How We Quit Our ER Jobs and Now Make Even More in Telemedicine Part 1 with Takashi Nakamura, MD and Suneer Chander, MD

Transcript YouTube English auto-captions. [Music] hey guys this is Dr miking welcome to another edition of bootstrap MD a podcast for physician and healthc Care entrepreneurs you know when I was in residency which is many many moons ago I was taught that there was a certain way a doctor should practice medicine and I learned this from my own dad who was a pediatrician the idea is that you went to medical school you then went to residency maybe near the end of residency you started interviewing with for a few jobs you found a group or Hospital of that you liked you joined up with them they gave you a contract and you worked for them for the next 30 or 40 Years of your life until you eventually retired it doesn't work this way and it's we've noticed that Physicians that can work in a variety of different ways and I think a lot of it has occurred since Co but even prior to co we have Physicians working non-clinical careers Physicians who do locom work doctors who not have one job and might have multiple part-time jobs that may require clinical care administration research uh name it and then there's this new way that you can practice medicine and it's what these two gentlemen that I'm being interviewed are referring to as virtual medicine they are the founders of the Allin all-in remote or also known as air physician Academy who helps doctors get into this field they just launched last year with some amazing results that they're happy to share with today so I'd like to introduce to the program Dr Tash Nakamura and drir chander how you guys doing fellas great great thank you for having us that's right thanks for having us Mike great well um a little bit of of inside baseball here is uh I work with you guys for probably in the last year or so as as a coach and as a business and may have had some contribution actually getting Air Academy started so I'm going to Pat myself on on the shoulder here but first let's talk about what you're guys do what is Air Academy what is it all about first of all you had more than just some contribution you were you gave us the idea you heard what we did and you said you know what you should teach other people um but T so obviously we're super thankful for for your your uh guidance and your coaching um uh what air does is we're we're an educational program that shows uh Physicians who want to transition into virtual medicine how to develop multiple income streams in the field uh by showing them what opportunities exist uh sharing the resources we have and the network we have wonderful so I I want to get uh into a Academy what's all about uh some may know you as a tele medicine platform but it is really a lot more than that and we' like to get into that so I'll start with you Tashi maybe just talk about your back ground and then we'll switch it over to senir and how you guys met and then decided to to launch this thing yeah yeah so uh so we're both emergency physicians uh by specialty right and a few years ago uh we wanted to just do tele medicine as a side gig and and both of us started a few years ago but for me I just wanted just a complete side gig right just wanted to maybe shave off a few uh shifts a month right in the ER so I got licensed in a handful of states and I started doing tele medicine and just the traditional synchronous you know two-way uh audio video Communication in that sense and just doing urgent care that's how it really started and then uh so that just led to doing a little bit more a little bit more next thing you know you know I'm nationally licensed uh in 50 states in DC and then just started really going at it with all things virtual health so senir tell us about your background and how and how you got launched into into into this career so uh I am an emergency medicine physician uh I started working during Co um I started dabbling in tele medicine during Co because I I needed to to make money I found out that I I really like loved loved it I Lov the access it provides to the patients I love um how Innovative the care delivery models are from different companies um and as I got more into it I wound up expanding more lure um I got to about 22 and started working at a company where tekashi was working and and I tell people that tekashi and I met very similar to the way my wife and I met uh we started texting each other and then we started calling each other and then I flew out to meet him and then we became besties and started this program together right we do right we we we actually have have a community of people I think uh in that sense we do different ly from those who do tele medicine who are just kind of in a corner by themselves uh I think over the past few years we just built communities of people and that's kind of how it met sener too just we just looked out to see like-minded physicians in this space yeah yeah so let's just kind of talk about that because there is this kind of maybe for lack of a better term stigma on tele medicine or at least it's the way that you guys practice tele medicine is a lot different than I believe most doctors at least perceive the way tele medic is done uh for example personally I I got involved in tele medicine like 10 years ago work for a company they help pay or pretty much paid for States I maybe got uh licens in about eight or 10 states and then when they got started it was just like okay we'll pay you by the hour and then they quickly realized that because they were a startup company they weren't having a lot of patients and then they said we're going to pay you by the patient there and there could be times where you're like sitting there for like 6 to8 hours and you know you're just sitting there and watching Netflix you know which isn't bad but you're also not getting paid a lot of money just just doing this and and your hourly rate is kind of small so so is that how you guys kind of connected because you were kind of sharing U knowledge about this or maybe you know what exactly was the connection that that that led to this I guess relationship um well a actually so when you dive into tele medicine there are times when you're going to need to obtain um new clinical knowledge we're emergency medicine physicians and um we were working for a women's health company so I I was sitting in there learning their protocols on up to-date learning new new new medicine that I I didn't use in my career tekashi had been at that um at that company for a couple years before I I showed up and he just reached out to help hand he said I know you're an emergency medicine doc I know you're going to have some trouble let me know if you need any help that's when we started texting hey how do I do this in this situation how do I take care of this patient and he just helped helped kind of grow my clinical knowledge uh that's how we we kind of met uh it's more about um you you know the community having a collaboration or someone who's open to helping other people along it was really helpful for my career yeah and we started talking about real estate we started talking about other contracts that we're doing and how that um meshed with what we were doing like on a daily basis right so hey what other what other are you doing Men's Health are you doing you know chronic care are you doing urgent care so we start talking about those types of things and how we're stacking them to make them efficient for our working hours right so so so when we started talking about we realized hey we're we're pretty like-minded we're trying to make the most out of tella health and and so it's it's the way I've been practicing and so sen was kind of learning about that too so we started collaborating in that sense as well and I think one of the biggest things is is the realization that you can work for multiple companies in addition to obviously working in different states you know usually when a tele medicine company approaches you or you're you look into it it's like we'll help you we'll help you get license for the states but because of that we kind of own you so they even thought about working for different companies is is kind of foreign to them is that what you you kind of saw and then realize that there's a different way to to practice this virtual type of medicine uh yeah I mean at I think our goal in general is to try to shift over to the right side of the cash flow uh quadrant for those for those people who are you know familiar with the uh the Robert kosaki book um and by doing what we try to do is you know obtain multiple contracts in a 1099 fashion and not ever sign a non-compete I think that's a mistake for any physician to sign anywhere there's no worth job there's no job worth it to sign a non-compete um so it that's what we do uh we we try to we try to maximize our our business income that's correct and um so we're we want to be Nomads in the space right and not just work for one company and so we felt that we can help so many more patients out so many more companies out with that business mindset of now I'm a contractor right so what can I do that fits within my own office hours and not the other way around like how can I work for that you know uh employer as an employee right so there's many ways to do tele medicine or virtual medicine uh as we call it more in a broader sense uh because just not it's not just that like I said not that synchronous two-way audio video uh conversation we can do asynchronous care we can do collaborations uh with Advanced practitioners Nationwide remotely uh there's a lot of leadership roles out there uh we do advisor ship roles um we're both medical directors at different companies uh you know there's the CMO roles out there uh opportunity to also do uh uh be remote uh group uh practice owners uh so companies can adhere to corporate practice of medicine laws um and so there's a lot lot of opportunities out there in tele medicine like I said not just synchronous care yeah tele medicine has like a bad a bad name to it amongst a lot of Physicians people roll their eyes and think it's about prescribing antibiotics to people who don't need antibiotics but it's far more vast the opportunities are so much more abundant and diverse than that that weird um like I don't know what the that branding that it's gotten as a doctor I wasn't used to asking for help especially when it came to subjects outside of medicine but then I found physician coaches.com in an instant I found hundreds of experts to help me in all aspects of Life on areas I was afraid to ask dealing with burnout starting a side gig money management even help with my marriage and the best part nearly all experts are Physicians themselves after reading their profile and a quick chat I knew I found the right Mentor for me at physician coaches.com help from professional colleagues is just a click [Music] away yeah so that that's why you're uh you know what you guys are really doing is what you guys are defining as virtual medicine so let's let's let's put out a definition what is virtual medicine oh great uh so it's anything you can do remotely um it which would include digital medicine like tele medicine that Physicians TR uh think about um when they think about virtual medicine but it would also include uh oversight of nurse practitioners and physician assistants um it would also uh be um helping uh digital startups uh comply with corporate practice and Medicine laws by being their PC own owner uh and I and then I think any kind of Entrepreneurship or leadership uh options there are um you know tele medicine virtual medicine is a field and its infancy and my my observation is that it's a field dominated by Business Without much clinical leadership so I think there's vast opportunities for doctors to step in and you know Steward Steward this field um into you know a quality field that can really put patient care and patient quality forward yeah and I think obviously since you know the pandemic we we've learned all these different possibilities the way Physicians can practice medicine so I want to get back to to when you guys were quote dating and but also I I I know that you guys started to talk more with some of your colleagues about this and and kind of taking them on your wing tekashi you want to speak to that yeah so I I did right because when I started doing this I had no idea what I was getting myself into I was just doing the basic things the things that the vast majority of people think tele medicine is that's what I was doing but as I started getting more and more into it and you know now I'm getting calls and and I'm speaking to like uh coordinators recruiters Healthcare attorneys like all the time and and I'm just kind of inserting myself in all these uh in in different parts of of you know tele medicine uh and I start making a good income uh so so quickly that um I I multiplied my own ER income and uh next you know I I put in my six my six month uh notice uh to quit and that's when I got started getting questions from my friends and colleagues right the night shift dos that that I used to to to work with and they want to know how I was doing things so so that's where I started teaching them right like I I just kind of took him under my wing I said hey let's let's get you licensed up let me you know I'm getting all these these uh these off-market job opportunities let me start kind of pushing them your way and that's how it really started and I I helped seven people out uh most of them were were from my brick and mortar but but there were some that just called me that friends of friends you know one from North Carolina you know some in in in the west coast just calling me and asking me hey how are you doing things so you know just because I wanted to help out I was just I was just giving them some jobs and and that's how it really started it was very organic and and all of them now are very successful and and then sen and I got to talking and like hey you know we I think we have a pretty good system in place right like we're we're we're teaching these guys how to do it our way as a business um and as Nomads and and it's and it's been working and and they're all successful well maybe we should we should more kind of formalize this and make a coaching Academy out of it and that's that's how we start and we started talking about and that's when we met you Mike and and you helped us a lot that's that's awesome so tekashi you left your your ER career to do this full-time S I believe also yep the same was for you yep I I left last October wonderful so what are you seeing you know with the the doctors that that you've been helping um you know are they being fulfilled in this new virtual uh medicine that they're that they're doing oh so I I think that you know the the the areas of fulfillment here are are there's a few opportunities right one is uh if you have any kind of entrepreneurship mindset if you want to learn about the business of medicine uh tele medicine is a a a great space to be in um there's a lot of opportunities to be you know on the business side of things an advisor uh and you can learn a lot that way I I really do like genuinely love the um the novel and innovative ways uh some companies are taking care of Niche populations uh tekashi and I both work for a company that uh you know helps um helps patients who uh engage in high-risk sexual behavior uh obtain HIV prep uh it's a it's a blind spot in the traditional Health Care system and we get to help out in that there's another company I work with that uh that is taking care of patients with irritable bowel syndrome and try to avoid them getting on on benzodiazapines and get them behavioral modication therapy and diet dietitians to help them um so I think there's a lot of areas to get fulfilled in then on top of that like I get to spend more time with my family I set my own schedule I I take my laptop when I go on vacation I and I you know bang out a couple hours of work um I I go to the gym whenever I want I used to be a night shift doctor like now now I have if you look at my aura ring stats every night between 10: and 11: p.m. I'm sleep sleeping and every morning between 5: and 6:00 a.m. I'm waking up I have a regular sleep schedule I feel like a human again yeah that's crazy it's here I we work on our own time like when we want to work and we don't when we don't we just keep our laptops closed right I get to take my kids to school every single day I get to go to every single uh kid event whether it's at school after school weekend baseball uh singing uh performances and I get to sleep with kids every single night and I work whenever my kids aren't around or you know my wife my wife doesn't want to hang out or whatever it is like then that's when I work um so it's just been it's been so so good I would never have even imagined a life like this yeah I spent some time with you guys at a recent conference and we were there and I think senir like you say hey I gotta I got to go for a couple hours kind of you know bang up some some anness work here and I'll be right back and you know he came back you know dur during the during the session like you know that that was amazing it kind of reminds me you know the the band The Beatles when John Lennon said he wanted to like uh get a swimming pool belt he went in and he wrote a song you know on on a spare time so that that's incredible so you guys got together you started to U realize that a lot of doctors were benefiting from the knowledge that you're staring and then it was decided to like hey let's create a formal company and that's how air remote physician Academy was born you you worked with your your your first group uh you know I believe started uh what six months to nine months ago um so to tell us about what is the all-in remote physician Academy and why should a physician be interested in in this program you want you want to take this to Cas you want me to take it oh no yeah sure so I you know our program is pretty unique right uh we provide lifelong resources and opportunities for our physician members it's so the educational part six months but it's not just a six month uh six-month coaching Academy right it's an immersive program uh we combine non-stop education uh both formally and informally uh we provide networking and also job assistance um so we uh what we do is we provide support with uh lure right so people getting a licensed multi-licensed we recommend National lur so you can leverage everything uh we can also we also provide the unique off maret job opportunities out there um personalized coaching catered to members specific needs uh and we do that until their objective goals are met um so it's very catered to that specific uh physician member additionally our our program Fosters a long-term community of like-minded Physicians similar to what we had uh when we started uh and we facilitate collaboration and networking pretty much for the rest of their career so it's this lifelong uh community that to get you get to be uh a part of senir you want to add on to that yeah I think the the other thing that we do is you know we're all nationally licensed everyone who joins our program is committed to getting their their license in 50 states in DC and with that there is there is increased risk and I don't say that to scare you I I say that to to show to to make sure that everyone knows what they're what what they're getting into and make sure that they're educated about it um if you think about it you know 51 different licenses that's 51 different jurisdictions you're you're you're dealing with in terms of um you know your CME compliance the tele medicine compliance um and it's it becomes kind of complex and hard to deal with our group leverages our the fact that we are a group uh to to obtain guidance from um from uh legal systems uh from uh Li licensing specialists in order to mitigate those risks for us and and we also educate the doctors how to what what potholes there are where the pitfalls are and what they should avoid um walking around with 51 licenses tekashi once told me is like walking around with a woking with a with a loaded gun and not and not knowing how to use it not having uh an ability to use it um we can FastTrack that for you we can show you how to how how to manage that and I think in addition and you did mention you know you you have resources that you use to help you with the licensure and it's oftentimes with a discount that that they would be able to get on their own is that correct that is correct correct so let's talk about the yeah let's talk about the 51 licenses um there some probably people doctors there may they have one license 51 sounds a daunting uh can you do this with just like a few licenses what would you recommend so you can definitely create a solid income with a few licenses but if you want maximum leverage maximum flexibility and maximum income 51 gets you there 51 gets you to making sure you're scheduling when you want to work how you want to work uh 51 gives you more business opportunities more advisory opportunities um certainly you could do pretty well with in the range of I mean tekashi and I debate this I think minimum 10 he thinks minimum 20 what you can figure it out right but it it you can definitely get a a a solid income if that's what you're looking for yeah and and I feel like you don't know what you don't know right and like there are people with 10 licenses that are making the equivalent of their brick and mortar and the way senir and I look at like that's that's pretty cute right like hey that's cute you know what are you doing you're doing synchronous stuff or doing maybe a little bit of asynchronous um but but you don't know what you don't know the the more licenses you have not only do you uh cap at a you can cap at a higher um income range but you can also like you have time on your side now right like imagine just opening up your laptop and you can just just open up five tabs and you you just look at the the cues on five different uh in five different companies and you're just going to have a full cue with everything and you can just you can play with it uh and and and do as many consoles as you want whenever you want to do it right you're not waiting for patients to get into the queue so there's a lot more you can do even if it's just clinical synchronous and asynchronous Care uh that with many more licenses so I I like senir said I always recommend the more the better if you can do it through uh what they call the imlc the interstate medical licensure compact if you if you reside in a state that uh that is that does that then you can get a lot more licenses quicker and cheaper yeah it it's not just about volume Mike though like you know more licenses get you more volume of patience right that's definitely true it's also about certain job opportunities there there there are people that won't hire non 51ers right uh and then it's also about you know helping uh companies with uh corporate practice and Medicine laws they want you to be a 51 if that's the case um and then uh you know we both do a little bit of uh nurse practitioner collaborations your expans and your ability to get more across multiple States uh is much easier when you have more licenses so it it it's not just about tele medicine volue it's about your entire we advocate for 51 because it's about your it's maximizing all of your opportunities through multiple streams right and even with one company right so you can talk about multiple streams um and multiple companies but even one within one company you can be their TurnKey solution you can be their director their advisor their P collaborator uh and their sweeper role like say there's no Physicians to be able to take care of so many doctors at the end of the night you can go back you can go down in there and be the clinician for them as well so multiple streams of income even within that same company yeah we we talked about how a is a six-month program you guys are you know sharing your knowledge if not every week or pretty much close close to it but I also want to also want to discuss you've had numerous guests you know from the industry in you want to sh share us some maybe some examples of of who you've brought in and how that's impacted the group you know I I think our Our Guest serve as a lot of inspiration and giving insights onto uh Inspirations for our doctors as well as gives them their personal insights on what is going on in the field uh we've had a few few guests we had Brendan Levy uh who is a physician that um started hey doctor which is the EMR that was acquired by good RX and now by wheel um we uh had rafid fidu uh who is a um a Serial entrepreneur and uh you T medicine expert was one of the original Founders I think he was the original CMO uh for wheel uh and then um we had Jen Peña former White House doctor in both the Obama and uh the Trump Administration uh and she she's she has multiple uh medical directorship roles in several uh uh tele medicine companies um you know the the experience their wealth and knowledge uh has been I I I think pretty valuable for our for our docs so we talked about uh you know not only do you guys provide the knowledge with yourself and with your guests let's talk about the different opportunities you know that air provides you want to that I'll let you take that tekashi uh well I I think we're really just it's I don't know if I don't know how to say but I think we just we give every opportunity possible we're GNA really we just we give the members all the tools they need to succeed really in Virtual medicine and we don't just give the tools we like we guide them through everything and you know there are a few of our members right now that have uh PC opportunities to be uh to to be owners of remote physician groups and we're like we're walking side by side with them and going through everything uh with the whole legal system where we're helping them uh get their attorneys um and ask making sure that they asked the right questions to put them in the positions to succeed so uh yeah we're not just we're not just handing out tools and saying hey take this course and you're done with it we're really uh we're really guiding them step by step and into what whatever whatever field of tele medicine or virtual medicine they want to get into and also you know since your Academy has been born a number of different companies have actually reached out to you you know asking about potential you know looking for 50 Physicians for 51 licenses you want to speak to that yeah we've we've had about five or six uh uh companies that have reached out to us after they've heard about us uh looking for for staff um you know some some even looking for Specialists uh in our group we have two cardiologists two dermatologists we have some GI doctors a PMR doctor um you know so those are 51ers and those Specialties are hard to find and they know that they can come to us and and ask ask us for for a referral so with the Air Academy you know it is a comprehensive program it is a it is an investment and I think it's an investment into the Physicians future and career opportunities but let's say you know docor listening to this it's like hey why can I just do this on my my own and I'm sure you you you've talked to some doctors who who listened to you and and uh for whatever reason they just decided to do this what does their Academy offer that perhaps they're not able to get on their own I think there's a few things one is you know our experience the the whole tele medicine landscape is is like the Wild Wild West and a lot of people don't understand the complexity of the rules involved in in engaging with patient care uh through all the different modalities that are available um and you know tekashi and I will be completely upfront and honest with you we've stepped in potholes before without even realizing it right we've been lucky we've been lucky so far but you know there's a lot of areas where you know most people who get into trouble they don't know what they didn't know and when we stepped into those pitfalls before we just didn't know that we're good people who just didn't understand that so one with our experience you're going to avoid all those pitfalls or we'll we'll show you where where where to watch out two like I think most people think of uh tele medicine as a solitary career people are in their cave and their basement doing this and we provide a community that's very collaborative people help each other out one person starts on a new platform and another person's already been on there they get together we get to be friends we and we get to be colleagues so we provide a community the second the third thing is that uh we provide our Network um which which which is which is great I think because we we're also expanding our network but all of a sudden people are calling us to to get get referrals for jobs so we're making a lot of friends in the industry on top of the friends we already actually have um so I think those three things are the major things that we provide tekashi what do you think anything no no just to add to that you're right like we got so lucky right like we we we stepped in a lot of potholes and uh we didn't get reprimanded for that but there were a lot and you don't know what you don't know right and it's oftentimes the mistake of the company these msos these these management organizations who are run by like these te Tech nerds and they're not run by physicians right it's not that that the establishment like like a brick and morot hospital where everything you know they have in-house compliance officer and things like that and so you do things without knowing that they're they're wrong right they they're you're you're breaking rules uh and we know colleagues that have have suffered as a result of that right and who had licenses reprimand and so we've been lucky and so and as we got more and more into it we realized oh my gosh we're making all these mistakes we got this has to stop and so you know this is it also creates an opportunity for Physicians to just pull in and with this community for example we we uh we paid for with the community with this membership we were able to pay for a 50 state uh survey a compliance survey to see what states can uh can do asynchronous care versus what cannot and why right all the nuances there now if a company were to do that it costs between $ 50 to $70,000 and some really big companies yeah they can do it every quarter but us Physicians we cannot do anything like that that's crazy who nobody would spend that kind of money right so um what we're able to do as as a as a community with the membership funds is to pay for that once every six months we're trying I mean if we can do it once every recorded we will but you know we we're right now we're planning to do it once every six months so we have so everyone's on the same page the Physicians know what they're getting themselves into and they know where they can practice certain types of medicine and where they can't so a physician is probably listening to this they're probably working at their other job this sounds very attractive but can Physicians do this while working their other job yeah I mean I I started uh I started doing this I was a 50 state license physician uh while I had was still working in the ER um I I I worked maybe 20 20 to 25 hours a week with tele medicine it was all on my own time right so in between shifts when my kids were at school uh when they were doing their homework or they didn't want to just they just wanted to kick me out of their room and not spend time with me that's when I worked um this extra time it really you know two hours here three hours there it adds up yep yep and and and going back to getting more licenses so you can do that on your own time so when you're not working when you're waking up in early in the morning your you know your family still asleep you can just open up your laptop and get a little bit of work done and for me next thing you know I'm I'm giving away shifts right because I don't want to work and and then and it gets to a point where now you get to choose to work your your your brick and mortar as opposed to having to work there right so um so you can definitely transition out as slow or as quickly as as you want uh if you get into our our membership um there's no rush into doing that um I think I it'll definitely take longer if you're do do it on your own but you you can absolutely do it on your own and and you can you can continue to work your your main brick and Mortage job um it's just we're just going to turbocharge that if you join the membership there's a lot yeah go ahead smir I just to add on to that tekashi like it's not necessarily about leaving your job either it's about attaining your goals so we we actually have um a member U Justin uh he he um loves teaching residents and works in an academic emergency department uh and he doesn't want to stop doing that but you know these academics they take pay cuts I mean they're they're not making as much as as us in you know private practice so he does this on the side in order to supplement his salary to allow him to do that and he's crafted like a career that he loves because of that uh so he gets to work on the Business and Entrepreneurship side with tele medicine he gets to teach residents it's not about leaving it's it's about attaining your goals now there's some you know maybe some myths that in tell medicine and I guess you know extended to Virtual medicine is that you know this is only good for like uh first liners Primary Care ER doct but you mentioned you had some Specialists on here so what type of physician can can have a career in Virtual medicine oh we we had a guest speaker the other day uh who who said that uh you know covid was the Golden Age of tele medicine and it laid the framework and the groundwork for tele medicine to grow and now he thinks it's a golden age for Specialists uh and and it's about to Blossom um and when he was talking about um we we talked specifically about procedure list and he his response was if you're a procedural list think about everything you're ignoring in your office while you're doing your procedures that is something that you can do in in Virtual me virtual care uh so I think it's it's good for anybody um mostly I think it's good for people who are self-starters who are organized uh and who if they're not they understand that they need to get help uh and who um are are not afraid of learning new things new clinical things I should say so let's talk about your program we recently just uh we well we will soon be completing that that that first cohort of it and and uh at the time listening I I know we're we're either just launching or about to to close your your your second cohort um let's talk about some of uh you know the stories or you know success stories from your first group you know like we said you know uh it is an investment it's investment in in your future let's talk about Roi the return on investment uh you want to be able to share some uh success stories from your first group yeah I mean I my favorite story is uh Haley Haley's story right so uh Haley I I actually got presented a PC opportunity uh uh for um a company that does uh continuous glucose monitoring um and I'm an emergency medicine doctor and they wanted a family medicine or internal medicine doctor so we uh we introduced Haley uh Dr cibit uh citz to um uh to to this company and she was actually going to turn down the company because she did not feel like she had the experience to do it and tekashi and I got on the phone with her told her that she absolutely had the experience to do it gave her confidence now she is their medical director their PC owner she works 20 hours clinically a week on her own time uh and she's got equity in the company um and we helped her kind of negotiate that Equity as well um and you know I I feel pretty proud of about that because she was not going to take it and now she's very happy uh now she's crafting her career around that one solid job so it sounds like they're not only replacing their income they're actually exceeding the current for sure there in the fifth month well I have some stories right like I there there's a handful of good stories in the fifth month there's a uh one of uh the members who is on paternity leave and he texted one of our coaches that he's making more he's making just as much more while being on paternity leave in his fifth month uh than the brick and mortar so he's good to go I mean he at any point he could he could leave um I don't know if he will but uh you know that's that's somebody just being in the fifth month in in our program and he's not even fully licensed yet uh we have another person who's now flying first class Justin Wright uh because he has enough asynchronous gigs um so he's like well now I'm Gonna Fly first class and and we're just talking about getting a privacy screen so he can he can start jamming out some asynchronous thing so he can pay for his first class while he's in first class um but but I think the most common one that I think we've heard is just people saying that there's so many opportunities that they just never knew existed and to be able to get into that confidently it's something that it's something they weren't they weren't expecting but they're really happy that they have yeah we talked about you know the benefits as well as the risk you know in in this type of medicine you know I I think uh it would be you know be kind of foolish to to learn about the possible risk and when we talk about risk we talk about malpractice uh insurance uh how is malpractice covered in these type of uh Endeavors so you know malpractice uh in tele medicine I I I don't think is as it is a common question it I don't think it's as big of a deal as most people think it is first of all like to answer your question um generally the contracts you you get they will provide the malpractice for you similar to the way your hospital provides it for you um there are some opportunities out there um where it requires you to bring your own malpractice I I took on a couple of those opportunities and I went out and bought my own malpractice insurance for for National licensure $5,000 for the year that that was how much I pay I think that tells you that the insurance companies don't think that tele medicine is a huge risk um the risk is actually elsewhere the risk is in making sure that you're maintaining regular Regulatory Compliance with a you know while you're practicing in multiple jurisdictions um and that can be a big problem um if you mess up one state you know if you don't get your uh you know pain pain CME in uh and they reprimand you the entire country will know that that happened and they will also investigate you and it can be um you know for lack of a better way of saying a big cluster um so you know what we try to do is provide organizational tools uh and systems in place so that we you mitigate that risk so as a member of air I know you guys have like tracking systems guys it can be very complex it's hard enough a physician dealing with one state let alone 50 50 plus and and utilizing your your expertise and knowledging to help the individual phys so where do you see virtual medicine going is it saturated or do you see a lot of opportunity moving forward definitely not saturated I think it's just going to grow and grow and grow anyone who tells you it's saturated are people who have like the three to five licenses and and they're looking at there's some national companies out there but we see startups growing every day almost it's crazy and there's bigger companies that are just like starting these smaller branches of companies um just kind of going with specific spefic care for certain like you know specific Diabetes Care retinopathy care or something like that right like there's these big companies that are just forming these so many small companies and and you can work within those small companies too right um but I just see it just growing and growing and growing um there's there's just no way it's going to stop the the other the other opportunity is start your own if you're an entrepreneur start your own tele medicine practice we have a friend who's a lipidologist all he he has a virtual practice all he does is you know care for people with high cholesterol that's his Niche practice um we suggested to one of our members to she she knows how how to speak nepes to create a virtual practice for nepes speaking patients um there is a lot of opportunity for growth from the business sector but there's also not a lot of opportunity for you to pursue your own passion yeah what I love about you obviously that cares to my entrepreneurial heart is that you are letting more Physicians get into this because it is imperative I think that the way we're going to be moving forward that a physician should be the key component uh you know in in in this uh you know tele medicine virtual medicine uh wave that that's already here and it's and it's coming whe whether you like it or not honestly Mike that's the reason why Tashi and I wanted to do this because most most Physicians enter this space and they're on their own and and there's no way that we can we can you know leverage our group as of Physicians against against like you know businesses medical boards without go coming in as a group there is no College of tele medicine physicians advocating for us um there is you go to these conferences like the American uh tele medicine Association or hlth there's no clinicians there it there there're huge tele medicine conventions with you know it's it's like me and tekashi walking around on the floor you know and that's it they they asked us to to raise our hands how many how many Physicians are in the room and it was just like just a handful of us that raised their hand like oh my gosh this is a this is a tele health convention right and there's like three Physicians here it's crazy yeah so that is part of our mission here is to to increase our numbers in a community that can then go out and advocate for ourselves but even as clinicians right like it just the the the the different mindset of having um just knowing that you're not just stuck with an one employer right we are we can we don't have we really don't have a boss even though we're working as clinicians and all these other uh in positions within teleah Health we don't really have a boss right we're working independent contracts for the most part um so just just to have that mindset as Physicians I think is hugee yeah so it's so much more fun working with people than for people it is like a it is a different animal yeah so 100% true guys this has been amazing thank you for sharing all of this knowledge if you're interested in joining the all-in remote uh group uh we'll leave a link here on the show notes to where you can go and get from information you guys set up a you know a free call with each of the uh potential uh uh clients uh why is it important for you to to make sure that that you're you're you're you're speaking to you know potential clients for this because like I said it's not for everybody right it's it's not for everybody so what what gets involved with uh you know what can expect uh uh you know when they talk with either one of you I believe you guys are answering you know you're talking to them individually uh for the only remote Academy yep yep I think the first thing you want to knows what what your own what your goals are what do you want to do are you stuck uh in your you know in your brick and mortar are you are like are you stuck with your golden handcuffs like or or what are you trying to do are you trying to get more time for your family or do you want more Geographic Freedom do you want to make money I think we want to know where where you are who you are as a person right and and what what you want to get out of this right what your goals are and and if we feel like we can get you there then then we'll we'll love to have you you know there there's some things that we we wouldn't be able to do we're we're not magicians right we can't do everything but but if if you feel like you're a match then you know we'll let you know and we'll be very honest with you yep and then you know honestly like I I I you know tekashi and I lose sleep over our members because we want to make sure that that you know we feel the weight and the responsibility to take care of them and make sure they get to their goals so it is it is something that when I first started doing this with Tashi like I I finally came out to him and told him like I haven't slept in it was it's something we care about deeply for sure sure if our members go all in with us I we tell them we're going all in with you as well yeah and I can certainly attest to that that you know the LI care that you putting in you know into the business has been truly amazing and uh yeah continued more success to the Air Academy and to you guys to what you guys are have put in because I know a lot of work BL one got gotone into this so again this has been tremendous thank you for your time any last minute thoughts before we end the interview today no I mean just thank you Mike you you've been you know you you inspired this whole thing so you know we we definitely appreciate you yeah yeah you definitely you helped us so much from the beginning to to now right so thanks so much uh for for making uh making it more fulfilling for us this is such a this is super f uh for us to be able to do this for other uh of our colleagues well it's been my my pleasure again uh continuing success with the era Academy if you guys are interested in potentially joining and and it if it's lucky enough to be open we'll leave a link where you can go and register for a free call to see if it's it's right for you and guys we talked about there's lots of different ways that you can practice medicine lot of different ways that you can make money whether it's be your own business whether it be working for lots of different companies you know we have opportunities we have different choices but it's not just about researching it and read reading it it's allowing you the opportunity to accept these potential opportunities do everything each day that keep you closer to your [Music] forward