent decision making in that state. So that's one big thing.
Leo: where do you find this information? Right? is there a good, you know, resource or do you have to go look up each individual state? especially if you [00:03:00] wanna start like a 50 state practice.
Phoebe: Yeah. I mean, I think that, most people are gonna go to an attorney and you know,
that's the expensive way. 'cause an attorney's gonna say exactly what I'm saying, which, yes, you can do it this way and we'll file it for you. We're gonna charge you, you know, this much money to do each one. the biggest thing is like Google it.
Most of the time, like the regulations are baked into different types of regulation packages. Most of them are in your business registration regulations which specify who can and cannot own a business entity based on however it's, categorized in that state. And then if there's any preclusion of, like, you know only a physician.
Or if maybe it opens it a little bit more broadly in the regulation and says like, only a clinician can own. But usually it's baked into those and then it tells you it has to be a hundred percent owned by a physician. Yeah. Has to be 51 49. And that's big for like the NP or the PA side.
Or even like, a chiropractor who's running a wound [00:04:00] care business. Right. Like those are all some of the nuances that I think come into play. When, you know, you're talking about some of those things and again, it's heavily different for, all 50 states. And so, you know, most people that I work with they're not trying to build a national, telemedicine company.
They're trying to just start something in three states or five states. And I think this is helpful because, you know, of course you wanna do it in your home state, but like, perhaps you wanna try to pick states that align more with some of these rules that could, potentially. You could own it. You know, like Alabama for example, anybody can own business in Alabama .
Leo: Now what if you're like, Hey, I picked out these, you know, handful of states. But some of the rules are contradictory, right? Like, one state only a clinician or a decision could own it a hundred percent while, you know, in another state, it has to be at least 51% owned.
What's the best way to structure that? Do you build two different companies or do you just go by the lowest common denominator and just go with that? Because I could see how hairy that is. Like especially if [00:05:00] you're not the clinician in that relationship, then you give a total ownership when you don't have to,
How have you seen that approach?
Phoebe: I think it depends. Like a state, like Virginia for example, like, it's a non-corporate practice of medicine state. Has loose rules around clinical oversight if you meet certain, criteria. So in theory, like you could practice independently and, operate under, so-and-so's structure.
If you wanna expand, I wouldn't say align everything across the board. Mm-hmm. Because that's gonna be, costly. Now again, I'm not an attorney and so, attorneys are gonna have different, you know, saying, I actually met with an attorney this week who told me, he's like, look like the safest bet is the model, everything after how California does it.
That was like his quote, which everyone knows California is The strictest. Yeah. I always base things off of risk and timing and money and so yeah, if you wanna have the safest bet, you're gonna wanna structure everything independently.
You wouldn't even wanna do foreign [00:06:00] registration. You would have separate bank accounts. Oh gosh, yeah. that's, you would wanna do everything separately, but that's, the least risk that you would assume now. On the flip side, again, cost, there's a lot of time, there's a lot of paperwork that will go into that.
So does it make sense for you to structure it that way? Probably not. So to me, again, those are the conversations that I typically have with clients where it's like we look at the regulations, we kind of decide what actually makes the most sense. That's again, within a compliant structure.
Leo: Yeah. And getting down to the nitty gritty kind of nuts and bolts of it. So you've decided to create something , right? You're like, Hey, I wanna create this structure, so forth and so on. What else do you need? You know, I'm thinking if you're a doc and you start a pc, you probably need an MSO plus minus, right?
Depending on where you want to go with this, right? you probably don't need one immediately, but it's probably an important piece of the puzzle, especially if you wanna expand. [00:07:00] You know, bank accounts blankety blank. You know what's kind of on your checklist while you go through building an entity such as this or a practice?
Phoebe: Yeah, I mean, the way that I kind of categorize it is there's kind of like three main buckets that I do. You have your business plan, which is literally the one thing that so many people I think glaze over, which is how am I gonna market this? Am I gonna do Google ads? Am I not gonna do, like how am I gonna get patients?
I think a lot of people just have this inherent audience around us, or we think we have a really great idea and people are gonna flock to it and that is not the case. Especially in healthcare, the hardest thing is patient acquisition. So even before people start thinking about logistically, can I operationalize this thing?
I'm actually encouraging them. Like, have you sat down and done the work to build your business plan? And if you haven't, let's brainstorm and figure out what works, And that goes from as simple as how do you want your website to [00:08:00] look Who are you targeting?
Because I'll have clients that go, well, we're targeting everyone. And I'm like, wrong. I want you to target such a specialized, super specific population that it's fail proof for you to get people because you're gonna be speaking to somebody so targeted. It's an interesting thing. A lot of people think the larger the market, the more people are gonna come and it's complete opposite.
So I have a client who, is doing something very specific population, but she's doing it all in Spanish. And to me, I'm like, what a great idea. Yeah. You know, now it's just like, we're gonna take time. It's gonna, take some time to grow that, but at least you know,
There's a niche there. Yeah. So I say like, that's one thing that I work with people on, and Leo, I always say like, it's a little fluffy. People don't like to have this and, and all that. But that's the most important part is like you're actually doing the planning of like, what the hell are we going to put together?
And like, how are we gonna make money doing this? Doing the thing that we actually still believe in.
Leo: Well, it's funny [00:09:00] 'cause a lot of these books and a lot of the people, you know, you read the books and you listen to other talks saying, Hey, how do you become successful? What do you focus on?
and a big part of it is, hey, just create your avatar, right? Just like what you're saying, create your target audience. And it goes into specifics, how old, you know, sex, interests, and you know, doing this exercise, you go down, you create names, they have two kids, one dog they live in, suburbia, they're higher, middle class, blah, blah, blah.
But you're right. You know, you want to focus your business on a specific audience, right? Because you can't shotgun and expect to have everybody flocking to you. another good thing is like the 80 20, you want to focus on your 80% right? And your 80% is gonna come from a very, very small percentage.
Of that population. So yeah. Yeah, creating that target audience and that avatar is key. and that goes into marketing too. the different marketing stuff, the different colors you use, font, how are the [00:10:00] approaches, you know, it definitely changes your whole approach from the very beginning.
Phoebe: Yeah. Well, this is kind of a funny, thing to say, but you know, Leo, we always joke like, you speak doctor, I speak compliance. we somehow get along because doctors care about compliance you guys are the only ones who really do,
To me, I find it funny. And that's the thing that you need to find, you need to find your person. Who also kind of understands what you're saying. you wanna speak the same language, but that's not super clinical. And that's how you pull people in. one of the other things that I focus a lot of time on with my clients is how can we actually turn you from clinician to entrepreneur?
And part of that is, I don't wanna hear Gestalt and I don't wanna hear intubate and I don't wanna hear that. I wanna hear, layman's terms, really relatable stuff. Because to me, again, you're trying to speak to an audience that does not understand this stuff.
One of the big things I work on is I [00:11:00] review websites, I review, social media plans. I review all this stuff because I'm like over everyone's head, We wanna make it to where people understand so they can find you. Otherwise, if you keep talking in clinical words, you're just gonna find more clinicians.
Leo: it is funny. It reminds me of kind of, you know, like social situations, right? Where, you know, our friends get together and unfortunately being doctors, you know, you get stuck into. Training world where nobody wants to be your friends and the only friends that you have are the ones that are around you.
Really just the other doctors, right? Because hey, find friends somewhere and, but we get together and if there's a non-doctor in that social situation, you know, we're joking around and all the references, all the jokes go straight over that non doctor's head. Right? But you know, you're right.
Other doctors are not gonna be the clientele that you're trying to get. And I think we take it for granted, right? Because, for most of us, we just get hired into a clinical [00:12:00] situation. Somebody else is in charge of marketing, you know, this bigger company, either if we work for a hospice system or, you know, even if private practice, you've hired somebody else to do that and you just focus on that.
But, you know, especially, starting up and, being bare bones. you don't think about those things until you have to, and then we just don't understand. And I think another thing, and when we were coaching other doctors to transition to telemedicine, one of the things that stood out was, you've kind of mentioned it, but the transition from being a physician to an entrepreneur, not just the language, but also the mindset.
it's that mindset approach. And this comes up often I think in a lot of discussions, especially with other platforms, and it's helping build other platforms as a doctor side changing your risk profile and changing how you approach problems. You know, as physicians, as clinicians, we are set to have the lowest risk profile that we can.
Phoebe: We want you to [00:13:00] have a low risk profile too. Yes. In the clinical side, you don't wanna
Leo: kill anybody. Right.
Phoebe: it's this double-edged sword, right? Yeah. Where like, I wouldn't tell a doctor to be like, take that risk during that knee surgery. Like, you do that thing that you think feels good in your gut, right?
But on the business side. it's that experimental side that physicians are not taught to be comfortable with.
Leo: Yeah. We're not, and this actually came up, I went to Health and went to a couple of talks and this came up specifically, you know, the business guys were talking about dealing with doctors.
And doctors could not get over the whole approach. Oh, we're just gonna do it and if it fails, it fails. No. Doctors are very used to. Making proactive plans where the risk of failure once it's implemented is as near as zero as we could get. And really the timeframe and how quick things churn, especially in the business entrepreneurial side, you just can't do that or you're just gonna get bypassed.
Nothing will move. And I think there's a lot of friction when it comes down to, you know, if you have [00:14:00] a clinician, physician, leader versus a business leader and how to approach things, you're gonna get that friction. 'cause one side, usually the business side is just go, go, go, go, go.
While. The clinician side is like, Hey let's formulate this plan. Let's try to think, you know, what are A, B, C, and let's see what's going on. But that takes a while, right?
Phoebe: Yeah. Well, and I think that's one of the things why, like, working with clinicians, it's actually been really interesting because, so I get 90, not a hundred percent of my business from people that come to the, how do I do the MSO, how do I do the what is this rule?
how do I set up the business? And then it's like after the first conversation or two conversations like that, I mean, that's the easy part. The hard part is all these other things that you haven't thought about, which is how am I gonna stay motivated?
Leo: Yeah.
Phoebe: How am I going to work with a web developer when I've never worked with a web developer before?
I mean, I just had a client who's, somebody you're working with who you know, had never thought about the [00:15:00] marketing and the web development side of it and was like, I don't even know what to do. And again, it's like my experience in working in these companies is like. It's not a problem.
We gotta write some content. so to me half of it is all these things that, you know, to your point, were taken care of at other companies, and it's the angle of, is it possible the compliance side, that's actually relatively easy. It's the hard part is getting your first patient.
Figuring out how you're gonna network and getting out of that, like discomfort of kind of being an imposter a little bit.
Leo: Oh, Absolutely. Getting over that is huge.
Phoebe: Yeah, I mean, I met with one of my doctor clients and I was trying to, explain to him about, let's do some, meal plans.
let's throw some cool stuff in here. And his doctor's like, well, you know, we just prescribe and what, and I'm like. We are gonna get you to be real holistic. You know, like some of it is just pump, reminding you [00:16:00] guys that like you're smart and
Yeah. You don't just have to prescribe. There's so many other things that you can do and you could layer this thing in and you can layer that thing in and it's not, certain things aren't risky even though, traditionally they might have seen so, you know, we totally derailed this. I was gonna talk about like the steps, but
Leo: No, but this is important, right?
This is important because, this is one of the major speed bumps, you know, the inhibitors that will prevent people from actually taking off even, you know, just getting over the mental hump of this, right? a lot of doctors will hit this. And they're like, I don't know how to do that.
I don't know how to market. I'm scared to market myself. I'm scared to put myself out there. I'm scared to take risks, and that will actually prevent them from going forward. Right? and then, you know, we go back into kind of the clinical shell or the shell that we're so used to the kind of golden handcuffs that, we're very [00:17:00] comfortable in.
But we're just stuck in status quo. Right. You know, it prevents us from actually making that step because, you know, a lot of us are so scared to do things that, we haven't done, honestly. we've been training for two decades just to make it as an attending. and really I think part of the process too is getting there, It was very traumatic just to get there, you know, like, yeah. So, do I wanna learn something new? You know, at least for me personally, learning something new. In that sense. There's a lot of emotional trauma that came with just the residency, so forth and so on.
I don't wanna relive that, you know? Do I have to relive that when I wanna learn something new? I don't know. So,
Phoebe: yeah, I mean, true. I've never even thought about that perspective of like. How traumatizing, residency and med school and like the whole thing. I can assure you it's not that painful.
And that hard and you know, my biggest thing again is like, this is where you, sometimes just need a thought partner. Sometimes you [00:18:00] really just need somebody to brainstorm with and be like, am I crazy? am I losing it here? I think half of the battle is that right?
So it's like, I am, a huge believer in private practice. I think it's the future of healthcare in America. I think that it gives people choice. I think it gives people higher quality care, and I think it would truly, truly, Change the healthcare burnout epidemic that we are in. it kills me.
I mean, how many doctors do I know Leo a hundred probably at this point. And it's so sad for me to hear how sad all these doctors are, or all these nurses, or all these physician assistants, and it's like, y'all get into this field. To give care, to help people, to educate, then you get there and you're not able to care or educate
Or do anything. 'cause you're so scared that you're gonna get sued because it's been pumped into you
Leo: well, The numbers are out there. Like last year during one of the a TA, lectures, they put the numbers out there. 80% of the docs now are [00:19:00] employed.
Way or the other, they've been driven out of private practice and 80% of the providers are either employed by a big health system, you know, VC backed health system, so forth and so on. But it's funny going on another tangent, you know, how many of those systems have failed, right? How many are going back and now bankrupt?
And now, trying to get bought out by another entity, right? So, yeah, no, that's interesting kind of numbers there.
Phoebe: I don't think people trust insurance. oh, absolutely not. I don't think so. I trust you're my pediatrician. You know, I have another emergency medicine doctor who helps me, my hormones.
You know, it's like to me, I don't trust insurance and a lot of the clients that I work with, they're not taking insurance. The ones that do, again, they're Medicare, medicaid programs. Really trying to focus on expanding access in places where there isn't any. And so to me it's this really interesting, thing where I do, I think that doctors could find new passions, they [00:20:00] could be reinvigorated and I don't think it would take that many patients.
To honestly build your practice up to where you're self sustaining. The hardest part about it is it takes time and we live in a society that is so impatient and has real issues with like instant gratification, but for doctors who are doing locums and doing telemedicine gigs, like you could very easily build your own practice at your own pace and like do it the right way yourself.
You know, the right compliant way. Provide the services you wanna provide, the way you wanna provide it, and, to me, I think that's the future of what we need in America. I do not believe that insurance has our best interest at hand.
And I think. The longer that we're all thrown into the, I mean, we had Wyatt on a couple months ago talking about how much cheaper it is to get, a [00:21:00] service if it's cash pay versus Yeah. You know, bill insurance. and that's what I think about, like, at the end of the day, you know, I might as well just every month that I'm gonna pay to a premium, I'm just gonna throw it into my savings account.
Save up. and then pay cash for services. Oh, you have bigger
Leo: balls than I do.
Phoebe: Yeah.
Leo: when he said that, I was like, oh yeah, that sounds great. Gosh, you know, that's a big leap of faith.
Phoebe: I mean, will I ever leave Kaiser? No. My husband's a government worker, so I'm covered.
But the last time I went to Kaiser, I mean, it's probably been five years, yeah. Sorry, this took a crazy turn into my opinion about the insurance industry. You know, I will, just to tie it all up, I've been inundated with people asking, and again, it's a nurse, it's a physician, it's a chiropractor.
It's a nutritionist. Every single story has been. I wanna provide care because I'm so passionate about X and I can't do it because of [00:22:00] Y. I work for this clinic and they don't let me provide the diabetes care. I want to, I work here and I can't do this thing and I'm so burnt out and I hate it. And so to me there has not been a single person that I was like, you can't.
Yeah, I've been able to like tell them exactly like how to get that process started. And I am, heavily convinced that more and more people are leaning into it. And so I really here just wanted to explain like, it is possible. So if you've heard that it's not, it is, is it complicated and does it take time and is it a little tough just like everything else in this world, right?
But for the clients that I had, we're gonna have them on in a couple weeks, but, you know, a group of PAs that all launch separate private practices and they all, you know, have been leading up to this launch and, you know, finally launch and are getting their first patients, they are so happy and glowing.
it's great. So to me it's like it showing those success stories and being able to share [00:23:00] this stuff more and more I think is just really important because it's all possible. you just gotta figure out how to do it. Come up with a plan, make sure you're doing it the compliant way, 'cause no one's going to jail.
And stay motivated and have some encouragement and the right support in your corner.
Leo: No, no, this is good words of wisdom too. And I'm gonna exclamation point the compliance part too. You know, we've had a couple of guests here that, all in agreement, right? You know, one of the pieces of the puzzle is even in early on, is compliance, right?
You know, in addition to your market plan, in addition to, you know, the right finances, you know how to move the finances, the ownership structure with A-P-C-M-S-O, and, that's another puzzle, right? You were talking about? Just depending on what state.
Phoebe: I cracked it. But yes, it's a
Leo: puzzle.
it's tough though. It's funny, 'cause a lot of people don't realize, you know. With this P-C-M-S-O structure that there's a way the money has to flow and [00:24:00] to structure that is confusing to a lot of people,
Phoebe: and that's what regulators look at.
Leo: Oh, yeah.
Phoebe:
Leo: first.
Phoebe: Well, let us see your bank accounts and you know, that's the first thing people look at. so, yeah, I think, again, it's really easy to set things up incorrectly. So do it the right way, because it's not more work, it's a lot more work to unwind.
Leo: yeah.
Phoebe: But, yeah. there's a lot of other pieces. I know we glazed over it. I think what I'm trying to say too is there are a lot of pieces, so get ready for a little bit of a rollercoaster ride, but it is not something that's in perpetuity. I think most of my clients have been able to set up in about two to three months.
Leo: Oh, yeah. actually, you answered the question even before I asked it. Yeah, it does take some time, but it doesn't necessarily take that long. How much does it cost around, conservatively, right? Depending on what lawyer you get, so forth and so on, and a lot of times you've been able to actually save people money, right?
Bypassing the legal costs. 'cause you know how to set up the PC MSO [00:25:00] structure. Of course you need legal, right? you need to have somebody on retainer in your corner. But, when I was looking into it, setting up P-C-M-S-O legal actually was like, Hey, you know, we could do it, it's very expensive, but here's some people that can, so they actually farm it out. But, how much would that cost in terms of just planning ahead.
Phoebe: Yeah. I mean, so you would wanna think about what your business entity fees are. Mm-hmm. In some states, like, I mean, I could say California, you're paying about, I don't know, to set everything up, probably like 500 bucks plus the cost of your annual taxes.
California has like an $800 fee. Let's say you do Delaware, lots of people do Delaware for tax purposes. Delaware is like $300, so you're looking at like 300 bucks to get the business set up, right? Mm-hmm. There's a couple fees that you're gonna need to have day one malpractice. Of course, as a physician, you're gonna need malpractice, right?
From a business side, like I'm gonna tell y'all to get, you know, professional liability, you're gonna want cyber insurance. So, malpractice, let's say [00:26:00] is three grand a year. You know those other ones that I just mentioned, probably another thousand. So $4,000 a year for full protection, right? Let's get you protected.
End to end. We're gonna wanna add some other softwares to make sure you know that you can scale. So, website, domain, email, registered agent, EHR. So, you know, you're looking at like a tech stack of let's say $300 a month, right? Yep. And that's mainly gonna be for your EHR 'cause I would encourage you to get.
A higher end EHR that kind of consolidates a lot of your tech stacks. You don't need a CRM, which is like how you track people and market, will wanna bake all of that in. again,
Leo: I encourage everybody to hire a va. Usually you can get a really solid part-time support for under a thousand dollars and a thousand is probably on the higher end.
I'm gonna exclamation point this one too 'cause dude, VA is worth weight in [00:27:00] gold, right? You think about how much you pay the VA versus how much you make per hour and how much they save you. if I had my VA work five hours a week, I've paid off the VA visas. And yeah,
a lot of doctors are like trying to skimp the VA part. I'm like, get a dang VA and let them do those things.
Phoebe: Yeah, noI completely agree. I think it's really important for people to. Delegate out the things that are not their strong suit. You know, I have had clients that are like, I can file my own business entity stuff.
I can do this. But I really struggle on, you know, the marketing side and it's like, well, let's get you a social media manager, VA, who can give you topics and can force you to give videos and yada, right? Let's try to make this as painless for you as possible. You can use a VA in it.
Any way that you want for the most part. And I've heard, you know, a lot of physicians are like, how should I, it's like you tell me like, what if, so I always say, delegate the things that you [00:28:00] can't support, get the support that you need, right? So
Leo: mm-hmm.
Phoebe: You're gonna also have just like service fees.
So as you think about it, you're gonna need an accountant.
Leo: Yeah.
Phoebe: And then depending on like legal fees. So some people actually join other kind of like legal networks, which is what I recommend 'cause it's so much cheaper. You can get on something called up counsel and have different documents reviewed.
If you're going the legal route to have like the contracts and all that set up, you're probably looking at around $10,000 for that entire process. Which I know that attorneys that are listening are gonna hate this, but like it's all templates. The hard part is figuring out what. The attorney won't tell you, which is what is fair market value.
And that's where we gotta get creative. And it is an interesting thing. But I digress. so those are kind of the key things that you need to think about in terms of like a budget, right? Yeah. So really depending, the things that are the most important are you need the business set up.
You need your malpractice. You need your tech stack to kind of get [00:29:00] started. Whether or not you wanna do the expanded insurance when you start is up to you whether or not you want to have, you know, support or, you know, have legal assistance or get a consultant or whatever. All of those other things are kind of optional.
So I say you can definitely do it for under, a thousand dollars.
Leo: Yeah. that's not a bad piece of change , right. Especially if it's going against your expenses and whatnot.
Phoebe: Yeah, and I always say too, one interesting thing that I've seen a lot of success in is I think everybody needs some sort of encouragement.
So when I first started my consulting firm it was me and my sister-in-law. didn't work out, but she gave me the encouragement to actually do it and jump in. I have a couple clients that are,they're partnerships. It's mm-hmm. Two nps, a PA, and an np a physician and an np.
And to me it's this interesting thing where they kind of hold each other accountable and force each [00:30:00] other to keep pushing. Yeah. And so if this is something that you're a little scared about. I do recommend like, have a conversation with one of your colleagues. 'cause I can almost guarantee they're thinking the same thing.
Unless they're like fresh outta like med school or PA school, then they're probably still real happy
Leo: with life.
Phoebe: They really still have life.
Leo: there's no salt on 'em yet.
Phoebe: Yeah. No rust. Well that was funny. I saw a meme the other day and then like I reposted it and it was like, if you haven't thought about like selling feet pictures on the internet, like do you really even work in healthcare?
I
Leo: was like,
Phoebe: feel that one.
Leo: That is so true. They're so bright eye and bushy tailed. It's so cute when they first come out.
Phoebe: but I think that's the sad thing too, right?
I think it happens in a lot of these professional industries where you are going to school. And it's fun because you're learning and you're, going through those motions. It's the practice aspect, I think that is the [00:31:00] fun part, right?
Leo: Yeah.
Phoebe: And it's exciting. I think what gets hard is there gets to be a point where you are the expert, right?
What do they say in med schools? C one, do one, teach one,
Leo: yeah. See one, do one, teach one.
Phoebe: So you get to that point where you're like, okay, like now I wanna go teach people. And then you have. Insurance or whatever system, but no, you can't, like, we actually can't have you say those things that we've trained you to have this brain and to think this way and to assess like, we actually don't want you to do that.
Go read from this screening tool that's in this system, or click this button. And I think that just turns into this idea where it's not fun. It's not exciting. It's you just, yeah.
Leo: Well that's a big part of the burnout, aspect, right?
Phoebe: Yeah.
Leo: Yeah. No, most definitely.
Phoebe: Yeah. I mean, that's why I do startups, to be perfectly honest.
I get Certain things just get kind of boring. I like learning. Yeah. I learn something new from every single client because I don't go in going, I've done this before. I know exactly what to do. every [00:32:00] single one is so different because that's what makes it fun. I tell you what not to do.
I tell you, what I've seen work and what hasn't worked, but at the end of the day, You know, like the part of the process is like, it, everything should be not so customary. Yeah. Everything should be, different.
Leo: How, how can they get in contact with you if people are like, Hey, I need help, Phoebe.
Phoebe: Oh Phoebe at Camino. So my name at Camino, C-A-M-I-N-O-S g.com. Or. phoebe@telemedicinetalks.com. I joke and say if five minutes with me can save you hours of pain and anxiety and frustration, I will give you 10 minutes.
so please don't hesitate with reaching out. I believe so much that we need this is one of the reasons why, this is my niche, you know, I really believe in making this work for the people who [00:33:00] need to provide our care.
Leo: Thanks. I know I lean on you a lot for these things too, so Definitely.
Phoebe: But that's how it's supposed to be. Yeah. Right. Like to me it's so funny, I spend a lot of my time. we talk, we brainstorm. I mean, Leo, you know how I work 'cause you get it. 'cause we're friends. that's how I am with a lot of, my doctor friends.
And it is funny because. You're able to just work through stuff so much easier when you have somebody in your corner.
Leo: you can't do this on your own. Especially nowadays, you know, I bet you there's one or two that are like, oh, okay.
I know it all but there's a lot of things that we don't know that we don't know. So getting people in your corner to work things out, especially people that have definitely already is critical. Yeah. Absolutely.
Phoebe: Yeah.
Leo: Cool. Shoot, you know how to get in touch with Phoebe. Drop us a line too. If you wanna be on, just drop us a line as well, info@telemedicinetalks.com and yeah, no, thanks for listening.
Phoebe. any last words of wisdom?
Phoebe: No, just,
do it the right way if you're gonna do it. [00:34:00] Otherwise, you're just gonna spend a lot of time. Staying awake at night and unwinding things and paying a lot of money that you don't wanna pay.
Leo: of unnecessary money.
We've seen that a lot too. A lot. Yeah. Well, hey thanks for listening and we will see you back next week. Thanks, y'all.