Licenses, Laws, And Telehealth Growth

Ready for a frank, field-tested guide to building a real telehealth business without losing your mind to 50-state rules? We sit down with the ER physician turned  CEO of Guardian MD who turned COVID-era travel medicine lessons into a scalable system for compliance, collaboration, and patient outcomes. From multi-state licensing nightmares to the surprising places boards disagree, this conversation unpacks what it actually takes to protect your license and launch services that patients love.

We dig into the practical stuff: why ERs overflow with “bread and butter” cases better handled by telehealth, how protocol libraries can standardize safe care across med spa, wellness, functional medicine, and urgent care, and where a telemedicine arm can support RNs who can’t diagnose or treat. If you’ve wrestled with corporate practice of medicine, prescriptive authority, or those state portals that make you re-enter every detail, you’ll hear strategies that save time, money, and stress.

The big idea is simple and hard: build programs, not fads. Weight management beats “selling semaglutide.” Hormone health beats “selling testosterone.” Educate patients, measure outcomes, and the revenue follows. Along the way, we challenge the myth of autonomy—real clinicians collaborate, even in full-practice states. That mindset, paired with clear agreements, malpractice alignment, and living protocols, is how you scale without risking everything you’ve built.

If you’re an NP, PA, or RN dreaming of your own practice—or trying to make your existing one safer and stronger—this episode is your playbook for compliance, state-by-state collaboration, and outcomes-driven care.  Or Dr. Seitz offers his services at the following link: https://affiliates.guardianmedicaldirection.com/hamiltonhealthwellness 
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Subscribe, share with a colleague who needs a boost, and drop your toughest licensing or protocol question in the comments so we can tackle it next.

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Transcript

Welcome, Disclaimers, Guest Intro

Kelli 0:27

All right. Hey everybody. Welcome back to another episode of Tattoos and Telehealth. We have a very special guest speaker today. But before we get started, you guys know our lawyers make us say this. This does not constitute a patient-provided relationship. We're just a couple of gals chatting it up. And this also does not constitute medical advice. So please know that anything we talk about today is just us chatting. So I want to introduce Dr. Chris Seitz. Is that right? Seites?

Dr.Seitz 0:54

Yep, that's correct.

unknown 0:54

Okay.

The 50-State Licensing Gauntlet

Kelli 0:55

He is a board certified emergency physician and CEO, chief medical officer. Another shout out of Guardian MD. So you're licensed in all 50 states, right? That's hard to do, man. That's hard to do.

Dr.Seitz 1:06

I am. Yeah, I am. And it took a while. Uh, but yes, I I am. And I will say I don't know if I recommend it because the continued education to keep along with the date is it's a challenge, but it's okay.

Kelli 1:18

So Nicole, Nicole is all 50 states plus DC. I'm 24 and working on more. And not only is it hard, it's expensive.

Dr.Seitz 1:25

It is, it is.

Nicole 1:26

It took me five years. Five years. I finally got the last state. Yes. Lots of meltdowns in the in the beginning because I was trying to do it myself. Yeah. Continuing education is is its own creature. The fees to keep this up is its own creature. Like, totally get it. Totally, totally get it.

Dr.Seitz 1:44

I've worked out a little bit because on the physician side. So we have something called the IMLCC. It's kind of almost like a compact license type of. So like you can once you get that one, then you can like more quickly grab 20 of them, or something like that. But yeah, like California took like a year. You know what I mean? There's certain certain ones that just take take forever. But yeah, it's not it's not an inexpensive endeavor by any means.

Kelli 2:06

Look, California was a nightmare for me. There were two states. California, I finally had to let go because I got my RN license. So some of us we can compact our RN license and then apply for the NP license, but some states you don't compact your RN and you have to apply for both. Well, California's one of those. Well, I got my RN license and everything was fine. But then a year and a half went by and I still couldn't get my NP license. And it came time to renew the RN license, and they still hadn't given me my MP. And I was like, I'm done. I'm out. I'm not paying any more fees for you. Like, this is it. And it was more fees on top of more fees. I'm like, I'm out, guys. I'm out. Like, I can't keep doing this. So yeah, it was just a pain. But you you founded a couple of healthcare companies, and you, your passion, and correct me if I'm wrong, is really to help drive healthcare professionals like myself, Nicole, other nurse practitioners, nurses, just healthcare professionals in general, to do their own thing, to just like be their own person, start their own businesses, how to be innovative, how to practice within their scope, especially so they can stay compliant, which is a big thing, as Nicole and I know, especially when you're statewide and you're practicing telemedicine and those laws change all the time.

Speaker 3 3:15

Yep.

Kelli 3:15

That's kind of your thing. So I'm gonna shut up now because I need to and let you kind of tell us what you do.

Travel Medicine Through COVID

Dr.Seitz 3:22

Yeah, no, absolutely. I appreciate the opportunity. It's a privilege to be here. I so yeah, I'm a board certified emergency physician. I did emergency medicine for a number of years. I mean, I'm still I said I still work here and there in the year. Uh my CEO job takes takes up most of my time now. But I started doing travel medicine a bunch. So I I did my training in Detroit, level one trauma center residency. I went to a community hospital here in Detroit, worked for a couple years, , and then decided to do travel medicine. So I got licensed in a couple states, and I started doing that, and then and then I did that all through COVID. So I was like one of the only doctors working a bunch of it. There's actually one Delta flight where they almost canceled it. And I was just trying to get home after working a few string of shifts. And the pilot asked, he's like, What are you traveling for? You're the only one on this flight. Oh, what he's like, What yeah, what are you traveling for? And I was like, Well, I just remembering COVID, like we were heroes, right? So like I gotta they they flew me just by myself home on a Delta flight. I felt bad. The guy felt like he had to give me the safety briefing, like in person. I'm like, man, you you you don't you can still do this over the loud speaker. Like, I'm just gonna go to sleep here. Just you know, we don't have to but no, so I was saying I just want an app, truly actually.

Kelli 4:31

Exactly, exactly.

Why Guardian MD Was Built

Dr.Seitz 4:33

Just fly a couple circles around it right before we land, I'll get some extra sleep. But no, so I was doing travel medicine during COVID. And as you guys know, like during COVID, we saw massive advances in telemedicine, right? Telemedicine technology, remote monitoring, oversight, that type of thing. Well, I have a EMS background, being an ER doctor. So I was already very familiar with remote medical direction. Uh, you know, obviously it's been you know, paramedics calling in from the field, getting orders, working off the protocols. So during COVID, we saw this advance in technology, and then we also saw kind of this mass exodus of healthcare practitioners moving away from traditional medicine and trying to, you know, kind of start their own thing. So I started getting asked, hey, could you be my medical director for this? Could you be my collaborative physician for that? I'll admit it's you know, selfishly, I was like, hey, if I can do this for five or six people and they pay me, I don't have to work as many shifts. Uh but when I went to look at how to do it, there was just this wasn't a model that was that was there yet, right? So every state had different regulations about what people could do, could not do. Even telemedicine regulations were like, can I prescribe? You know, even now I feel like can I prescribe testosterone over? I guess I guess I can for another year. We'll see what happens next, you know, these different types of things. So we decided to build Guardian MD to really kind of empower that to happen, right? The physician shortage isn't getting any better. It's an inevitability that the healthcare system has to turn to another pool of providers to deliver care to increase access. And it's going to be nurses, it's going to be nurse practitioners. I mean, this is the biggest group of clinicians that are growing, but how do they do that with the right oversight and compliance pieces in place to make sure that their licenses are protected, to make sure that they know what they can and can't do with all that kind of stuff. So that's where Guardian MD was born. Our platform, again, we match physicians to clinicians who are looking to start their own medical business. We help them structure the business legally, compliantly, and give them the tools to create the right protocols, navigate their scope of practice, protect their license, , and kind of the rest is history a little bit. We we we support about 900 clinics now across the country, , and that's growing. And everything from you know, med spa to wellness to functional medicine to primary care, urgent care. It's very exciting. I I've learned a ton. It's really cool to see clinician innovators taking on a challenge of figuring out how they want to deliver the way they want to deliver it. Uh and I think that this is where healthcare is headed, in my opinion. I think the , you know, the traditional traditional hospital medicine, like people can access care now at their med spa, at their gym, at the pharmacy. When you give people the ability to access care where they're most comfortable and where that, you know, they it used to be my ER, right? Everybody was actually accessing care in my emergency department. Now there's more options, and I think that bodes well for health in general here in the United States. People are much apt, much more apt to follow, you know, healthier habits and things when they can do it in a capacity that makes sense for them.

Kelli 7:28

So what are your thoughts on, and this is something Nicole and I have touched on a few times, is you know, being an emergency room physician, you understand this. Nicole and I felt this burden when we were, you know, still in in-person care. But speak to, if you can, how telehealth has helped to reduce the burden of the ER being the revolving door of the walk-in clinic. Like now you don't see the ER as being overburdened by somebody who just says, Oh, I've got a runny nose, I've got to go to the ER, you know, like because they can't get in with their PCP.

Dr.Seitz 7:57

Like, well, exactly. Right. And no, I mean, and that that has been, I think, a huge, and I actually think AI is gonna help us even more with that in a big way. Yeah. I mean, I think tele the remote telemedicine, you know, increases in technology that we've seen and just the ability to deliver care that way. Again, it all goes back to access, right? If I can access this here on my iPhone, I don't have to now drive up to the emergency department. And and I don't I think people probably know this because most people have been to an emergency department like we don't see emergencies. I mean that we do, we do. I always say the emergency physician job would be super fun if you only saw emergencies, right?

Nicole 8:34

It's 90, it's 90, 90 bread and butter, 10% complete terror.

Telehealth Eases ER Overload

Dr.Seitz 8:39

Exactly, right. Yeah, nothing in between, nothing in between, right? So again, and and I won't I'll I'll admit to you like I always actually enjoyed that though. Like I always got like I I would I liked seeing people who had simple things that you know they just needed advice or encouragement and that type of thing. But the the problem wasn't so much that they were coming to my ER for it, it was how much how expensive it was to come to my ER for it, right? That's where things were breaking, right? I mean, like, I'm happy to give you some advice on your stubbed toe. Sorry, I just had to charge you $5,000 for it. Though this is where, like, I think telemedicine is giving us the ability to deliver care more efficiently, meet patients where they're at, keep them out of the ER, keep them out of their primary care office to reduce cost. And I think that's huge, right? It's you know, same thing that primary care physicians run into, is that they just don't have the time to spend with their patients to educate them. So the patients have to come in more often. A lot of this goes back to like, hey, can we as clinicians get back to what we were meant to do in the beginning, which was heal people and truly healing people is educating them and spending time with them. Uh, you can do that, they don't need to come as often, right? If I can educate you well like now in the next 15 minutes, because I have that time to spend with you, well, now you don't live in as much fear. You don't feel like you have to keep coming back. You you have access to be able to ask the questions and the clarifying thing. And telehealth has been obviously really the pivotal technology piece as well.

Nicole 10:04

It's been it's been really good because the if you you have the time to explain to the patient why they take this pill, why they take that pill, go over their labs with them in detail. When they understand why they're doing something, they're much more compliant, much more compliant, you know? Yeah. And so that's it's given us the time to do that. I come from in-person trauma surgery.

Dr.Seitz 10:26

Okay.

Nicole 10:27

And I loved it. I loved it, loved it, loved it. And I miss it to this day. But the outreach that I can do on telemedicine is significantly large, not on that scale. Believe me, that's that's obvious. But the impact can be near or just as powerful on some of those patients who are just struggling, and there's no that maybe they're in a rural community, they don't have the resources, maybe they don't have insurance. So it's just, you know, like a cash pay, you know, thing, like just you know, easy peasy. I see you one time and that's it. And so it's it's it's been very good in that manner. How long has Guardian MD been doing its thing?

Dr.Seitz 11:10

Yeah, so I think we start, I think we're coming up on almost five years. So we're like in our fourth year right now, and yeah, it's been so one of the things. So as we started to support more and more nurses and nurse practitioners who are kind of doing their own thing and building these businesses, one of the things that we found is that RNs, obviously, like I said, within their scope of practice, they can't diagnose and treat. They can deliver care, they're probably the best able at delivering care compared to anybody else, but they can't do the diagnosis and treat part. So we actually started a telemedicine arm within Guardian that allows nurses so we can see their patients, we can diagnose, we can treat, and then they can deliver the care in their business, you know, in the Red Spot, in their wellness center, in their Ivy Hitration Clinic, and that type of thing. So yeah, we see about 10,000 patients a month right now through our telemedicine platform service, which has been fun. But again, it what's cool about that is it's it's in this collaboration with the nurse on the ground, right? So it's like, hey, we'll stay the patient, we'll diagnose the three, but then they're managing that care, and it's really created a very cool kind of ecosystem that hasn't really existed up until now, , where everybody can kind of do their thing very well, and the patient gets this kind of holistic approach without falling through some of those gaps.

Education, Access, And Patient Costs

Nicole 12:23

So I love it. I love that. From a provider standpoint, a couple of questions I have for you. Um doing it myself was very overwhelming when I first started in in 2019, even before COVID. Like I kind of started to get a few states and then it kind of went all crazy. But I did seek out a company to help me. And so this is super valuable because there's not a lot of there's not a lot of options. So I'm super, super glad. Now, in the telehealth space, it's just it's it's a small world, right? In the past, I've worked for one company and then I go to I have maybe do PRN at another company, and the like the same nurse practitioners, the same doctors are there. So it's a very, very small niche, if you will. It's it's it's a small world, right? So I want to say, hey, here's Guardian MD. They do what you know, maybe you only know one other company that does it. So a little bit about the process. The number one, do you offer collaborating for physician assistance as well? Because I do. Okay.

Dr.Seitz 13:24

Yep, yeah, we do.

Nicole 13:25

And how do you handle states like South Carolina where the the physician has to live in the state? Do you have those? Do you have a couple of those that so you can facilitate that relationship?

Speaker 13:37

Yeah, and this is where we really where we have been able to really come along, people and help is that again, those those those rules are hard to find sometimes. And they're also always changing.

Nicole 13:47

They're gray, they're California.

Dr.Seitz 13:49

Yeah, yeah. And they're gray, right? Like, what do you really mean? Like, but you know, sometimes the regulations agree that the physician needs to be easily accessible. What does that mean? Does that mean in person? Does that mean like on the street? Can it be my phone? You know, so so one of the benefits that we drive is that we navigate all of that, right? So we have we've sat with the state boards, we've sat with the attorney general's office in a lot of cases to really make sure that we have a deep understanding of that and we keep up to date on it. So to your point, yes. So for South Carolina, the only way we can serve South Carolina is that we've recruited a bunch of South in per in-state South Carolina physicians. You know, in Georgia, they gotta be within a 50 mile radius in a lot of cases, right? So we've got to kind of navigate that. But we take on a lot of that burden to navigate the regulatory environment so the clinicians can do what they do best, which is deliver care. But I always say, like, my goal, my my I know that we're doing a good job if you go to sleep at night knowing that your license is protected from what you're doing. I think a lot of times, I don't know if you guys experienced this, but I did this in medical school residency. I always tease it. I don't know what day they taught this, but at some point they taught us that like if you don't understand it, it's a threat to your license. Right? Like, no matter what.

Nicole 14:53

That's true. I like that. If you don't understand it, it's a threat to your license. I I like I'm gonna use that. I'm telling you, I'm gonna use that.

Guardian MD’s Telemedicine Arm

Dr.Seitz 14:59

Yeah, no, I mean, and and that, and that's kind of this this and it's not wrong in the sense. But one of the frustrating things, I mean, we work very close with a lot of medical boards and nursing boards. There's some lot, a lot of good people there, and their mission is aligned with our mission as clinicians too, it's protect patients, right? The problem is a lot of times is that you call up and you ask, like, hey, can I do this? How do I do this? And they won't give you the straight answer, but they'll discipline you when they decided you did it wrong. And it's there's this disconnect there. So we really try to bridge that gap by trying to be that kind of incessant voice with the board saying, hey, help us do this right, help us do this well. We are aligned in what we're trying to do, right? Clinicians are not out there purposely trying to like harm patients to make money most of the time. You read an article and one guy decided. But , but you know what I mean? Like, so this is where again, I think there's a lot of opportunity for we talk a lot in our business because it's our model, it's collaboration, right? Connecting collaborating physicians to nurse practitioners, TAs, but more so than that, helping the attorneys collaborate with the medical boards to collaborate with the clinician, to collaborate with the business owner. A lot of people don't realize that, like, you know, the nursing boards regulating the nurses, the medical boards regulating the doctors, the attorney general's office is regulating the business, and they don't always agree. They don't always speak to one another. So it can be very difficult, but it also can be a great opportunity. I always kind of say, like, hey, if you can navigate the compliance well and build a strong, compliantly sound business that we feel like you're licensed and protected. Well, now clinicians will in those in that environment, clinicians will drive outcomes. And when clinicians drive outcomes, patients benefit, right? And that's that's what we're all here to think.

Kelli 17:06

And I think that that type of model is first of all, that's incredible. And kudos to you for being able to do it and do it so well, it sounds like, because I'm gonna pick on Texas because I live in Texas for just a minute. What you said about the boards, you know, that govern it that govern different persons not speaking to each other. Texas is a prime example. So the Texas Medical Board, and then you have the Board of Nurse Examiners for the state of Texas. And the Texas Medical Board says something very different than what the Texas Board of Nurse Examiners says with regards to governing bodies and being able to speak to one another. And so, like whenever we connect, as you know, to a physician, well, not only do we have to connect ourselves on the Texas Board of Nurse Examiners, then we have to go to the Texas Medical Board and attach ourselves on the Texas Medical Board side. And so there's several different steps. And I think Alabama's the same way, several other states are that way. And if you don't, you know, take that step to go, well, I attached myself on the board of nursing side. Well, now I have to go to the medical board side and attach myself here, and now I have to go here and do that. Like there's all these different governing bodies that you that are players, you know, in this, in this piece. And, you know, it dra it draws this very sense of of disconcerting urgency. It's like, oh my gosh, did I do everything right? You got to check all the boxes, did I cover myself? Did I do I need prescriptive authority in this state, or does it come automatically with my license? Do I have to apply to a set? Do I have to apply to a pharmacy board? Is there a pharmacy board in play here? Like, like Nevada, there's a separate pharmacy. And it's all these things that it's very overwhelming. And so I think that it keeps nurse practitioners. I read story after story of NPs that sadly went to school. They spent all this money to be to get their master's in being NP, only to decide within a year that it's too much for them. And they go back to being a nurse, a bedside nurse, because they just don't want to do it. It's too much.

Matching Rules Across States

Dr.Seitz 18:49

Yeah. And it is such a shame too. You know, I and because we haven't, again, going back to that collaborative approach, like we haven't done a good job as a system of truly empowering nurse practitioners specifically. And what I mean by that is, you know, we opened up this all of a sudden in the last like two years. A lot of states have said, hey, there's a doctor shortage. We recognize it now. Nurse practitioners can be autonomous. And I hear so many nurse practitioners be like, okay, cool. What does that mean? Like, look, I wasn't trained to be autonomous. And you didn't train me to practice independently in that way. In fact, you scared me to tell me that without a physician's order, because I, you know, like so how we we haven't done a good job of educating and tolerating. And and again, you know, that's one thing that we tried to do at Guardian. Is our hope is that if we can help unlock some of the you know compliance regulatory pieces and make it understandable and educate to it, all of a sudden it does kind of kind of say, okay, maybe I can do this, right? Maybe I can do this well. Another thing I'll say too, , you know, and this is a unique perspective I have that I like to share because a lot of people don't know this. We work a lot, a lot of times with the nursing boards, the medical boards, with nurses on our platform or doctors who are getting paid to saying, hey, we don't know if you're doing this right, we're investigating you for this. We've navigated tons of investigations even in cases where licenses have lapsed. Like, hey, I was seeing patients and I didn't have a license because I didn't renew it in time, which is like a big, in your mind, it would be like a big offense, right? But even in cases like that, when the boards see that the nurse practitioner, the physician is doing their best to protect patients, to follow the rules as best they can, the worst outcomes have been like, okay, pay this fine, do some kidney medication. I've actually never seen, I'm not gonna hold here, but I've never seen someone lose their life. And I like to tell people that because I think like when you get that letter saying that the board is investigating you, oh my gosh. Your heart sings. It's terrible. But even that is very navigable with the right partners. And that's one of the things that we offer. Like one we've got some other there's some other groups out there that do what we do where they'll match you with it. But one of the things that we stand by is hey, not only will we match you with the right group, we'll give you these tools. And if the board ever comes knocking, we'll be there for that too. We'll help you to navigate that too. Because it has to be a part of the exact.

Kelli 21:09

So I want to I want to highlight that because if there's any nurse practitioners listening, any PAs listening, I want to highlight what Dr. Seitz just said. Not only does his service offer you the ability to connect with collaborators to have all of these extra resources in place, but if you have any pressure from a board, he's offering you an opportunity to have someone in your back pocket should that should that come up, right?

Boards, Gray Areas, And Compliance

Dr.Seitz 21:29

Is that yeah, 100%. Yeah, 100%. Because that because that really and that because that and and it's always been my you know thesis that that's how it should be, right? Like am I truly collab being your collaborative physician? If as soon as our relationship gets challenged, I go, oh, I don't know what she was doing. No, that's not right, that's a paper relationship, right? We want to actually build, and that's what the board wants too. And that's why we've had such luck navigating these things. Because in a lot of cases, we can say, hey, yeah, you know what? I I we see how the form that we had maybe didn't have the language in it that you would have liked. But we but but but in principle, we did the thing that you wanted us to do. How can we how can we work together to change it? And a lot of times it's like, yeah, you know what, let's let's adapt that, let's change that. We've turned a lot of these investigations into great opportunities for us to better understand what the board's thinking, what they're looking for. But going back to what you said earlier, too, really talk, a prime example of that too is Alabama. So recently, this was in the last three or four months, the Alabama nursing board officially came out. And this is one of the privileges of being licensed in all 50 states, is I got all the newsletters, right? Every board's newsletter. Uh so the nursing board came out and said, Hey, we we've decided that it is within the scope of practice of an RN to inject you can do motors, right? I saw that. Within a week, the medical board emailed all the physicians in Alabama and said, that's cool, but we don't give you permission to delegate it. Yep. Like completely under. So it's like, so and what's wild about this is again coming from EMS, what's wild about this is that my job as a excuse me, like my job as a medical control authority for an EMS, you know, when I worked in the Detroit area and I would oversee EMS, it was not my job. Like I could get on the phone and I could say, hey, Jason, my brother who's a paramedic, crack the chest, right? And he would have it was his role and responsibility to say, hey, Dr. Seitz, that's not within my scope of practice. I can't do that. And I say, okay, sorry, I can't, I'm not allowed to ask you to do something that's not in your scope. In this situation, I can tell you to do something in your scope, but I can still get in trouble for it because I'm not allowed to ask you to do it. It's just kind of this wild again, it's it's it's it's a lack of communication, right? It's a lack of collaboration there, right? That's a very solvable thing. Just someone just picked up the phone and talked to somebody else over there, right? But , but they don't always. So clinicians a lot of times are unfortunately left holding the bag. And and you know, we're hope we hope that through our through our business and and through our mentality of how we approach things that we can start to break that a little bit, you know. I mean, I think especially with digital health. I I we've seen this, of course, too in the business world of healthcare, where I think you know, people want first healthcare business wants to make money, then they want to prove outcomes. And a lot of companies fail right there, right? We how many companies that you guys know of in the digital health space that like we're making a ton of money, and then when the research started to come out, there is no actual value to patients, right? That happens all the time. If they can show value, then then and only then do they turn to provider satisfaction. And a lot of times it's already too late. Yeah, I really believe and I advocate for this all the time. If you start by taking care of your clinicians well, they are trained to drive outcomes, and you will then be able to make money. But what people don't like about that is that making money was the third step in my scenario, not the first. Uh, so that doesn't always happen. But but again, I really try to encourage you know business leaders as well. Say, hey, like if you empower your clinicians, they will drive the patient outcomes. And that's you want to make money in healthcare. I mean, healthcare is a business in the United States, for better or for worse. You want to make money doing it and drive outcomes of patients. The people who are gonna do that are gonna be your clinic.

Nicole 25:16

Yeah.

Kelli 25:17

Well, and if you drive patient outcomes, you will secondarily drive out drive, you know, bottom, bottom dollar because patients will come back to you. And that's that's the thing that Nicole does very, very well. That that joining her, that joining her practice, you know, when I did was was great for me was because patient outcomes was was her was her thing, taking care of the patient. And she knew that that was you know something that I was invested in. And so being able to step in in the telehealth space and know that she and I, at the end of the day, just want to know that that patient is taken care of. That's all we care about. Because we know that's gonna drive those patients to come back to Hamilton. That's gonna drive those patients to know that we care about them, we love them, we're gonna take care of them, and it's gonna create a bottom dollar, no matter what. It's going to.

Nicole 25:59

Yeah. Because they're gonna keep coming back.

Dr.Seitz 26:02

Wait, sorry.

Nicole 26:02

They're gonna keep coming back, and they're gonna also like we get a lot of referrals, a lot of referrals from our patients.

Texas, Alabama, And Conflicting Boards

Dr.Seitz 26:08

Yeah. Well, and and we see I, you know, again, like with what we do, I see a lot of business, businesses and healthcare happening. What what what they're trying to do, the innovation happen. And there's two very clear models, and I've seen it time and time again, only one of them works. And it's exactly what you guys are talking to. The one business model is when the nurse or nurse practitioner, someone comes to me and says, Hey, Dr. Seitz, how do I make money on testosterone? And I say, Well, if you're asking me how to start a women's or men's hormone health program, I can help you with that, right? Uh, if you want to just make money selling testosterone, though, I can tell you right now that's not gonna work. Same with you know, things like semaglutide. Hey, how do I sell semaglutide? Well, I don't know, but if you would like to start a weight loss program that happens to me or you're like, and this is the thing like you know, any of your guys, any of you guys as viewers who are listening who are you know doing telemedicine, doing their own business, like that is the key, right? Like, don't the the comp and I can and I can say this from experience, the companies they never make it when you build your business model on selling medicines or selling the next new hot fad, that doesn't, it never works because patients see through that in a heartbeat. We we talk a lot about like traditional medicine versus like you know new functional wellness medicine. You can you can practice traditional medicine in a very functional med with a functional medicine mindset just as much as you can practice functional medicine with a traditional medicine mindset. And I see this all the time. Hormones are a prime example where you have these wellness functional brands all they're doing is just convincing every guy to get on testosterone because as soon as your level is lower than X fallus algorithm, get on this. Like that's that's no different, right? It doesn't it doesn't drive those outcomes when you can actually drive those outcomes of patients as you guys have seen in your own business. Again, business grows. The only way to do it.

Kelli 28:23

Yeah, and the best the best part of that is when the patient comes back and says, and I quote, I never knew I could feel this good.

Dr.Seitz 28:30

Yeah, that's huge.

Kelli 28:31

That's huge. That helps me sleep that night. That's when I know for the last five or six patients that maybe I banged my head against the wall or had to spend an hour and a half with or was a frustrating day, that one patient just made my day.

Dr.Seitz 28:43

Absolutely. No, that's that's amazing.

Nicole 28:45

So you've listened to the podcast, so you may know, but I got my second master's in healthcare law because back to all the rules, it I really learned about the process of things and the court system and how things kind of roll out. But the rules still change. And so but Kelli got her double board certification in functional medicine. So our mix is works really well. Works really, really well.

Dr.Seitz 29:21

Yeah, that's very cool.

Nicole 29:23

It works, it works really, really well. Um, another provider question though for you, because we have a we have a circle of our people, right? So I'm I know they're gonna be they're gonna be interested. Um do you cover, does Guardian MD cover the malpractice for the doctors and then the the nurse practitioner or PA, they they carry their own, correct?

Dr.Seitz 29:44

Correct. Yeah, we cover the malpractice for the physician under our umbrella. Excuse me. And then we ask the nurse practitioner to actually cover themselves and and their business in that way.

Nicole 29:54

Perfect.

Clinician-First Models Drive Outcomes

Dr.Seitz 29:54

Oh, yeah. And we, you know, another thing too is that even in states, you know, some of you guys may be familiar with like going back to the kind of healthcare law side, the corporate practice of medicine. So in some states, who can own the practice versus who can own the business might be a little bit different. We navigate all that as well.

Nicole 30:10

So we'll there's an MSO, there's a exactly like like Texas.

Dr.Seitz 30:15

Yep. So we'll set up the PLLC or the PC with the physician. We have all those templated agreements to navigate that component as well. But yeah, I love that.

Nicole 30:23

So you help with business setup then.

Dr.Seitz 30:25

We do, yeah. And that's something that kind of happened early on, is that as we started to provide medical oversight and collaborative physicians, that became kind of an acute issue. This was a couple years ago. This was even before really the boards or the attorneys understood, you know, really because again, these weren't models, you know, like non-physicians weren't starting business as a practice way. It's really after COVID, we saw this big boom. So that was one of the things that came up very early on. It's like, hey, you know what? Like we can provide the doctor, but people don't we people don't know how to structure this stuff either. You know, maybe maybe we need to help them figure out how to do that component because again, it's all that kind of that infrastructure layer, right? That compliant, that oversight compliance infrastructure. You can build that the right way, then the sky's the limit of what you can do with your business, right?

Nicole 31:08

So some states have very specific collaborative agreements that you have to have. And other states, they're like, I don't even want to see it as long as you have it if I ever ask for it, right? So it's all the way from like A to Z, like how it goes. You and I I'm I already know the answer, but I just want our listeners to hear you say it that you provide those collaborative agreements that are appropriate for each state.

Dr.Seitz 31:36

Yep, exactly.

Nicole 31:37

They're vastly different. You cannot use the same agreement for all 50 states or whatever.

Dr.Seitz 31:42

Yeah, exactly. Yeah, and then going back to Kelli's point too, like, and then there's states like Texas where you have to literally go online and fill it out.

Nicole 31:49

Go to the medical board.

Dr.Seitz 31:50

Georgia just did this too, where they changed it. Where now you used to draft your own and send it in. Now you actually go and like almost fill it out in real time on their web page and on their website. So yeah, every state's very different. But yeah, yeah, we have all we have all those templated agreements. Uh, we keep them up to date as the regulations and change. You know, for we also have like a robust protocol library. So we have protocols for hundreds of services and procedures and things like that. Uh, you know, how you know how to deliver Botox appropriately with the right history and all that stuff in there, how to how to do hormal replacement you know, in an appropriate science-based fashion.

Nicole 32:27

I love that one. I love that because not all clinicians are built for autonomy. I've worked for I've worked, you know, over the course of in a previous lifetime, I've worked with different companies, and you can tell which providers have worked autonomously and which ones have never worked without a physician right by their side. Like they're afraid to do anything. They're like, I need a protocol. And I'm like, Yeah.

Autonomy Versus Real Collaboration

Dr.Seitz 32:49

Oh, and this is one thing that we do as well. Like, you know, even in states where nurse practitioners can be autonomous, sometimes we have nurse practitioners come to us and say, Hey, like, can I still get a collaborative physician with you? Like, of course. You know what I mean? Like, like, absolutely, right? We don't have to like do something as formal. It doesn't maybe need to cost as much. You know, but like we still, you know, that partnership model is still there, even for those. And this this I think sometimes nurse practitioners, to your point, like they they decide, okay, well, maybe I just can't do this. I I would hate for that to be the case, right? Like, like just because you're not comfortable working autonomously doesn't mean you shouldn't still be working within your scope. Like, right, we'll still partner with those people to say, hey, we'll give you a physician, advisor, whatever we call whatever you want, but like they're still available, you can still use our services. You're not alone, too. Exactly. Exactly.

Kelli 33:35

I like that. I like that. There's nothing wrong with that. Like, I I want to point out to our listeners, nurse practitioners, there is nothing wrong with that. Like, we are not all cut from the same cloth, we are not all the same people. Like, you may not be a Nicole, you may not be a Kelli, you may not feel comfortable practicing autonomously because of where you were born and where you were bred and how you were raised and what training program you had. And that's perfectly fine. There's nothing wrong with that. And so I think that it's fantastic. What you are offering, and I really want to hit home here because I think this is very important. What Nicole has built and what I have experienced trying to get all these licenses by ourselves, trying to build companies by ourselves. You know, we have legal teams, we've paid attorneys' fees, we've hired this attorney and that attorney, and we've gone over this with the fine-tooth cone, and we've talked to this board and we've had to call this attorney general. Like we've done this footwork ourselves. It's literally thousands of hours, tens of thousands of dollars. Guys, when you have a company like what Dr. Saints is offering, you have the whole package. He even has protocols for you. He has backup collaborators, he has an attorney on call. He has like, that is a package deal. Like I wish Nicole and I would have had access to back in the day when we first started this, you know, this long haul.

Nicole 34:45

Absolutely. Absolutely.

Kelli 34:47

It's not something that you should shy away from because that is something that probably took you a very long time to build, if I had to guess. And a lot of manpower and a lot of you know, blood, sweat, and tears that Nicole and I could have saved ourselves had we had access to something like that.

Nicole 34:59

So whatever, whatever you're and we don't have to talk about it here because it's maybe we can talk about it another time, but whatever, whatever your company charges is worth it because I can email my attorney. I can email my attorney and I get a bill. Get an email back and it's $250. Yeah. Okay. And if I email my attorney and he's like, well, I gotta reach out to a Texas attorney. Because I right, because I'm I'm I'm not quite, you know, familiar with the Texas laws. Now I have two attorneys that I'm just getting questions answered. So whatever you charge is completely, it's completely worth it because I promise you, doing it yourself. I paid a lot of stupid tax because I didn't, I didn't, number one, I didn't know. Number two, I was way early on in the game where you know you were probably you were probably just trying to grow your grow your stuff too, right? Because getting licenses is is expensive. It takes a long time. Nobody's in a hurry, especially during COVID. Nobody was in a hurry to do anything. So, and then as they started opening back up, they were backed up. So everything took a really long time. So attorneys are expensive, $250 to $500 an hour. And when they send an email, it is like even if it's two sentences, they're you're you're gonna get a bill 100% of the time, you're gonna get a bill. So what you do is incredible, it is a great offering. Yeah, appreciate that.

Dr.Seitz 36:32

No, and Kelli, I want to kind of reiterate something you said. I think like going back to the autonomy thing, autonomy and healthcare is a misnomer. It is none of us are autonomous. None of us are autonomous. You guys are you guys work together, right? Like we like I had someone ask me one time, you know, Dr. Seitz, oh, you're they thought I was an ER doctor, and they were like, oh, so if you know, if we were out in the woods and someone got, you know, you know, bit by a lot of what would you do?

Kelli 36:58

Like, I don't know.

Dr.Seitz 36:59

I was like, I don't know, like put my hand on the bleeding and hope someone else shows up. I it's not like I like unless I've got a CT scan, a team of nurses, a couple specialists, and it I again, like none of us work autonomously, right? Like it's kind of like a miscommunication. So and I say that only to like encourage those who may be overwhelmed by that term or that idea that like, oh my gosh, like I'm all by myself. You don't have to be all by yourself.

Malpractice, CPOM, And Setup

Nicole 37:22

We're never all by ourselves. And with even in the states, even in the states where I'm autonomous, where Kelli's autonomous, we still collaborate. So I truth be told, I don't need an agreement to collaborate with what I do. I mean, you you you have the states have rules, and I have to be compliant and I have to do what I have to do. But without those rules, I'm still going to call my, you know, my my neurologist colleague because it's specific for him. And I know he's gonna, he's we're gonna collaborate. I'm gonna call ortho because this is something that maybe I'm not quite familiar with. I'm still gonna collaborate. I'm still gonna call my people. Like I'm still gonna do that. Even if you don't make me, I'm still gonna do it. So we're never, we're you know, we're we're never we're never alone. We're never alone.

Kelli 38:13

And to speak to that, Nicole and I are in touch all day, every day. We ping off of each other all the time. And, you know, it's like you said, as an ER physician, I worked with what who I consider two of the best neurosurgeons in Texas. I truly, truly feel that way. They were both Parkland trained. They came up under one of the best neurosurgeons in Texas and they opened up their own practice. I practiced with them for seven years, and I never not one day saw them not collaborate with each other or their other partner. Never. No one knows everything. No one they always ran cases by each other. They always tagged off of each other. They always, hey, let me run this by you. What do you think about this? Have you did you have you ever seen that? Like always constantly, because it made each other better. You are, you know, two minds are better than one, three minds are better than two. Like you never know it all.

Nicole 38:58

And I think, I think as you get into healthcare and you get into the meat of it, maybe at first there's a little ego with with you know with some some people, but when you truly get into the meat of medicine, you know that you should never be the smartest person in the room. There you and you're not the smartest person. Like even if you think you are coming out of school, you are you are never you are not the smartest person. And it is only going to be helpful to your patients when you realize you don't know everything, you're not the smartest person, and you need other people. Yeah.

Dr.Seitz 39:30

It's funny. I people ask me sometimes about my craziest story. So I I'll share this one because I think it speaks to this a little bit. But I was working up in the upper peninsula of Michigan when I was doing travel license. I was the only doctor in like the little town. There's nobody else there. They made me the medical examiner when I was on shift. I was like, you can do that, but I'm not, I can't do you know I can't do that. You can put my name down, I guess. Y incision. Yeah, right. I'm like, I have no idea. I'm like, I got it. So I'm the only doctor. I'm in this little ER. And I get a we get a call from EMS saying, hey, we had a 20-year-old female got her arm stuck in machinery and full amputation above the elbow of her dominant, like her dominant right arm. She got it caught in what?

Nicole 40:15

I didn't hear what she said.

Dr.Seitz 40:16

What's that sorry?

Nicole 40:17

She got it caught in what?

Protocol Libraries And Support

Dr.Seitz 40:18

In like the machinery. They said, We're bringing her in and we're bringing in the arm. And I looked at the secretary and I said, Find me someone who knows what the heck to do. Well, I mean, like, like first call a helicopter. We're gonna need that for trip. Yeah, , also, like, who do we have? It's a small little rural town. She's like, Well, there's a guy who lives in the neighborhood over there. He was a Vietnam vet. I go, him, I want him. Call him. I brought this random guy. This guy taught me more about amputation repair than any physician ever had. Any nerd, this guy's not clinically trained at all. I mean, he is in the sense that, like, but again, it was like, and it's it's just it's just kind of one of these crazy stories. You don't even feel like it's real. But it's, you know, it it speaks to that whole like, you know, and I think this is where I got excited and why we started Guardian, because like, you know, even I had some other opportunities to work. Again, we are the only doctor. There's a baby being born up on the third floor, and there's a trauma coming in. It's like Dr. Sice, which one do you want? And I'm looking at the nurse saying, Which one do you want? You know what I mean? And she's like, Well, I've delivered a bunch of babies. Okay, yeah, please go deliver that baby for me, right? I'll be over here. And you just like again, nothing in medicine is is is truly autonomous. Like we don't, we don't work in these bubbles.

Nicole 41:35

Um, even you collaborated with the either was it the charge nurse or the or the secretary. Like even you collaborated with the secretary saying, Look, I gotta have I gotta have somebody. Like I need somebody.

Dr.Seitz 41:45

Yeah, yeah, absolutely.

Kelli 41:47

We have to have our people, and it doesn't matter what their title is in that moment.

Dr.Seitz 41:49

No, not at all.

Nicole 41:50

I love that story. It gives me goosebumps. I love it. I love that. And you know what? You probably made his year, that Vietnam vet. You probably he probably tells that story every day.

Kelli 42:00

Yeah, but so do I, so do I use that story as much or more than you do. You know, yeah, exactly.

Dr.Seitz 42:04

I'll say we both do, we both do, yeah.

Kelli 42:06

So it's so I love that. I absolutely love that. That is so good. Well, Dr. Seitz, I could sit here and talk to you forever. I think our listeners could too, but if we don't wrap it up, they're all gonna kill us, and so is our production, our production team is gonna be like, what are y'all doing? But we will have you back for another episode, guys. Please don't absolutely have you back. So one last time, Guardian MD, correct? Guardian MD.

Dr.Seitz 42:28

Yes, guardianmd.com. Um, yeah, you can check it all up. We got a lot, please. Yeah, we got a really robust, you know, educational-wise, like a lot of our our marketing strategy is education. Go to our blogs and we we we talk a lot about all this type of stuff. Understand corporate access to medicine, how physician collaboration should work, what agreements should look like. Again, even if we can just benefit you guys by going there and educating yourself, you know, please do.

Kelli 42:52

Please don't pay the stupid tax that Nicole and I paid.

Nicole 42:55

Please don't. Please don't do it. We can save you from paying stupid tax. We would love to do that. Well, we'll definitely stay connected with you and hopefully we can do some things together in the future and just continue to help help people who are trying to get into this, into this world grow. And I love seeing people succeed, and both of you do as well. So we are here for it. Awesome.

Dr.Seitz 43:15

All right, thank you guys so much. It's been a privilege.

Kelli 43:18

So all right, guys. If you want, please like, subscribe, follow all the things. Any questions, please comment below. We would love to know if you have any questions for Dr. Seitz, we will field those over to him. I assume that your that your production team can get those questions to you. Yeah.

Dr.Seitz 43:31

Yeah, absolutely. Of course, yeah.

Kelli 43:32

All right, wonderful. He'll be happy to answer those for you. So thanks for joining us. Bye, guys. Bye.

Speaker 43:36

Thank you.