#8: What Physicians Should Know About Telemedicine ft. Saya Nagori, MD

Welcome to the Passive Income MD Podcast, where we talk about creating your ideal life through multiple streams of income. I'm your host, Peter Kim. If you enjoy hearing about this stuff, make sure to hit subscribe so I can bring it to you every week. Now let's get on with the show. Hey, everyone, this is Peter. I'm extremely excited about Today's episode because Dr. Sayon Ngoori is an expert in telemedicine. I know that's super relevant today with everything going on and changes to medical practice. And there are constant and exciting changes that are up ahead for this whole field. And so I think you'll really enjoy this episode. Dr. Sayonigori. She's an ophthalmologist, but she's not only an ophthalmologist. She's the creator and co founder of several telemedicine companies, including Simple Health. I mean, this company uses emerging technology like telemedicine to deliver healthcare to patients, and we're gonna talk about that on this episode. We're also gonna talk about how physicians can integrate telemedicine into their practice and how important it is for physicians to understand this emerging field. So if you're at all interested about telemedicine, the future and how you can participate in it, definitely just really take some notes. Then you're really gonna appreciate this episode.

It's.

Enjoy. Hi, Saya. How you doing?

Hi. Good. How are you?

Good. For those who might not know who you are, I mean, I think a lot of people do, but do you mind introducing yourself?

Sure. So my name is Saya Ngori. I'm an ophthalmologist. I got into telemedicine about five years ago. I started a company called simplehealth.com we actually started in eye care, which obviously makes sense. But about a year and a half ago, we actually transitioned over to women's health. We actually don't do eye care anymore because women's health just really took off. And so I've been in the space for about over five years now, and I consult for a bunch of different digital health companies. And, yeah, it's just been a great ride.

I mean, that's amazing. How did you get into it? I think that's what a lot of people are wondering.

Thanks. Well, honestly, I took a huge risk in the beginning. I was pounding the pavement for a while trying to find something innovative and entrepreneurial to do right after fellowship and had a bunch of things that I did that didn't work out. Some were in digital health and wellness, and some were Not. And it just kind of took a lot of networking and meeting people and finally meeting my co founders and launching something from the ground up. And then once I got the hang of it, I was just able to really expand it into different fields and I mean, well, different projects within digital health and telemedicine.

Gotcha. So just to back up a little bit for those, maybe some people aren't fully aware of what telemedicine is and, and I'm sure it's a big broad field, but just for those who aren't really familiar with it, do you mind telling people what telemedicine is? Things have changed quite a bit lately.

Yeah. So, you know, telemedicine is really anything that involves virtual health. So I think I also would probably categorize telemedicine and digital health and health technology all together. Right. So it can be anything from doing a face to face patient interaction. Like if you were my patient, we were having a discussion about your health right now. Or it can be things that lead to prescription rules, like some of the companies that we see now in addition to Simple Health, which is my company. But you know, you guys see companies like Roman and PIMS and hers, it can be remote patient monitoring, it can be uploading health information from your wearable. So there's just like a bunch of different spaces that health technology now has taken off and a lot of ways that a lot of doctors can get involved.

Yeah, I think that's what people are wondering, if they are interested in getting involved. Like, I guess we'll just jump right to it. Like, how do people like you get involved? I mean, five years ago you got into it just because you were looking for something else. Sure, things have changed, but how does someone today get into something like that?

Yeah, there's a lot of opportunity, but it can definitely be tough because there's also a lot of competition. I think, I think I was telling you this story is that five years ago when I started my company, I could not convince someone to work for me. Like it was like twisting someone's arm and convincing them that it was safe and like them feeling really hesitant. And I ended up with 15 licenses because I just had to see all the patients myself. And now I probably get a few emails a week or a few Facebook messages a week on, hey, is there a job out there? Is there a job opportunity out there? And you know, of course I take everyone's email down and make sure that we do have jobs. And actually there are going to be a lot of jobs that are going to be out there with this virus right now. So if anyone wants to work in telemedicine, their opportunity is 100% coming.

Let's talk about that real quick. I mean, do you think that's accelerated? Obviously it probably is, but I just want to hear your input on it. Everything that's going on with COVID and coronavirus and how that's impacting the way we treat people. I mean, I'm just wondering what. You're in the middle of it.

So, yeah, it's been wild. I think, obviously it's a very serious situation. I think even just three weeks ago, I was underestimating how bad it was going to get. And it does feel nice to be somewhat part of the solution. So I've been working with a few different large systems and hospitals on telemedicine rollout and how we can get their systems up and running and equipped to start handling a massive amount of patients, not just their regular patients, but also new patients coming into the system. And the upside is that there's going to be a lot of opportunity and things that were barriers to innovation before are really not going to be barriers anymore. And that's because people are going to realize, well, like, what the hell are we even arguing about with this regulation and that regulation, like, we just got to get these people treated. And that's going to set a very unique precedent going forward because people are going to be like, well, we didn't have all this red tape during COVID because people just needed care, so why do we have it now? And I actually think for telehealth in general, that's a good thing. I don't know the impact overall on medicine because if all of a sudden we realize, hey, we don't need to go into the doctor as much as we actually do, what does that mean for the healthcare system as a whole and the way we all make our money?

Yeah, I think some people are today are being actually forced to do it. I mean, it sounds like I talked to an oncologist the other day and she was saying how she had to convert. I mean, they didn't know how to do this, but they had to figure it out just in the last couple days how to integrate into their business. And so I guess that's what a.

Lot of people don't have a lot.

Of direction as to how to do that. Right. And so for some, someone like you who's been there, like, what's their first step in trying to, like, get this to work for them?

I think you need to have, first of all, just the baseline understanding of the landscape. You need to understand the landscape of telemedicine. You need to understand data interoperability. You need to understand where telemedicine works and where it doesn't. And you need to start getting a little comfortable with being creative about how you start treating patients. Because while telemedicine is a fantastic tool, it's something that I've been really passionate about for years now. It is not the same thing as going in person. Right. I don't know when it will be. It might be at some point in the future, but today it is not. So you have to be creative and mindful of what you can and cannot do. And so I think just a really deep understanding of that. And then of course, a lot of the nuances and regulatory. How does regulatory affect me? And right now that is really changing pretty rapidly because we have states now that are opening up their licensure. So for example, Colorado very recently, like maybe three days ago, said we're now accepting out of state licensure as long as you're in good standing, because they're predicting that they're going to need help. And so things are really changing. So I would say a really deep understanding of how the technology works, the different ways it can be applied, and then also regulatory reimbursements, which are also really in flux now. Like, how are you going to treat Medicare versus Medicaid versus your commercial insurance versus someone who's paying out of pocket and what the steps that you need. Do you need consent? And what kind of consent and what defines a physician patient relationship? So there's a lot of nuances to learn to understand.

How about liability there?

I mean, is that a big concern for people? I think that's probably one of the major reasons that people say, oh, I just can't do it. Doesn't make sense.

Yeah. So the good thing about telemedicine liability is because you're kind of limited in what you do, your liability overall is probably lower than. So, you know, I'm an ophthalmologist, and when I'm in the office and I'm doing procedures or if I'm in the operating room, I mean, my liability is just way higher versus if I'm treating someone via telemedicine, I'm not sticking needles in them. I'm not poking them with sharp objects. So there's that. And then also now, again, such a big difference. Five years ago, five years ago, I couldn't find a malpractice carrier. I had to get some random company. Half the management was, like, based out of London, and it wasn't even a company. It was like a broker for another company that covered me for my telemedicine visits. And now almost all insurances have a telemedicine rider. Like, they all. You can add a rider off. It's not hard, you know, you just need to do the legwork to do it.

All right. How strongly do you feel that, I guess all physicians should at least explore and learn about this?

Yeah, we were talking about this before. I think I really feel very strongly about it because this is the future. Right. Like, if this outbreak has taught us anything, it's that, you know, I've been preaching about telemedicine for five years, and in the last five days, my phone has never been busier. I have never been so popular as I have been in the last five days. Like, we need you to consult here, and we need you on the phone here, and can you help me do this? And, I mean, it's great. I feel, like, sort of validated. I'm like, yeah, I knew this was coming, but obviously it's very scary, too, because why aren't we equipped for this? Like, from a patient standpoint, you're like, am I the one who's gonna help all these people implement this, like, today?

Well, yeah, I think it's an awesome responsibility and opportunity as well. I mean, it's like. It's like almost like you've been preparing yourself for this moment. So that's awesome. I mean, I think that.

I mean, I guess I'm pregnant, so I hope I don't go into labor.

Oh, okay. There's that, too. Right. That you have to think about. Okay. I mean, what kind of. Somebody doesn't want to necessarily start this for their own practice? I guess there are other ways for them to get involved. I know that's one of the biggest things, but, I mean, do they just go about and just sign up for these different telemedicine companies? How's that? I mean, again, just thinking about it from the basic step for somebody just wants to get out there, what do they do?

Yeah. So definitely you need state licenses. Most companies won't hire people unless they have at least three or four. Although the demand now is going to, like I said, because of COVID it's going to skyrocket. So they may have a lot more opportunity. But also, there's an email list that I put out every time I see a job opportunity. So if anybody wants to be part of that email list. They're more than welcome to sign up for it. But the main thing I would say is really distinguishing yourself. Right. Is you don't want to just be another doctor that's just going to be seeing exams. And I think that's okay if that's all you want to do. But if you sort of prepare yourself and really have a deep understanding of how this works and you're able to implement it on your own, companies will see a lot of value in that. And so you don't have to be just a doctor that sees a patient every five minutes or every 10 minutes via telemedicine. You can actually be someone who helps more on strategy and implementation and sort of bigger picture stuff. And I think that's a nice way to sort of distinguish yourself and stay very relevant and very desirable in this very competitive market. And I think that's knowledge based. I think that's also networking based. But yeah, I think you can do either or. But I definitely think that if you're just a physician who is in the grind, always just seeing patient after patient after patient, if you could be replaced.

Absolutely. I think it's the same concept that I've been talking about so much is that you've got to create value. Otherwise you're just another kind of cog, that type thing, and you're just trading time for money and ultimately you're not in control. And that can be a scary thing, as I found out in the past. So, uh, it's awesome that you tell people about that now. I guess that sounds great. Like I want to learn all that stuff, but I don't know.

Where did you pick up all that information?

I guess exactly how to do that. It sounds great, but five years. Okay. Yeah.

Five years of picking at stuff and trying things and just doing it myself. Learning. 5 years of not getting paid, doing things and getting paid, doing some things and figuring out what works and what doesn't. So. So it's been a long road, but I think that the opportunity now is really opening up for telemedicine. I think it's like a very hot, hot market, despite all the awful things going on right now.

Yeah. I mean, what does your daily life look like then? Is it since. But you're running these companies, right? I mean, you're just not.

So. Yeah, I advise for a lot of companies and then I have my own practice, which actually I've been doing virtual visits because of the outbreak and trying to just keep people out of the office. So I do Telemedicine on different levels. So I do it on the physician level where I am seeing the patient and doing the visits and building out a small practice framework. And then I do a lot of institutional stuff where we do like back end integration with EPIC and systems to actually have entire departments be able to roll out telemedicine quickly. And then I do stuff with that's just like strategy and more like what's next beyond telemedicine? Is it voice? What is the next thing that we're going to be doing that's going to make healthcare more efficient and easier to access?

Yeah. So someone wanted to come to you and say, okay, Dr. Ngori Saya, can you teach me how to do these things? Is that something like an opportunity that somebody might have?

Yeah. So I do a couple different ways of teaching. I have private consulting that I would say is probably more appropriate for larger organizations. It has a minimum retainer and I work really pretty integrated in the systems to try to specifically solve how that organization or practice is going to integrate quickly. I also have a telemedicine course that you know about, which I think is really more appropriate. Like, more like all physicians that are just sort of trying to understand this, trying to get into it themselves and trying to really be not just knowledgeable, but distinguish themselves as really having a unique set of skills and now adding this to their skill set. Because I can guarantee you there's not going to be a job out there in six months or 12 months that is not going to ask you what's your background in telemedicine? How can you help us if we want to expand our telemedicine services? It's going to become a very important skill set going forward.

No, it's absolutely important. I think that, yeah, being able to position yourself as an expert in this field and whatever you're in, it'll only give you a leg up, especially as medicine is changing so quickly and rapidly. Yeah, I mean, I'm a big fan of your course. I've taken it myself and I will link to it in the show notes. And I think people have an opportunity to get in. I've actually talked to Dr. Ngori about giving people who are listening to this discount as well as people who are reading the blog. So look out for that as well too. I think like people are interested in knowing what someone's life might look like in medicine. And we've talked about a lot on my blog about really creating your ideal life through these other streams of income and not just being like A, a one trick pony. Just kind of being a physician that's on the track, maybe unemployed and just expecting to be that way, the same way until you retire. What kind of life can people create using telemedicine? I guess, like, is it wide open for them?

Yeah. I will tell you, I have never been happier in my life. I mean, I'm so happy that I found a good balance because I used to work two different hospital jobs, take call at night. I was building my company at the same time. I was probably working like hundred hours a week at least. And between all the things that I was doing, I wasn't really making great money. And well, that's because it was also my own company, was a startup. But yeah, and so now just learning all these things I have, you know, I see patients two and a half days a week. I do a ton of telemedicine. The other times, whether that's actually seeing the patients, whether that's actually doing some kind of strategy or implementation, or whether it's doing private consulting for other people to get their practices in telemedicine businesses and companies off the ground. And so most of the people that get their telemedicine businesses off the ground, they'll start with the course and then they'll bring me on as a consultant afterwards. And I think it's really important because you want to have the framework first before you bring me on as a consultant because you need that foundation. Otherwise it's a lot of teaching back and forth that you can just get in one place. And so I think that telemedicine and just finding different ways to use your skill set and people think that, oh, how am I going to acquire this? You can acquire it, you can like, you don't have to limit yourself to. I never thought I would be doing this 10 years ago, ever. And so I think that, I mean, it's changed my whole life and I, I don't even know what's going to be the next cutting edge thing in five years. Maybe I'll be like, snooze on the telemedicine. Maybe it'll be. Who knows what?

I doubt it. My perception of this is only getting bigger and this just will provide more access because that's been one of the biggest challenges, I say, for healthcare. People are saying there's going to be a lack of access and this will kind of level the playing field of get people out to where they need to be. So, I mean, I think you're positioned really, really well for the future. Definitely where else can people reach you besides obviously the course? And we'll put a link to that in the show notes. How else can people reach you or find out more about you?

I mean, honestly, they can just straight up email me if they want to. It's my first name.last namemail.com or siaimplehealth.com.

Great.

And your website there for the company is.

Oh, medicine and tech dot com.

Medicine and tech dot com. And your company is simple health dot com, right? Yeah.

So if anybody. We send the telemedicine jobs out via the medicine and tech email listserv. So like I said, I think it's going to ramp up. So if people want to work for another company, they can put their email in there.

Good. Okay. You help them as well. Awesome. I know you're really busy, so I appreciate your time. I think I want to boil it down to have this question at the end that I'll ask a lot of people. What's your number one tip then for someone who, who's considering kind of doing something outside of the norm of the typical thing, trying to figure out other streams of income, try new technologies, these kind of things. What's your number one tip for someone like that?

I think just dive in. Dive in, do it. I don't think that it's going to happen overnight. Like, I think you need to probably do a few things, take the right steps, whether it's get the education you need or go to the events that you need to go to or meet the people that you need to go to. But if you dive in and you start doing things and be patient, I mean, me and you are both Tony Robbins fans, but one of my favorite quotes from him is, you know, people underestimate what, you know, they can do in a decade and they overestimate what they can do in a year. And so I feel like you just have to keep at it and be patient. And sometimes I think right now the situation is very ripe for telemedicine. So I feel like if people dive in now, they'll actually have a lot more success than I did five years ago. Like, it took me five years to get here. I think someone can get where I am in this situation probably in under a year, because it's just. It's a different world.

It's amazing. Okay.

World. So I think that in 12 months they could be exactly where I am, doing consulting and implementation, if that's what they want to do.

Right.

Or running their own telemedicine company. Because right now we need actually individual people to start their own telemedicine platforms because the system is going to be overwhelmed. Even the big companies are going to be overwhelmed. And so I think it's important to just get right in there.

Okay, awesome. Thanks for that advice. Thanks for your time. I think people will love it. And definitely people. Don't hesitate to reach out to her if you need her. And yeah, I'll just continue to follow along and see all the awesome things you're doing, Peter. All right.

Okay, thanks.

All right, take care, guys. Take care.

Bye. Bye.

Enjoy the show. Let me know by dropping a review in the podcast app you're listening to us at. And if you haven't already, make sure to hit subscribe. Are you a part of our community yet? Join thousands of physicians who are also on this journey to creating their ideal lives through multiple streams of income. You can join us on our Facebook group Passive Income Docs, and you can always learn more at our website, passiveincomemd.com thanks again for allowing me to be a part of your journey. See you next time.