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What if PAs could lead the charge in closing healthcare deserts through telemedicine—and what's holding them back?
In this episode of Telemedicine Talks, hosts Phoebe Gutierrez and Leo Damasco welcome Ashlyn Smith, as she shares her journey from aspiring veterinarian/dancer to endocrine specialist embracing telehealth during COVID. She highlights telemedicine's advantages like meeting patients at home for deeper insights, fewer missed appointments, and family "pop-ins" while addressing PA challenges: limited infrastructure, state-specific supervision vs. collaboration agreements, and the upcoming 2026 PA Licensure Compact for multi-state practice. Ashlyn discusses pivoting to entrepreneurship amid work-life tensions, reading contracts meticulously, overcoming imposter syndrome, and blending evidence-based endocrinology with lifestyle medicine. Her clinic offers telehealth care in Arizona, nationwide coaching/e-consults, EHR templates, and resources to empower clinicians and patients. This episode inspires PAs to explore independence, collaborate across specialties, and expand access in underserved areas like endocrinology, where reimbursement issues widen care gaps.
Three Actionable Takeaways:
- Read Contracts Thoroughly: Before signing any professional agreement, review every detail—don't just scroll to the end. This week, practice by analyzing a sample contract to spot restrictive clauses on scope or independence.
- Research Your State's PA Rules: Check if your state allows PA-owned practices, collaborative agreements (after 8,000 hours), or the upcoming Licensure Compact. Start by contacting your regulatory board for clarity on ownership and telemedicine options.
- Leverage Telehealth for Deeper Patient Insights: In your next virtual visit, ask patients to show their home environment or medications on hand. Use one session to note family dynamics or lifestyle factors for more personalized care plans.
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 Guest:
Ashlyn Smith is a board-certified PA and distinguished fellow of the American Academy of PAs, with 14 years in endocrinology and over a decade in medical education. A certified Diabetes Prevention Program lifestyle coach, she owns Elm Endocrinology and Lifestyle Medicine, a telehealth practice blending hormone health with evidence-based lifestyle medicine. Past president of the American Society of Endocrine Physician Assistants, she lectures on pituitary disorders at Creighton University and supports clinicians through e-consults, coaching, and resources.
· Connect with Ashlyn Smith:
📧 Email: [email protected]
🌐 Website: https://www.elm-health.com
📱 Instagram: @elm.pac
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:
https://www.linkedIn.com/in/pkgutierrez/
[email protected] (mailto:[email protected])
The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with.
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