What does it really take to leave traditional practice and launch a specialized telemedicine clinic? In this episode of Telemedicine Talks, host Phoebe Gutierrez sits down with Savannah Elkins (PA) and Katie Wakeland (NP), both Type 1 diabetics themselves, just seven weeks after launching Type 1 Telehealth, their endocrinology practice dedicated exclusively to patients with Type 1 Diabetes in Texas.
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:
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
📱 Instagram: https://www.instagram.com/type1telehealth
About the Host:
[00:00:00] Hey everyone. Welcome back to an episode of Telemedicine Talks. This is Phoebe Gutierrez, and today I am doing a solo episode. No Leo, no surf vibes. but I am joined with some dear friends who've actually already been on our show.
but we are gonna be spotlighting type one telemedicine today. Welcome Savannah and Katie.
Thank you. Thank you for having us.
of course. last time you guys were on, I think you were really gearing up to launch your practice and I thought maybe, this time, since it's just you both, you could, we could talk a little bit just about, How you started, when you started to get this idea and really how long it took for you to, get to where you're at. Where now what? You're month two, right?
we just finished week seven. Yeah.
We lost track of time.
I
it reminds me of when you have a baby and you're like, the baby's eight 18 hours old. You're all week [00:01:00] seven.
Yeah.
In your infancy. It's, no, it's great. It's great. for those listening, do you guys mind just, maybe sharing a little bit about your practice and who you are?
Yeah. Katie, you got it. Oh me. Okay, I'm gonna go. so we are the people behind type one telehealth. We are a, endocrinology subspecialty practice meant for patients with type one diabetes and we are licensed in Texas right now. so Savannah and I met in traditional endocrinology, and we are both Type one diabetics and so we had a strong passion for.
the medicine behind type one and the pathophysiology of that, but also just the patients we loved taking care of those, types of patients in that population. And we felt like in the traditional medicine and traditional endocrinology, we could give more and we wanted to give so much more. And so we sat down one day, probably almost about a year [00:02:00] ago now, and said, what's the dream?
What do we wanna do? How can we do this? and we're just toying with the idea of, starting something on our own meant for type ones, from type ones to type ones. and that was the birth of type one telehealth. And I'll let you take over.
I, and that's a perfect explanation.
I'll just take over from about November timeframe. Katie and I left our previous positions and then the moment that her and I were both done is when we buckled down and got serious. And, I honestly can't believe how quickly things moved. that was the biggest surprise of it all. But again, that's like a huge thanks to having helpers like you, Phoebe, and like ipac giving us the guidance and the general gist of, this is the process and here's a good timeline and having a idea.
'cause Katie and I had no idea what we were doing. and learned about formation, that was the most important and the biggest piece of it all. And that's [00:03:00] what took the most time and what should take the most time. So you're doing it. correctly and compliantly. and then, the search for finding a supervising physician took a little bit of time as well.
but then once things got rolling, we have connections. We're very grateful for including, Katie's husband. And so we had basically in. Marketing Right there. He made our website and, was able to get us, and he like, I didn't know what SEO was before starting this, but he's all about it.
We know what that means now.
Yeah.
That was a huge piece of it. That was like a, that's why we were able to get going so quickly is because within the blink of an eye for me, I'm sure it wasn't for Matt, but in the blink of an eye for me, the website was up. Running and it was going. And, then we learned social media and then we opened our doors March 2nd.
And, we're here today with patients to take care of now. It's wild.
no. I love your story only because, not only because, [00:04:00] but I think, it always cracks me up when I talk to you, Savannah. 'cause you're so shocked. every little, you're like, we have these people like, it's I find it like.
Thing because I'm like, yeah, because like you guys built a practice that, what I always preach is you ha you have to build what you wish was out there for yourself. And if you do that, you're gonna find people that are pretty, relatable Basically you'll be able to find the right patients because you have the lived experience. maybe could you talk a little bit about, some of like your, like marketing strategies of like how you were planning outside of the website and outside of some of those, like traditional, things that you just have to do, but how are some of the other, what are some of the other tactics that you've started to do to try and increase, both brand recognition but also just like being able to like, get in with your community and find patients.
S
lots of meetings. We did a lot of, a lot more in-person meetings than you would imagine, just local to DFW. Katie hit the nail on the head. We started with the local charity, and so that was one of the very first meetings that we [00:05:00] had, which was Breakthrough. T 1D expressed our interest and not only selfishly Hey.
Tell patients about us, but really Hey, we have time. Help us get back involved into break through T 1D as a mutual relationship. and so we did a summit, and then that summit was basically just a, a tent and table and getting our names out and handing out flyers and. But it's also something very important to Katie and I both in the world of Type one diabetes, there is technology and it is changing by the month, by the week, honestly.
and something that's very important to us is staying on top of all of it so that we can tell our patients all of the information, not just pick one and say, this is what you should use. that way the patient can have the best understanding of what's out there and what they can do. So in order to do that, we meet with.
All of our reps frequently. And so we talk to our reps and we say, Hey, tell us what's new and what's coming and what do we need to [00:06:00] know? so there's those meetings as well. And, I don't know. Do you have anything to add, Katie?
social media. So we were born into social media. This was my first Instagram, profile.
First TikTok for the both of us. And, we just flew into it. Thank you. Chat, GBT for all the, real recommendations and scripts, and, caption, Scripts and everything like that, but that's really where a lot of, faces are getting in front of our name is through our socials from what we've learned.
and then word of mouth like we think. Both, thankfully and, not so thankfully have a very tight niche community in the type one world. and each kind of local, group has their own chapter and they're locked in and everybody knows everybody, for the most part. And so word of mouth in the niche community goes a long way.
and so getting connected to breakthrough, T [00:07:00] 1D was like our kind of. First, not that we wanted it for exposure, but we really wanted to help and we wanna be part of that advocacy and that research and everything going on because we, not only do we want patients, but we want to have a cure to one day selfishly, for ourselves.
and so any way that we can contribute to that community in itself is, beneficial to us and for our patients.
Yeah, no, I think it's, I think one interesting theme that I've noticed across my clientele, are the people that have in my opinion, like the strongest practices, are the providers like you that are.
Constantly educating themselves. So it's really interesting. I find it,I'm one of those people. I learn something new every day. I'm always like, half the time I do consulting sessions, I like don't know the answer at that moment. I always have to go back and do the research. And I find it funny is you have one subset of providers that are like very stuck on the oh, I'm just gonna do my traditional CME and call it a day.
And then you [00:08:00] have where you guys are at now of no. Like it's like this, like business owner, like learning hat of I need to know all the things about all the different devices because like I owe that to my patients. And I need to, research this and, oh, gosh. Yeah. I mean, Savannah, we were researching Medicare stuff.
you're constantly having to stay fresh on all these things because that's the stuff that matters to your patients. And it's no longer that you're just there for that sliver, but you're, really trying to meet them where they're at and give them, the best experience.
Yes.
Yeah. Yeah. And that was the whole thought process behind this. a, it's the time required to do all of what we wanted to do in a visit from an education sense to, talking about prescriptions, talking about new things that are coming up and about that patients may be interested in or their family members even maybe interested in.
but alongside of that kind of meeting where medicine is, and then the reality of life with this chronic disease, and then giving both of those. And ends to our [00:09:00] patients during that visit so they don't have to go four different places to get, everything when they could just get it from us.
Yeah. In an hour or two.
Yeah. And that's, and the reality is like that is honestly what it's taking. Like the consults are no short of an hour. and. I'm okay with that. I'm not even looking at the clock. It doesn't matter. It's just whatever time the patient needs is the time that the patient needs.
But I don't have someone on my back saying that I have to get outta that room and move on to the next one. It's just. Being able to take a whole list of we have a questionnaire, right? And it's an open form so they can put whatever they would like to get outta the visit and like making sure, not just, okay, we'll cover the first two things and then next time I see you, no, it's like we're here.
Let's go through it all and we'll keep going over it again, but we'll make sure that we get you covered, fully. So it's funny, like people that are reaching out to us are not. Seeking prescriptions like they [00:10:00] want to do better all around, blood sugar wise, health wise, all of the things. So it's been very rewarding.
Yeah, you know, not to go down like a completely different rabbit hole, I think that's the frustration of like consumers, when we're talking about, the healthcare system is, I don't really care too much what you're prescribing. I'm trying to talk to somebody who can like actually educate me.
Like clinically, and then you go to a doctor's appointment and they have to read off of their little like protocol script and you're like, can somebody just tell me what's going on with my body? And I wanna feel better so I can manage my own health a little bit better. and so I think, to your point, Savannah, is you're able to not.
Not correlate so much of okay, we have this allotment of time to be able to cover maybe one portion or two portions. But it's sure. Like I'm sure probably the first few appointments, are gonna take a lot more time. And then once you get in the groove, just like anything, it'll probably taper down to a place where, people are self-sustaining.
So is that kind [00:11:00] of, how many, I guess since you guys are month two. So how kinda, how does your model work when it comes to, seeing patients? Is it like monthly? Is it quarterly? how does that work?
So we have a few options, because every person is different and during the period of your life, we may need, to see you more often.
And so we do have a monthly membership, which is whenever you need us, whenever you need us. we can see you if you're paying that monthly. And then we have the per visit, just standard price if you wanna do payments from visit to visit. And then we do have annual packages that have including, either three visits in the year or four visits in the year, just depending on how, stable you are, in your.
Current diabetes management and if everything is looking good, you don't need a whole heck of a lot from us. we don't need to see you as often and we'll be the first ones to tell you that. But then you have those patients who are newly diagnosed in a brand new world, where your whole life is about [00:12:00] to change and those obviously need a whole lot more attention, a whole lot more time and a whole lot more frequency in their visits.
And then you have patients that are wanting to try new technology. And so anytime we're changing therapy, we obviously. We need to see you a little bit sooner to make sure things are working, everything's going well. We don't need to change anything. And then we talk about pregnancy, we talk about,GLP one medications, which are important in the type one population.
And there's a lot of research and studies going on, with those medications for type one diabetics. which we should hopefully see in the near future in the FDA approvals. But, but it just depends person to person. And so we wanted to create this model that gave. Every person an option and an opportunity for, Hey, I don't need to, I'm good.
I've done this for 27 years. I just wanna touch base with you every, six months. And that's okay. We understand that would be me as a patient. and then we have those patients that just either want a little bit more, one-on-one attention or a little more [00:13:00] frequency, or talking about pregnancy where things change very quickly in the, in the disease process.
And so we just wanted to make sure we covered everything at something that wasn't gonna be,outrageous in cost. Because we know medication supplies, everything else as a type one diabetic can become incredibly expensive.
as you guys were exploring like pricing and your offers and even just, having the different kind of like encounters and visits with patients, what were some of the things I think that you either.
Were like learning lessons or things that kind of caught you. off guard a little bit.
I think one of the biggest positive changes we made was allowing the patient and we did before, but we made it in a very bookable way now, allowing the patient to meet with us before committing to anything.
that was the most positive change. And so that allows, so we have a, what we call a diabetes strategy session, which is not. It's intended to [00:14:00] be any sort of medical advice or anything. It's just what are your goals? Will we be able to help you reach those goals? And also, who are you and who are we?
And so the patient can determine what they think from that. So that was a pivot from the original, like what we came out with, with a consultation to doing that in the 15 minute visit. That was, something that I think worked to our benefit. That's been a really good thing.
Yeah. Yeah. And interestingly enough, I tell a lot of clients, Savannah, you're, you are, you're part of ipac,I'm always like, yeah, you have to do a free 15 minute visit because it's such a competitive landscape now.
And with so many other click and buy telemedicine, you guys are really selling yourself. I couldn't imagine having a visit with Savannah and being like, Nope. Not gonna book this.
We do have a very high conversion rate, I will tell you that. Yeah.
it's good. I think, I think it's the whole idea is you wanna be able to convert all the [00:15:00] leads that come to you, and sometimes it. it takes them a little bit of time and a little bit of sales. And I think that, that's the point of the first,the first encounter before somebody has to commit, because with insurance, you don't really, it's a, you're playing with, I don't wanna call it free money, but it's a little, you're, I think your standards are a little bit lower.
you're not having to put money on the table versus in like the cash pay industry. you have to pay a little bit, but. No, that's, I think that's an awesome pivot. I wish more. I think a lot of the concierge providers that I work with I know, have that model.
And do you know, to your point, Katie, see a pretty solid conversion rate? Have you guys, now that you're starting to get your, I don't wanna call it like feet wet, you're starting to get patients, you're seeing growth, probably week after week. are there any, you're, and you're solely telemedicine right now?
Yes.
Has, have you guys thought about doing any other kind of like hybrid approaches as you expand and grow? [00:16:00]
So I'll let you talk about your pump training skating, what that looks like too. 'cause Katie does. Something else outside of type one telehealth where she does see patients in person.
Yeah,I am a contractor with a couple of different insulin pump companies and I do trainings, for those pumps. And the goal in the end was to,convert it to the practice and therefore we would be doing. when we prescribe the insulin pump for the patient, we would also be training them on how to use it and then providing the follow up, setting changes, anything necessary in that end.
And so that,allows for a little bit of a hybrid. So during the training, a lot our, in person, if they're local or within a place that I can drive to, easily, and so we can meet up in person to do those trainings. Specifically, otherwise, it's standard for the visits themselves are telemedicine For right now,
I don't know if I see a future of [00:17:00] in-person in particular because the goal is to make the purpose of our business model is accessibility and flexibility.
And so we're trying to break away from, I joke all the time with people and I'm like, why? and. This is gonna sound bad so that I'm saying this as a joke everybody. I'm not saying 'cause I don't understand, but like why is diabetes a part of endocrinology? I know the answer to this, I understand the pathophys, but I just feel like we could be our own specialty.
there really could just be a diabetes. Doctor, and I feel like when we put diabetes type one or type two in the midst of all the other endocrinopathies, that it gets lost and muddled within all the other things that are seen. And a lot of those. Need to be in person. We need to see a thyroid patient in person.
For the most part, we need to evaluate the actual thyroid gland. There's a lot of things there. There's things with diabetes as well, which is why we tell our patients they have to [00:18:00] have a primary care doctor in order to evaluate their skin, look for lesions, everything, neuropathy wise. All of this, but for the most part, a well controlled type one who has a primary care does not need to be seen in person for their routine.
Let me look at your data checks and how are you doing? And let's talk about your mental health and the burden with diabetes. This is all things that can be done virtually, and so as much as I do miss patient facing, I want to help break this mold that diabetes care is so traditionally
set in.
yeah, no, I agree. I agree. I think the way people view telemedicine is, it's in twofold. I think, we do, we have a lot of,private practices that are, honestly, you can probably not. There's really not too much of a difference beside, besides seeing the person physically that like the care is not lower or different or shorter or anything.
And then, again, on the [00:19:00] other, telemedicine, click and buy, type of model, which is like the complete opposite, which again, I think. Leaves, different tastes and regulators', mouths around why certain things have to be in person and so on and so forth. taking a different, kinds of question.
Katie, you're a nurse practitioner. Savannah, you're a pa. Yes. and one thing that you know, always comes up is this concept of, I have to have a supervising, physician. I have to have a, private practice owner that's a physician. it makes a lot of people really uncomfortable.
But I thought maybe it might be interesting to just share what your experience has been like, going through that process with, this third party doctor that you just meet through, through, word of mouth, in terms of, really trying to like, build your business alongside this kind of, partner.
I think from [00:20:00] an emotional standpoint, the first part is fear because you, it's scary. It's what are, first of all, it's a whole business and you're inviting a another person into the business, and so there's a big scary piece of it and I hear people that are interested in started telling us in practice and they're considering, Doing something that doesn't involve practicing medicine itself or prescribing for this reason. And I understand that I was in that position where this was big and scary at one time, but I think what helped to get us through is the fact that this is an established model. and so whenever we. Talk to you, Phoebe.
Learned about the P-C-M-S-O, read up on the rules and regulations. We did hire legal, and legal helped us and confirmed that what we were doing was the best model. They helped us with, creating the documentation. It felt safe, and they also just very much. Suggest that this is common, like people do this and that we're not the first of [00:21:00] anybody to do this.
not to mention we have a great supervising, but it's also having the confidence that Katie and I know what we are doing and we would. Seek outside help if we had questions. There's no doubt about that, but we are confident in managing type one diabetes from a personal and professional standpoint.
I don't know if this is for a new grad who has never practiced and been feet wet. that would alarm me a little bit. But having experienced. in this realm, it gave me the confidence at least to say, okay, I know that I can do this and I will ask for help if I need it. And not only that, but I have Katie too.
Katie and I bounce back and forth all the time as well, so there's that. But I'll let Katie speak .
Yeah, and I think just to add, it's trust building, right? And so anytime you're stepping into something that puts you. in front exposed, incredibly vulnerable. It's hard to do anything, without kind of 20 different people saying, [00:22:00] no, it's okay.
Like you're doing it great, and you're gonna be okay. And so it took a long time for us to. jump in that water in the first place and decide that we could do this. And then we met with, a couple of different physicians, and found a great match for us. And, my, our physician is an ER physician, licensed, and I was an ER nurse for 10 years.
And so I was like, yep, I trust him. We're good. That's my people.
No, I think you hit the nail on the head. I think it is. It's all trust building. So to me, I think, I did like a social media post about it. but I find it so funny that clinicians are also risk adverse and then so many will enter into these relationships and be.
I'm not talking to the doctor and then the doctor doesn't. I'm like, wait, hold on. not again. like to your point, Savannah, I definitely don't think that, I think independent practice really is supposed to be reserved for people that are, can independently practice, right? They don't need this.
So much clinical [00:23:00] oversight, oversight in my opinion is still very good because mistakes happen and you want somebody to be able to like just help you like course correct when those moments, but for the most part, it's not like you're gonna be. relying on them for all these other things.
But I, I do find it funny that a lot of people will enter into certain things like this and then have zero relationship. but I'm also, yeah. I don't
see how that's possible.
Yeah,
it's really interesting. I've seen it. So many times where yeah, they will be like, I haven't talked to the doctor in a year and a half.
And I'm like, you're grossly outta compliance. But also that
doesn't sound good.
Also, like, why are you like, you're, why are you paying them? I'm confused. so one thing that I think also is like really interesting and I'm curious to get both of your take is,outside of ipac. other providers had done this completely independently.
Savannah was the one who was like, no, I have a partner. and so I [00:24:00] wanted to get your take on how it's been doing this kind of like within As friends, as partners, but also if that had anything to do with like where you guys think you are today, like your overall success in terms of speed, being able to just push through the hard times.
yeah. It's, but a hundred percent a partnership. So we both have our own strengths. We both have our own weaknesses. I'm not gonna get emotional. Katie is, she's more of a sister to me at this point. and so I would not have had the courage to start this without her because it was just like the times that I got scared, she was all in, and the times that she was nervous and losing sleep, I was like, I don't think that's.
That big of a deal, respectfully, we're gonna figure it out, And so having the, balance of that kind of, marriage partnership of being able to go back and forth has been, essential because I feel like I would be down in the dumps. [00:25:00] A lot more, a lot harder on myself if I didn't have,somebody else saying , it's not as bad as it seems, it's not as great as it seems like we just level each other out, in that way.
And I, I like from the very beginning though, I don't know if I would've had the courage to really take on and move forward without her saying yes, we can do this. I really believe in that .
Yeah, I mean it's, and it's a balance. and it's a true relationship. It really is. and you have to know your partner and, we've grown to know each other very well over the last, two years that we've been together.
all of the ups and downs. And so her strengths are my weaknesses and my strengths are her weaknesses. And it just ends up that we sat down one day and I think my literal words were, what's the dream? And you said this, and I said, okay, let's do it. This is day one. and that's where we are.
And it's been a wild ride. [00:26:00] Wild, a lot of learning, more so than anything up to this point. because you're medically trained and you're, you go through so many years of school to get to this point, and then. Oh, by the way, let's throw just a whole,another degree essentially, or two degrees, because now you're in the business world and now we need you to understand marketing also to grow a business and advertising all of that.
And so all of these things that, we can bounce ideas off of each other and learn from each other and learn from our mistakes. and it's just been, it's been great. And then truly. Truly it's been the growth that we've seen just with the business has been. Way beyond what I had ever would've thought we would be at this point.
which has been fantastic. But it's finally okay, the dream has hit that very first stage of reality where I'm like, all right, I can exhale just a little bit
to, to add to that, Phoebe, if I could. Last night, like I [00:27:00] said, Katie and I were together. We were at the breakthrough T 1D, gala. And, we were Type one, telehealth was a sponsor of the gala, and we got a unexpected announcement.
thank you. Shout out, in a room full of hundreds. It was, I'll paraphrase. It was like, special thanks to Katie Wakeland and Savannah Elkins who started Type one telehealth. This is a practice that is specializing for patients with type one diabetes. And, they recently got going or something like that, and a room of applause.
And it was one of those surreal moments where it was like, oh my gosh, We did this. it's not just a dream anymore. It's actually a reality. And, we had families there that know us on a professional level, and it was surreal. It was very cool.
Oh, that warms my little heart that, full circle.
full circle. I think the interesting thing though, Savannah and I said this like day one is. You. You did exactly what we [00:28:00] recommended. Get outta your community, talk to your people. Be boots on the ground. Go network. 'cause if you're trying to compete with insurance or these big companies.
It's just too hard. It really is too hard. And so you have to just go out there and, put yourself out there and do little events like this. And, gosh, this isn't a little event. This seems like a pretty massive event. So congrats guys. That's awesome.
Thank you. It was fun and it was a blast.
It was a blast.
I think, if, if you can go back and, do anything all over again, what would you do? What would you change?
Mine's gonna be snarky.
Go ahead
about social media.
Oh yeah. I, that was a necessary evil in my eyes, but mine, mine's in the lawyer category.
Oh yeah. It was very unexpectedly expensive.
Yeah.
Yeah.
Yeah. [00:29:00]
Yeah. we were quoted one thing and then it just kept adding up and we didn't realize it, 'cause we didn't have a visualization of how it was adding up until the month ended. And we were like, oh, okay.
That's our, yeah.
the interesting thing is the way. Not to go off on a tangent, but the way that it like works is they usually start out with a template and then they customize it as they understand what you're trying to do.
But getting that piece across is really difficult when you're talking to lawyers who've never actually built a private practice. So that kind of always been my struggle when working with lawyers is like, you can put whatever you want on the paper, but Operationally it doesn't work like that.
Or we can't do it like that, or, however, but, and then, yeah, and then they just bill you at the end of the month and it's here's a really big bill.
Yeah. I wish I could add to this, but I feel like I, I think I've been trying to give myself so much grace during this season that I'm trying not to see it as a mistake.[00:30:00]
Because we're learning and pivoting so much, and that's what's so amazing about Katie and I is neither of us are dead set in our ways. Like we're both willing to pivot. If it proves results, it's done. It's working. And that's where we're at today. Like everything that we've done up to this. Point, whether it costs money, whether it costs time, whatever it was, it's led us to, or both?
Yeah, or both. It's led us to the results that we have now and because we did the wrong things, if you wanna, put it that way, then. Because we did that, we're not doing it again. And so but I will say, like with that said, I've gotten a lot out of IPAC too. Like I bounce ideas off of that group as well.
And so it's giving me some shortcuts. It's been able to say even like the original pricing, we had that chat about it and I got that feedback from the group and. What do you guys think? And everyone was very generous. They were like, wow, that pricing is really good. For as much time as the CGM data interpretation is like Ashlyn [00:31:00] knows, she's I know what, that's very good price.
And I don't know. I don't know if I have anything that sticks out to me.
Yeah. I think, I think you answered my question of it's not so much that you have to do anything different, you guys just keep pivoting. So it's like when something happens, which I think is the perfect mentality that you have to have.
A lot of companies don't pivot soon enough. And so it's like after, oh my gosh, like it's this like painstakingly. Thing. I think you guys are, nimble and moving as it needed.
Yeah. And I think we have the same, top of the goal here or top of the pyramid that we want to reach, but like the journey up to it can be whatever it needs to be.
And we don't care. We'll pivot, we will, we're not stuck in a rut or, I am. Not that, I am not that confident to say that I know everything and how to get there. and I will say like going back, if on the opposite end of, regrets or [00:32:00] things that I would change if we, Savannah specifically, if we had not found ipac, I truly don't know where we would be.
I don't think we would be up and running in all honesty.
Yeah.
And maybe we would be, but maybe not Compliantly.
we would, she's right, we would not have our doors open to patients today. There's no way. Like we wouldn't have gone this quickly with confidence found the people found the super, there's just no way.
I know that we would've found a way, it just would've probably cost a lot more money would've been in compliance and it would've taken significantly more time. And so we have a database of patients that are probably very grateful that we found IPAC when we did because we've been able to make a huge difference already.
Aw. No, I think, I think the hardest part about all of this is I think everybody really wants a rule book. And so people go to an accountant or they go to a lawyer or they go to certain [00:33:00] things. And I think what I've learned over the years is sure there, there's absolutely a comp compliant ways to do things, right?
Like you have to set up your business entity in a certain structure and you have to set up your payments and there's certain things, and then 90. Like the other 90% is very variable and it is like really, like there's best practices and there's things that I would recommend, but ultimately,there's, to me there's like the.
The way that I see private practices needing to do things. And then I think there's a way that you could, do trial and error. go spend a bunch on ads and go, you know, get a website developer and spend, $10,000 or whatever. and I think, the whole purpose of IPAC really was just to make it so that it's.
It is not a scary thing jumping into private practice. Like it should not, somebody should not feel that they need to have $20,000 in the bank account before they can start to explore some of these ideas and we just want to, we need to support each other and like [00:34:00] we have fun at ipac. I think we have to conversation .
I learned stuff at track.
I was full, I was folding boxers. The last time I popped on Katie, I was literally just folding everybody.
That is so on point. Yeah.
I think the one struggle is especially not just in traditional medicine, but like in, in telemedicine. Rules are changing, things are emerging.
There's the different operational workflows that you guys probably never had to deal with before, right? So you're having to deal with all these other things that at a traditional telemedicine company. They have a team of 80 doing this stuff. They have a compliance team that actually fights with the legal team.
Compliance and legal would fight. Maybe that's why I have my thing with lawyers, but, because the lawyers will tell you the rules and the compliance team will be like, yeah, but that doesn't make any sense, but they have, we, they, we would have the infrastructure to support the clinician so y'all wouldn't have to Figure out, this stuff on your own. And so I'm [00:35:00] really happy that IP a's been able to supplement some of that gap for, the different practices that are getting up to speed.
Yeah. And that's been actually, I was like prepared for you to ask the question of what's our biggest struggle right now?
So I was like, thinking about it all day. but I think for Katie and I, both being clinicians, it's learning how to be a medical assistant and office manager. A front desk, like all the things, it's learning how to wear many hats and I thought I was not gonna like it, and I was really scared about it and I wanted to hire off the bat.
And Katie was very like, no, we have time. We can figure it out. I'm actually really grateful. Because to be a business owner, you have to wear every hat. You have to know what's going on because how in the world are you going to train somebody if you haven't done their job? Like it doesn't make sense.
And our biggest struggle, and we're getting help, we have meetings this week about it, is learning how, the most practical, let's put it that way to order [00:36:00] out of DME specifically is, so we're like, we're learning things that our medical assistants previously would take care of and like really help us with, but.
But we have a very special hat that we wear because we know if something didn't come out, the cost that we believe it should have as a type one, we're like, that doesn't sound right. I don't care what insurance you have. That doesn't sound right. And then we go back and we figure out why, and then we'll look at the deductible and the insurance.
'cause Katie and I have been working on this for 20 years ourselves personally, and They have basically a bulldog in us if things go wrong. So that's something the medical assistants like, they just took it as based value with the training they had. I don't blame them at all, but Katie and I have a little bit more, and we have also the personal stake of it, like we want the best cost and everything for our patients.
So that's what we're learning right now is how to wear the hats of duties that beyond running a business, like running a practice that we never wore [00:37:00] before.
Yeah. I think that's super important though. I think one of the reasons why I'm a solo, consultant I is the same thing.
It's you wanna wear all the hats because when it gets to the time that you need to train somebody on it, you actually have to understand what the best and like the right way is. I see a lot of practices that make the big mistake of, in my opinion, They launch and then they like immediately will hire like a virtual assistant or a medical assistant.
and then they defer to that person to figure out how to build the operations. And I'm like,wait, no, you, So like I, I'll do a lot of exercises, which I'm actually doing one with a client this week where it's no, we're gonna actually go through your whole patient encounter.
I'm gonna book an appointment, you're gonna run me through it. I'm gonna see, I'm gonna, let's try to order a prescription. Let's try to figure out where all the gaps are. And then you can go hire a person to do all the stuff you don't want to do, but you have to really understand it. 'cause you have to train them and it has to be, it's your brand, it's your [00:38:00] name.
So it's a representation of you both too.
Yes. Yeah, but that's a plug I wanna put in for type one telehealth is if you book with us, we are everything. Not saying it'll always be that way, but we're everything, and that's something so many people are unhappy. I remember a patient back in the day from previous practice that was like, I don't even wanna walk in here.
The energy is to like, it puts me in a bad mood to get off the elevator and, she's like, I love you, I love once I get here, I'm great. And, that always stuck. That always stuck with me because you have to think, a lot of patients are very unhappy with the practice and you can like, just look at any Google review.
The doctors are great, the practice is terrible. They'll never call you like all the things. And so I feel like. I feel like we need to put that on social this week. Like when you book with type one telehealth, you book with us. We are everything. We will from the very beginning to the. Seeing the patient.[00:39:00]
That's us.
Yeah. you guys are in the middle. You don't even realize it. But you're also like patient advocates, like patient navigators. Like those are all things that at large companies, they have titles. I don't know how many people that are patient advocates are actually patient advocates. except for, in my opinion, like the providers that are really doing like the work that you guys are doing.
So yes, you should do a social media post about that .
Yeah.
Love it.
Gimme a good background.
Yeah. God forbid somebody, any insurance company, deny one of our patients any sort of medication that we write, because you'll hear from us.
That's, I'm saying bulldogs like, and we know, like we know the science well.
It's not just personally living with it. Try us, let's go.
But see,this to me is what makes you both stand out as, like we just need more providers like you both, right? [00:40:00] she's not here, but I was talking to Christina earlier this morning and same thing. one of her patients got denied, something and she was like, this does not sound right.
it just does not sound right. And she was going down a rabbit hole of trying to fight, the insurance. But again, like people don't realize that like in a traditional setting, no, it just gets denied whatever,go deal with it yourself. But, I think that invisible work that, business owners and, clinicians like yourself have to do to, really stand up for your patients.
And for anyone who's thinking about starting a telemedicine practice, from what I have seen so far, and I'm only a couple months in, right? But for those of us that are doing it and doing it well, there is a magic sauce. And the magic sauce is finding the niche of unhappy patients and everybody has their own knowledge base.
Christina is. so knowledgeable in her field, I know nothing about what she does. and then Ashlyn is so good specifically with all hormonal [00:41:00] things and getting lifestyle into it. Katie and I with Type one Diabetes, this idea came about because I. Put myself back on social media in 2024 and saw like I was doing my best to be the best PA I could ever be, and so many grumpy patients, so many grumpy type ones, hated their endos and this, that and the other.
I'm like, this is depressing. I don't like, I need to get off social media. I am working 10, 11, 12 hours trying to. Put in the work to not be that person. and how disappointing is it that all of these type ones across the board are unhappy? so then whenever Katie and I like, were just brainstorming this idea, she was like, I don't know.
I don't know if it's gonna work. I don't know who would pay for this. And I was like, I can show you on my feed. I
didn't believe her. And it's weird because I think like the only. Other person that I could see were your patients. And my patients who I know loved us.
So I could [00:42:00] not see the other side. And I thankfully, knock on wood, had no poor experiences with my endocrine team growing up and everything. Like I was very fortunate. but that is not everybody's story for sure. And I'd never heard the other side.
Yeah, I would say find your magic sauce.
I feel like the people who are doing great that found a telemedicine practice found patients that were unhappy and I don't know, maybe this is a stretch, but a lot of times the current healthcare system and limitations of. Insurance in particular, feed into that unhappiness. So I would start cash base, I really would.
I would do telemedicine, start cash base. You can always pivot from there. but I would say give it a go because once you take those restrictions out, your patients will be much happier because of all of the things you're able to do. When we take out that big, bear that was overruling everything we wanted to do in the first place.
Yeah. Yeah, I've had an interesting observation too I'm relatively early in my kind of consulting career, so [00:43:00] I'm, also in a space where I'm taking on different clients, seeing what I like, but I don't like, and it's been a really interesting thing is the clients that I feel, and I'm gonna just say this, So none of my clients that listen are gonna get mad. But the clients that I feel that are really, to your point, Savannah, finding the pain point of, patients, this is the one area that I see a gap where I'm specialized, I'm gonna like super niche, right? those are the clients that are finding so much success.
And then, on the flip side, I have a lot of clients that are like,I'm gonna build this 'cause it's really popular right now. Or, other people are making lots of money, I'm gonna go make money. those are the practices that are really struggling to compete because it's like they're kinda like yours, right?
it's a little different If you're not so passionate about something, you're not gonna necessarily wanna be out there talking about it. You're not gonna be wanting to do social media about it. You're not gonna be wanting to, go to events and sponsor events. So it's. Been a really interesting observation, at least [00:44:00] for me, seeing the different practices, at least all the ones in IPAC are very successful, yay us.
but, I found that to be a really interesting thing, especially since everybody kind of jumps into this, oh, I'm gonna make money. But also, find the happiness side.
Yeah. Yeah. I think about this too in the world of education, like when you get really highly motivated students that want really great outcomes, that's who's coming to you in ipac.
Like they have a dream. And so it's not just a general easy click here and we promise you a whole telemedicine practice like we put in the work with your guidance. And that's the difference. And so you have very highly motivated people who want better, and that like your success proves itself if you're willing to put in the work, just sign up and make it happen.
Yeah. Agreed. Agreed. You guys did definitely,everybody does the work, right? It's like that's the whole thing that we can actually do anything we want to, We have to have the right vision and [00:45:00] it has to live in our heart a little bit, and you have to be willing to put in that sweat equity.
That is really hard sometimes, but also fun. I don't know. I love building practices . It's my favorite thing to do We're so
happy that you do. I think it's really cool . I think everybody has a really good idea. I get to hear really great ideas, all the time and I think.
Everything is slightly similar, but it's also very different because everybody has a different niche. Everybody has a different problem that they're trying to solve for themselves. Everybody's gonna be talking to patients in a different way, bringing in, them and their own flair and their own passion and style.
And so I think there's so much room in this space for so many providers to find happiness and success and. Honestly, just not be so burnt out. Like we just cannot keep having burnt out providers because the more burnt out you are in my opinion, the crappier the care, Yeah. and it's not the provider's fault, right? it is the [00:46:00] end of the day. You are not gonna wanna spend an hour with me when you've been doing 15 minute back to backs. I totally get it, but as like somebody who does not understand anything you guys talk about.
at all. And at this point, I really should know a lot more about type one diabetes. I swear I don't even try to pretend that I understand the
schedule, a free 15 minute session with that.
I'm gonna have to maybe during My mock hormone visit today with the endocrine clinic, I'll ask some questions, I think we just really need more providers that are willing to take the time to explain stuff to us, because again, I am proof.
All I work with is doctors and clinicians. And like the only word that comes to mind that's clinical is intubate
and we'll not do any of that. We're not doing that over telemedicine.
if there is one thing that you wish other, let's say PAs, nps, that could potentially launch a telemedicine practice, one thing that you wish that a [00:47:00] younger version of you knew, what would you tell them?
it's Sunday night right now. and I can tell you a year ago on a Sunday night, I would have pulled out my laptop because all of the portal messages come in over the weekend. Unfortunately, when you have a 7 45 consult and you have to get the kids daycare no earlier than six 30 and then drive 45 minutes.
You won't have time to get through those portal messages maybe until noon or you stay late the next day and that's just not an option when you're raising a young family. So I would put in an hour, hopefully, sometimes it would turn into two 'cause I get very off track and sidetrack and start prepping the day for the tomorrow.
that's what a year ago me was doing on a Sunday night was putting in two hours of work and getting the anxiety of ugh. I don't know if I can handle it tomorrow, but I'm gonna do it. I'm gonna show up and I'm gonna do it. And, today I sat by my pool and I read a book and I had no anxiety over the week ahead.
I have a [00:48:00] busy week, but I don't have any anxiety over it. I am honestly living a dream of seeing patients in the capacity that I am proud to see them in. we're making a difference in patients' lives. And I'm living a career that I never thought would be possible ever, and especially at the age that I am.
and so if I would tell my younger self something, I would say, everything you're going through in this moment, all of these ridiculously hard times, they are worth it. You need to do it. You need the experience. You have to get those years in under your belt. 'cause you can't come in a new grad and just start this practice, but you need it, but it is going to pay off.
More than you'll ever imagine.
Yeah. And I think like you can call it fate, you can call it, religion or whatever you want to call it, but I think there were little just. Snippets I'll call 'em sparkles. I don't even know what to call them, but it was just like things that
Just glimmers. Glimmers, yeah. That's great. Things that like literally just were dangled in front [00:49:00] of us. when we were talking about taking this opportunity, we were both very hesitant, can we do this? I don't know. And it would just be right in front of us and we're like, okay, this is our sign.
this is what. 10 years in the making what we were supposed to do. and from age 11 when I was young and first diagnosed, and I know I wanted to be in the medical field and then I wanted to be a pediatric endocrinologist and I never went through that dream.
in nursing school, in, getting my master's, I never actually thought I could do it. And it all led me here. And all of those moments were literally just put in front of me. So it was like, this is what we were supposed to do in life. And, I would tell my younger, self, like the dream is possible.
It's, make it what you wanted though. Because I think we get burned out so much with the system and everything. we could talk about the system of healthcare for three more days if you wanted [00:50:00] to, but,it's, everybody gets burned out. It's not meant for everybody there is.
Another way though, there's another option. You don't have to, get so bogged down with work and everything that they're telling you to do from the system level. You can create something of your very own and still be successful and still have a work-life balance and do everything that you want to in life.
Yeah, I definitely want to like double tap on the concept of do something that. You're passionate about, that's not gonna burn you out because, one thing that I try to tell everyone is you'll absolutely get burned out doing this right? And then you'll have to take a pause and take a moment.
I actually took this like weekend and like Friday off a little bit for same reason, and Savannah, you know this about me probably by now. It's like I do a lot and then it's oh my gosh, I need to like, hibernate. Because I'm gonna not enjoy this anymore.
And that removes all the fun for me. So to [00:51:00] me it's very important that you are focusing on something that you're passionate about and that. also you're giving yourself the grace to go at the pace that works for you. and not by the arbitrary pressures from like the external world.
so thank you both for coming on telemedicine talks today and spending your Sunday evening with me instead of charting.
Beats charting by tenfold.
if people are interested in learning more about type one telehealth, where can they, find you? and then you're also only servicing Texas at the moment, correct? This is
correct, yes. Type one telehealth.com is our website. Our socials are at type one telehealth, and then TikTok type one Telehealth.
we're also on LinkedIn and on Facebook, and we can see. Patients with diabetes anywhere in the state of Texas. we are soon to be seeing patients [00:52:00] 13 and up. As of right now, it is 17 and up. And anywhere in the state of Texas come see us.
Best providers in Texas for diabetes care. thank you both again, and to everyone listening, we'll see you on the next Telemedicine Talks episode.
Thanks for listening.