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Why are so few Physician Assistants (PAs) entering the telemedicine space, and how can they overcome the barriers to start their own practices? In this episode of Telemedicine Talks, Phoebe Gutierrez and Dr. Leo Damasco are joined by a panel of innovative providers: Ashlyn Smith, Christina Davis, Savannah Elgins, and Katie Wakeland. Together, they share their journeys from traditional clinic settings to telemedicine entrepreneurship, highlighting the frustrations with the broken healthcare system, insurance challenges, and the shift to cash-pay models. Three Actionable Takeaways: Know Your State Laws and Build the Right Structure: PAs face unique regulatory hurdles like CPOM and supervision requirements—research your state's rules on collaboration vs. supervision, and consider structures like PLLCs or PC-MSOs to enable ownership while partnering with physicians. Find Your "Why" and Join a Supportive Community: Clarify your mission to stay motivated through challenges; seek out groups like the Independent PA Collective (IPAC) for mentorship, shared knowledge, and encouragement from peers who've navigated similar paths. Embrace Mistakes and Prioritize Balance: Shift from a risk-averse clinical mindset to an entrepreneurial one—expect pivots, learn from failures, and remember to set boundaries, as you're irreplaceable only to your loved ones, not your job. About the Show: Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine. About the Guests: Ashlyn Smith is an endocrine PA based in Arizona with 15 years of experience, passionate about whole-person care in endocrinology. She's certified in lifestyle medicine and advanced diabetes management, and runs her own telemedicine practice focused on bridging care gaps. Christina Davis is a PA in Florida's Panhandle specializing in developmental behavioral pediatrics with a functional medicine approach. She operates a hybrid telemedicine practice to serve underserved families nationwide. Savannah Elgins is a PA with over 20 years living with type 1 diabetes and an endocrinology background. She's co-founder of a telemedicine practice dedicated to specialized type 1 diabetes care. Katie Wakeland is a nurse practitioner with an endocrinology focus and type 1 diabetes experience. She partners with Savannah Elgins to provide patient-centered, tech-savvy care outside traditional systems. About the Hosts: Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health. Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models. Connect with Phoebe Gutierrez: / pkgutierrez phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) #TelemedicineTalks #PAsInTelehealth #HealthcareEntrepreneurship #TelehealthRegulations #Endocrinology #BehavioralPediatrics #Type1Diabetes #IndependentPA #HealthcareInnovation #PayerChallenges