August 12, 2025 • 21 mins
Recorded at the Ascend Conference in Salt Lake City, David A. Saltzman talks with Lorenzo Amaya, Vice President of Business Development at Integrated Source One. They explore the nationwide physician shortage, the challenges of quality care and timely access, and how innovative solutions like on-site, near-site, and mobile clinics are changing healthcare delivery for employers and employees alike.
Lorenzo shares his journey from banking to telemedicine, and how Integrated Source One works to remove friction from care — making it more affordable, proactive, and accessible no matter where employees are. The conversation dives into proactive healthcare strategies, the role of virtual primary care, and meeting patients where they are with flexible delivery models.
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🔑 Key Takeaways from This Episode
📌 The Physician Shortage Is Real
Patients are waiting months for appointments, creating a bottleneck in care.
📌 Quality and Access Go Hand in Hand
Lorenzo explains why true care solutions must address both simultaneously.
📌 Virtual Care Is Here to Stay
From chronic condition management to urgent needs, telehealth is becoming the norm.
📌 On-Site, Near-Site, and Mobile Clinics Reduce Friction
Flexible care delivery can keep employees healthier and out of the ER.
📌 Proactive Care Saves Costs
Continuous access and preventive screenings stop expensive, episodic events before they happen.
⏱️ In This Episode
00:00 Live from Ascend: Introducing Lorenzo Amaya
02:00 From banking to telemedicine and healthcare innovation
04:30 The scope and causes of the physician shortage
07:30 Quality of care and reimbursement challenges
10:00 The telehealth boom post-COVID
13:00 Generational comfort with virtual healthcare
16:00 Streamlining access for better patient experiences
19:00 On-site, near-site, and mobile clinics explained
23:00 Cost and feasibility considerations for employers
26:00 Serving underserved and rural areas
29:00 Proactive care vs. urgent care
33:00 Employer adoption and employee education
37:00 Reducing ER visits and plan costs
40:00 Frictionless care for better outcomes
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
With all the conversations that we have
around problems and challengesin the industry, one of the
biggest challenges is theshortest of physicians and we
haven't talked about it a lot onthe podcast.
How do you solve that problem?
We'll find out on this episodeof Shift Shapers.
Speaker 2 (00:16):
Change either energizes or paralyzes.
The choice is yours.
This is the Shift Shaperspodcast, bringing the employee
benefits industry interviewswith individuals and companies
who are shaping the industryshifts.
And now here's your host, davidSaltzman.
Speaker 1 (00:37):
And to help us answer that question, we are joined
here at the Ascend Conference inbeautiful Salt Lake City, utah,
by Lorenzo Amaya.
Lorenzo is the Vice Presidentof Business Development at
Integrated Source One.
Welcome, lorenzo.
Thanks for being here.
Thank you for having me.
So let's talk a little bitabout as I mentioned in the open
, but before we get to that,let's talk about how you got to
(00:58):
be doing what you're doing today, because everybody's story in
this business is a little bitinteresting, sure, how'd that
happen?
How'd you end up where?
Speaker 3 (01:05):
you are, I'm going to give you the Reader's Digest
version.
So, I've been in banking for 20years and actually started out
because I went to church with agood friend of mine who was in
the telemedicine space andhelped that company build, went
from 54 employees to over $4million in annual revenue and
oversaw the reseller, broker andwhite label channel and just
(01:27):
found a love for the healthcarespace.
Speaker 1 (01:29):
Interesting, so that's a great place to come to.
So let's talk a little bit.
Let's set the table.
We talked in the open about theshortage of physicians.
I don't think it's a problemthat gets talked about a lot
because everybody thinks, well,there are doctors on every
street corner and you can gofind somebody whenever you want.
What's the scope of thatproblem?
How big a problem is itactually?
Speaker 3 (01:48):
in practicality.
Well, I mean, from a practicalstandpoint, people are
experiencing it just, and I'msure we've all experienced it on
some level.
But you know something assimple as my daughter waiting to
see her OBGYN for five months,and there's been stats a growing
stat of shortage of physiciansfor over the last five months,
and there's been stats a growingstat of shortage of physicians
for over the last five years,and they're saying it's becoming
(02:10):
more and more of an issue.
So accessing quality of care,accessing affordable care and in
a timely fashion.
Speaker 1 (02:16):
You know we'll discuss all those things, so I
think those are very importantaspects also.
But to what do you attributethe lack of physicians?
I mean, when I was growing up,every mom and dad wanted their
kid to be a doctor, right?
And now all of a sudden, we'renot graduating enough doctors
for the population that we have.
What's happened?
Speaker 3 (02:33):
Look, I believe what we're seeing in.
We live in a litigious societynumber one, right, and so you
see all these lawsuits that takeplace and lawsuits on
malpractice and all theseridiculous things taking place,
but aside from that, you'reseeing a lot of the red tape,
you know, with the insurancespace.
Doctors having to which is agood thing having to comply and
(02:54):
all the paperwork that isnecessary right In order to just
have or deal with a Medicaid orMedicare patient is a good
example.
Speaker 1 (03:03):
You know, I I wonder, if you know.
You go into medical schoolbecause you really have this
desire to take care of humanbeings and then you get bogged
down in all the malarkey thatour industry you know serves to
you, and so you're not helpingpatients.
You've got to see somebodyevery seven minutes.
You're $300,000 in debt.
I mean, are people just optingout and saying you know what?
(03:24):
It's just not worth it.
Speaker 3 (03:27):
It's a great point because I think the reality is
doctors are getting bogged downmore with the administrative
stuff, which is the stuff theylove doing, which is the stuff
they don't like doing, becausethey went to school to deal with
, to help people right.
Speaker 1 (03:41):
One of the things that you touched on in our first
question is not only theshortage of doctors, but quality
.
Now, we've danced aroundquality in this industry for a
long time.
I've been at this sincedinosaurs roamed the earth, and
I've heard about quality backsince the early 80s, but it
seems like it's one of thosethings that a lot of people talk
about, but not anybody has donea whole heck of a lot.
What's happening about qualityand marrying quality with
(04:04):
availability and accessibility?
Speaker 3 (04:06):
The industry is experiencing when we talk about
quality of care, is that now,with limitations on the care
that you're given, doctors aregiving X amount of dollars.
If you can't deal with thatwith the patient, then you need
to figure out and it comes outof the physician's pocket, right
?
So here now we're saying, okay,I run lab work, I run an MRI,
(04:29):
and when that's not sufficient,what else is needed to do in
order to make sure thatpatient's going to come back
with a healthy profile.
When I say that, it's like haveI taken all the necessary steps
to make sure I can diagnosethis patient and treat them
properly?
Speaker 1 (04:43):
How do you?
I mean, are there objectivemetrics by which you can, you
can judge quality?
You know, one provider to thenext, to the next, it varies,
right.
Speaker 3 (04:51):
If you're going to a cardiologist versus a urologist,
or whether you're going to adiabetic specialist, a urologist
, then it all.
All those things come into play.
Speaker 1 (05:02):
So this, this shortage of physicians, is that
kind of what you you know, youmentioned that you were involved
in telehealth early on Is thatkind of?
What gave rise to the need fortelehealth Was both the lack of
physicians in general andaccessibility.
Speaker 3 (05:15):
I believe it did because it realized that we
could do more, virtually, thanwe ever anticipated.
And, shockingly enough, eventhough telemedicine has been
around for 20 years, it reallydidn't blow up until after COVID
.
And then, after COVID, we sawthe great response to virtual
primary care.
So to help flatten the curve ofthe COVID virus, they were
(05:38):
saying, okay, keep people goinginto the hospital where there's
other sick people.
And so what they allowed peopleto do to flatten the curve is,
they said, okay, so long as I'mhaving this continuity of care
with the same physician, youmean to tell me that I can go
and get my chronic caremedication refilled that I've
been getting for the last fiveyears virtually for 10 minutes,
instead of taking two hours offof work sitting in the doctor's
(06:00):
office?
Have my high blood pressure goup because?
Speaker 1 (06:07):
my appointment was at 12, and it's 1 o'clock and I
haven't still seen my doctor,and we've certainly all been
there For sure, and you knowit's not a fun place to be, For
sure, Is it?
do you think that some of thepickup on telemedicine was
generational?
I mean, we're now.
We've now got adults who arethe first generation born with
smartphones in their hands.
Sure, We've now got adults whoare the first generation born
with smartphones in their hands.
I remember years ago we hadflip phones and T9 dialing.
(06:27):
Anybody who's old enough toremember T9?
Dialing should probably bethinking about retirement about
now, but was that part of it?
Are they more amenable?
Is the younger generation moreamenable to doing things via the
phone?
Speaker 3 (06:37):
Absolutely.
You know, technology isconstantly evolving, right, and
the idea of you know picking upthe phone and speaking with the
doctor is great, but, to yourpoint, we live in what we call I
think they call this generation, you know the slide generation,
where they slide left, and sothe ability of not speaking to
someone and being interacting,whether that be via text or
(07:01):
whether scheduling thatappointment on a, on your,
through an app or through a webbrowser, it makes it.
I mean, this is the generationwe live in.
Speaker 1 (07:10):
In best practices.
If I'm having a telemedicinevisit and it's clear that I
actually need to see a doc, howdo I do that?
How do I do I then again runinto the roadblock of lack of
accessibility, lack ofavailability?
Speaker 3 (07:27):
Look, great question.
The idea is, one of the thingsthat we see in the space that
becomes a hurdle is that thetypical method of scheduling a
consultation is calling in,you're going into a call center,
the call center then hopefullyit's a, you know, a medical
advisor of some sort that'sfamiliar with the terminology.
(07:48):
But what they do is they'llschedule that consultation with
the doctor and then thatconsultation begins To answer
the question that you wereasking is it makes it easier
when you can mimic that of abrick and mortar and when I say
that walk into a hospital, walkinto a physician practice, you
know the receptionist checks youin but the nurse is the one
(08:09):
going in, taking all the triageinformation, prepping you for
the doctor.
When the doctor come in, hejust literally confirms what the
nurse says and the rest is over.
Speaker 1 (08:17):
Now I know one of the ways that some employers have
tried to solve this problem, tounravel this, is by doing
on-site and near-site and evenbringing in mobile clinics.
Talk a little bit about that.
I mean, what kind of anemployer decides that they want
to do something like that?
Speaker 3 (08:34):
Look, it's not a one-size-fits-all.
And when we look at adding orputting, let me just, when
you're looking to putting in anon-site, near-site, let me just
when you're looking to puttingin an on-site, near-site or
mobile clinic, it really dependson the pain points that
employer is experiencing at thattime.
So we would assess or I'mtrying to say I know you won't
(08:58):
Every client is assesseddifferently.
So we build the box, as opposedto putting that client into a
box and having them say this iswhat we have, this is what we
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And now back to ourconversation.
One of the downsides or rapsthat I've heard for a long time
about building on-site clinicsis that it's a huge endeavor.
It's frightfully expensive.
Is that always the case?
Speaker 3 (11:01):
Not necessarily.
Again, is there space that thisemployer has?
You know we're talking, we havecurrently.
There's currently a universitythat had the space and
essentially we just facilitatedthat space and we equipped it
accordingly, based on how manypeople would be Is it just going
(11:21):
to be the student or is it justthe employer group?
So we facilitate and equip itdepending on how many people
were going to be utilizing thatclinic.
Speaker 1 (11:29):
It's interesting.
I mean, I think most peoplekind of conceptually understand
on-site clinics.
I think everybody understandsmobile, right yeah, for people
who don't know what is anear-site clinic and where is
that applicable, where does thatfit, where is that a good
solution?
Speaker 3 (11:42):
A near-site would be something along the line of
let's think of a truckingindustry.
A guy driving a tractor trailercannot pull an 18-wheeler into
a Baylor Scott and White.
So we would then put anear-site clinic either in route
for that tractor trailer or forthat trucking company that
(12:02):
they're familiar or they'rerunning, and it would be a
near-site clinic versus a mobileclinic at times.
So it literally would besomething within route.
Speaker 1 (12:11):
Are near-sites, a solution that's also used by
perhaps a group of employers whoare, you know, not co-located
but within a reasonable distanceof each other.
It's almost like creating alittle center.
Speaker 3 (12:21):
Absolutely.
So let's take something likeMaine right, where you don't
have a bunch of physicianpractices.
Maybe that would require usgoing in and looking for a
physician practice near thatemployer group and then us
working with that physicianpractice, saying, hey, we have
an employer group with about 150employees.
What would that look like if westarted steering them towards
(12:43):
you?
Speaker 1 (12:44):
In your experience, and I'm sure it varies, but do a
lot of employers includeemployees only or do they
include family?
Is it just dependent on how theemployer sees their population?
Speaker 3 (12:54):
It does, and typically you see it just for
the employee.
And this is when the virtualpiece would come in handy,
because, to your point, if it'sjust the employees, well what
are you going to do if a familymember or if that employee gets
sick and they're away from work?
So this gives the ability ofhaving that virtual access as
well.
Speaker 1 (13:14):
Is.
You know?
People who've been on thepodcast a number of times have
heard me say that, unfortunately, as an industry, for a long
time we've spent of necessity,we didn't have the tools.
We spent a lot of time lookingout the rear view mirror and not
out the windshield.
Does this help companies andpeople who pay claims be more
proactive rather than beingreactive, and if so, how, and
(13:34):
can you give me an example?
Speaker 3 (13:35):
Great question.
So typically, yes, we wouldlike to say that we think
proactively.
Right, we want to do somethingbefore something episodic
happens.
Right?
The idea of knowing that youhave someone or having they said
well, let me back up a littlebit.
There's a stat that says halfof the American population are
walking diabetics and don't evenknow it until something
(13:57):
episodic happens.
Right?
So the idea that you realizingyou're a diabetic because you
passed out, you're in thehospital and you just racked up
a $100,000 bill.
So if there were ways that youcould actually build continuity
of care with a physician andexplain how you're feeling, have
blood work done?
Now you take the guessing gameout of your health.
(14:18):
They could look at your bloodwork and say okay, you know what
, your insulin levels are high.
Well, these are out of rangeand now you can do something
proactively about your healthbefore something episodic
happens.
Absolutely.
Speaker 1 (14:31):
So I'm a benefit advisor.
How do I start having thisconversation with the groups
that I serve?
Speaker 3 (14:38):
I think it's we fit in and the good thing is we're
not insurance right.
We could be added at any giventime.
So there's no open enrollmentor any special time.
We're not, you know, can bebolted on in any you know, onto
any plan.
These conversations are greatbecause everyone talks about
reducing costs and mitigatingrisk, but that only really
(14:58):
happens if you can keep theemployee out of the ER.
What are you going to do whenthat face-to-face is required?
So the ability of having thaturgent care accessibility is
great.
The ability of having thatvirtual primary care
accessibility is great.
But when that face-to-face isneeded, because x-rays you
cannot do virtually, suturesaren't going to be done
(15:19):
virtually.
So we can now steer thatindividual towards a doctor
network to make sure that theyget the proper care they need at
an affordable rate.
Speaker 1 (15:30):
And as the advisor for this firm do, I have to do a
lot of employee education.
Is that changing?
Is it becoming a more normalpart of what employers offer, or
how do I have to get toemployees to get them to utilize
these services?
Speaker 3 (15:44):
That's a great question and it really boils
down to look.
We always talk aboututilization in this industry,
right, and utilization is onlygoing to be good as awareness
and education.
So it's making the employer aswell as the employee know not
only how the plan works, butwhen and how to use it.
Speaker 1 (16:05):
Do they do this with an app, or do they do this over
the phone, or do you try to meetthem wherever they?
Speaker 3 (16:10):
are.
We meet them on site.
So many times we go on siteeducating and that would be
anywhere from going in person.
Anytime a new group is comingon, we make an effort to be
there during that openenrollment to make sure they're
educated properly.
But then we have Zooms that wecan educate not only the HR but
(16:31):
we can educate the employees aswell.
Speaker 1 (16:33):
Well, that's an interesting question.
How does this sell to HR folks?
Do they see it as one morething they have to deal with, or
do they see it as taking up,generally speaking, as taking a
problem off their plate?
Speaker 3 (16:42):
I would like to see it as an advantage is where we
kind of work with the HR person,because they're juggling so
many balls and they're trying tokeep them from hitting the
ground.
Yes, we work with HR to makesure that this is seemingly
integrated into their plans.
Speaker 1 (16:59):
So put on your crystal ball and, you know,
think a few years down the road.
What are the inroads that thesekinds of services have made and
where do you see it going?
Speaker 3 (17:12):
services have made and where do you see it going?
I think having the ability tohave quality of care, the
accessibility of the care,affordable care.
What I didn't know when I gotin this industry over seven
years ago, I didn't know thatmany of these urgent cares were
owned by VCs.
Was not aware of that untilseven, seven, 10 years ago.
When you have a practice that'sran by physicians and not VC,
(17:35):
the love and the quality of carethat an individual get is
different from just a bottomline.
Speaker 1 (17:40):
Tell me about that.
How might that manifest itselfif I'm a patient?
Speaker 3 (17:43):
Well, look at it this way If we have an onsite clinic
or we have mobile clinics, wehave these in place.
They're not owned by a venturecapitalist.
They're not looking for an ROI.
I mean, they're looking for anROI.
I apologize For us being inthis space.
When we create these clinics,we're making care accessible
(18:09):
right, Whether that be in arural area, whether it be
on-site, whether it be near-site, whether it be mobile, we're
making it just care accessible.
Speaker 1 (18:18):
We haven't talked about that a lot.
I mean, do you see a lot ofplay in underserved areas?
Speaker 3 (18:23):
Absolutely.
I mean many of it.
A lot of it has to do with, youknow, just building a facility
and the cost of erecting thefacility and then the structure
of having the infrastructure forhaving, you know, the internet,
and so many people don't havethat accessibility of, as we
take for granted, just openingup your laptop and having a
video consultation.
(18:43):
Most people don't have that.
So the idea of just going inand physically seeing a
physician, it's still a goodthing.
Speaker 1 (18:50):
Why, in your opinion, why is this a better solution
than urgent care?
Is it that rearview mirror orwindshield thing?
Again, yes, absolutely right.
Speaker 3 (18:59):
And, by the way, there's a stat right now that
states more than 80% of urgentcare visits can be handled
virtually.
So you're thinking of your lowand common acute conditions,
right?
So we're talking about cold flu, fever, pink eye strep, throat,
swimmer's ear, the list goes onand on.
They say more than 80% of ERvisits aren't of an emergency.
(19:20):
So we have the ability ofaddressing those low and common
acute issues.
But then when that face-to-faceis needed, we do provide that
ability for someone to see aphysician face-to-face.
Speaker 1 (19:33):
Well, and that's kind of like a trifecta it's better
care, it's better outcomes andit's way lower cost for the plan
.
Speaker 3 (19:38):
Absolutely, absolutely.
Speaker 1 (19:40):
Have you had any self-funded employers chat with
you about them seeing this aspart of their fiduciary
responsibility?
Speaker 3 (19:48):
Just like you know, we're here at the conference and
they talked about theconference.
There's that line, right, thatwe're fed and so, yes, we fit
well into a self-funded or alevel-funded plan.
Right, because the idea is wewant to reduce costs and
mitigate risk, and we talkedabout earlier.
The only way that's going tohappen is if you can keep the
(20:09):
employee out of the ER.
The only way that's going tohappen is if you can keep the
employee out of the ER, so wecould say, okay, great, before
you go into a hospital and rackup the bill, why don't you go to
one of these doctors within ournetwork?
And there's no additional cost,there's no deductible, there's
no copay.
Therefore, it keeps the claimsbucket clean.
Speaker 1 (20:29):
Yeah, I mean, at the end of the day, the things that
people are gravitating towardstoday, especially the younger
generation, is places wherethere's no friction.
Speaker 3 (20:33):
Absolutely.
Speaker 1 (20:33):
And if you can provide good care without
friction, it's easier to getbuy-in.
I would imagine Absolutely whata great place to end our
conversation.
Lorenzo Amaya, vice Presidentof Business Development at
Integrated Source One.
Lorenzo, thanks for a greatconversation.
Thank you, sir.
I want to give a quick shoutout to our sponsor and our
(20:56):
producer, hatcher Media.
Hey, if you need podcastproduction or professional
graphic design, josh Hatcher isthe expert to contact.
For more information, visit himat HatcherMedianet.
That's H-A-T-C-H-E-R Media dotnet.
Speaker 2 (21:16):
This Shift Shapers podcast is copyrighted content
and may not be reproduced inwhole or in part without the
express written permission ofShift Shapers Solutions LLC.
Copyright 2024.
With all the conversations that we have
around problems and challengesin the industry, one of the
biggest challenges is theshortest of physicians and we
haven't talked about it a lot onthe podcast.
How do you solve that problem?
We'll find out on this episodeof Shift Shapers.
Speaker 2 (00:16):
Change either energizes or paralyzes.
The choice is yours.
This is the Shift Shaperspodcast, bringing the employee
benefits industry interviewswith individuals and companies
who are shaping the industryshifts.
And now here's your host, davidSaltzman.
Speaker 1 (00:37):
And to help us answer that question, we are joined
here at the Ascend Conference inbeautiful Salt Lake City, utah,
by Lorenzo Amaya.
Lorenzo is the Vice Presidentof Business Development at
Integrated Source One.
Welcome, lorenzo.
Thanks for being here.
Thank you for having me.
So let's talk a little bitabout as I mentioned in the open
, but before we get to that,let's talk about how you got to
(00:58):
be doing what you're doing today, because everybody's story in
this business is a little bitinteresting, sure, how'd that
happen?
How'd you end up where?
Speaker 3 (01:05):
you are, I'm going to give you the Reader's Digest
version.
So, I've been in banking for 20years and actually started out
because I went to church with agood friend of mine who was in
the telemedicine space andhelped that company build, went
from 54 employees to over $4million in annual revenue and
oversaw the reseller, broker andwhite label channel and just
(01:27):
found a love for the healthcarespace.
Speaker 1 (01:29):
Interesting, so that's a great place to come to.
So let's talk a little bit.
Let's set the table.
We talked in the open about theshortage of physicians.
I don't think it's a problemthat gets talked about a lot
because everybody thinks, well,there are doctors on every
street corner and you can gofind somebody whenever you want.
What's the scope of thatproblem?
How big a problem is itactually?
Speaker 3 (01:48):
in practicality.
Well, I mean, from a practicalstandpoint, people are
experiencing it just, and I'msure we've all experienced it on
some level.
But you know something assimple as my daughter waiting to
see her OBGYN for five months,and there's been stats a growing
stat of shortage of physiciansfor over the last five months,
and there's been stats a growingstat of shortage of physicians
for over the last five years,and they're saying it's becoming
(02:10):
more and more of an issue.
So accessing quality of care,accessing affordable care and in
a timely fashion.
Speaker 1 (02:16):
You know we'll discuss all those things, so I
think those are very importantaspects also.
But to what do you attributethe lack of physicians?
I mean, when I was growing up,every mom and dad wanted their
kid to be a doctor, right?
And now all of a sudden, we'renot graduating enough doctors
for the population that we have.
What's happened?
Speaker 3 (02:33):
Look, I believe what we're seeing in.
We live in a litigious societynumber one, right, and so you
see all these lawsuits that takeplace and lawsuits on
malpractice and all theseridiculous things taking place,
but aside from that, you'reseeing a lot of the red tape,
you know, with the insurancespace.
Doctors having to which is agood thing having to comply and
(02:54):
all the paperwork that isnecessary right In order to just
have or deal with a Medicaid orMedicare patient is a good
example.
Speaker 1 (03:03):
You know, I I wonder, if you know.
You go into medical schoolbecause you really have this
desire to take care of humanbeings and then you get bogged
down in all the malarkey thatour industry you know serves to
you, and so you're not helpingpatients.
You've got to see somebodyevery seven minutes.
You're $300,000 in debt.
I mean, are people just optingout and saying you know what?
(03:24):
It's just not worth it.
Speaker 3 (03:27):
It's a great point because I think the reality is
doctors are getting bogged downmore with the administrative
stuff, which is the stuff theylove doing, which is the stuff
they don't like doing, becausethey went to school to deal with
, to help people right.
Speaker 1 (03:41):
One of the things that you touched on in our first
question is not only theshortage of doctors, but quality
.
Now, we've danced aroundquality in this industry for a
long time.
I've been at this sincedinosaurs roamed the earth, and
I've heard about quality backsince the early 80s, but it
seems like it's one of thosethings that a lot of people talk
about, but not anybody has donea whole heck of a lot.
What's happening about qualityand marrying quality with
(04:04):
availability and accessibility?
Speaker 3 (04:06):
The industry is experiencing when we talk about
quality of care, is that now,with limitations on the care
that you're given, doctors aregiving X amount of dollars.
If you can't deal with thatwith the patient, then you need
to figure out and it comes outof the physician's pocket, right
?
So here now we're saying, okay,I run lab work, I run an MRI,
(04:29):
and when that's not sufficient,what else is needed to do in
order to make sure thatpatient's going to come back
with a healthy profile.
When I say that, it's like haveI taken all the necessary steps
to make sure I can diagnosethis patient and treat them
properly?
Speaker 1 (04:43):
How do you?
I mean, are there objectivemetrics by which you can, you
can judge quality?
You know, one provider to thenext, to the next, it varies,
right.
Speaker 3 (04:51):
If you're going to a cardiologist versus a urologist,
or whether you're going to adiabetic specialist, a urologist
, then it all.
All those things come into play.
Speaker 1 (05:02):
So this, this shortage of physicians, is that
kind of what you you know, youmentioned that you were involved
in telehealth early on Is thatkind of?
What gave rise to the need fortelehealth Was both the lack of
physicians in general andaccessibility.
Speaker 3 (05:15):
I believe it did because it realized that we
could do more, virtually, thanwe ever anticipated.
And, shockingly enough, eventhough telemedicine has been
around for 20 years, it reallydidn't blow up until after COVID
.
And then, after COVID, we sawthe great response to virtual
primary care.
So to help flatten the curve ofthe COVID virus, they were
(05:38):
saying, okay, keep people goinginto the hospital where there's
other sick people.
And so what they allowed peopleto do to flatten the curve is,
they said, okay, so long as I'mhaving this continuity of care
with the same physician, youmean to tell me that I can go
and get my chronic caremedication refilled that I've
been getting for the last fiveyears virtually for 10 minutes,
instead of taking two hours offof work sitting in the doctor's
(06:00):
office?
Have my high blood pressure goup because?
Speaker 1 (06:07):
my appointment was at 12, and it's 1 o'clock and I
haven't still seen my doctor,and we've certainly all been
there For sure, and you knowit's not a fun place to be, For
sure, Is it?
do you think that some of thepickup on telemedicine was
generational?
I mean, we're now.
We've now got adults who arethe first generation born with
smartphones in their hands.
Sure, We've now got adults whoare the first generation born
with smartphones in their hands.
I remember years ago we hadflip phones and T9 dialing.
(06:27):
Anybody who's old enough toremember T9?
Dialing should probably bethinking about retirement about
now, but was that part of it?
Are they more amenable?
Is the younger generation moreamenable to doing things via the
phone?
Speaker 3 (06:37):
Absolutely.
You know, technology isconstantly evolving, right, and
the idea of you know picking upthe phone and speaking with the
doctor is great, but, to yourpoint, we live in what we call I
think they call this generation, you know the slide generation,
where they slide left, and sothe ability of not speaking to
someone and being interacting,whether that be via text or
(07:01):
whether scheduling thatappointment on a, on your,
through an app or through a webbrowser, it makes it.
I mean, this is the generationwe live in.
Speaker 1 (07:10):
In best practices.
If I'm having a telemedicinevisit and it's clear that I
actually need to see a doc, howdo I do that?
How do I do I then again runinto the roadblock of lack of
accessibility, lack ofavailability?
Speaker 3 (07:27):
Look, great question.
The idea is, one of the thingsthat we see in the space that
becomes a hurdle is that thetypical method of scheduling a
consultation is calling in,you're going into a call center,
the call center then hopefullyit's a, you know, a medical
advisor of some sort that'sfamiliar with the terminology.
(07:48):
But what they do is they'llschedule that consultation with
the doctor and then thatconsultation begins To answer
the question that you wereasking is it makes it easier
when you can mimic that of abrick and mortar and when I say
that walk into a hospital, walkinto a physician practice, you
know the receptionist checks youin but the nurse is the one
(08:09):
going in, taking all the triageinformation, prepping you for
the doctor.
When the doctor come in, hejust literally confirms what the
nurse says and the rest is over.
Speaker 1 (08:17):
Now I know one of the ways that some employers have
tried to solve this problem, tounravel this, is by doing
on-site and near-site and evenbringing in mobile clinics.
Talk a little bit about that.
I mean, what kind of anemployer decides that they want
to do something like that?
Speaker 3 (08:34):
Look, it's not a one-size-fits-all.
And when we look at adding orputting, let me just, when
you're looking to putting in anon-site, near-site, let me just
when you're looking to puttingin an on-site, near-site or
mobile clinic, it really dependson the pain points that
employer is experiencing at thattime.
So we would assess or I'mtrying to say I know you won't
(08:58):
Every client is assesseddifferently.
So we build the box, as opposedto putting that client into a
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And now back to ourconversation.
One of the downsides or rapsthat I've heard for a long time
about building on-site clinicsis that it's a huge endeavor.
It's frightfully expensive.
Is that always the case?
Speaker 3 (11:01):
Not necessarily.
Again, is there space that thisemployer has?
You know we're talking, we havecurrently.
There's currently a universitythat had the space and
essentially we just facilitatedthat space and we equipped it
accordingly, based on how manypeople would be Is it just going
(11:21):
to be the student or is it justthe employer group?
So we facilitate and equip itdepending on how many people
were going to be utilizing thatclinic.
Speaker 1 (11:29):
It's interesting.
I mean, I think most peoplekind of conceptually understand
on-site clinics.
I think everybody understandsmobile, right yeah, for people
who don't know what is anear-site clinic and where is
that applicable, where does thatfit, where is that a good
solution?
Speaker 3 (11:42):
A near-site would be something along the line of
let's think of a truckingindustry.
A guy driving a tractor trailercannot pull an 18-wheeler into
a Baylor Scott and White.
So we would then put anear-site clinic either in route
for that tractor trailer or forthat trucking company that
(12:02):
they're familiar or they'rerunning, and it would be a
near-site clinic versus a mobileclinic at times.
So it literally would besomething within route.
Speaker 1 (12:11):
Are near-sites, a solution that's also used by
perhaps a group of employers whoare, you know, not co-located
but within a reasonable distanceof each other.
It's almost like creating alittle center.
Speaker 3 (12:21):
Absolutely.
So let's take something likeMaine right, where you don't
have a bunch of physicianpractices.
Maybe that would require usgoing in and looking for a
physician practice near thatemployer group and then us
working with that physicianpractice, saying, hey, we have
an employer group with about 150employees.
What would that look like if westarted steering them towards
(12:43):
you?
Speaker 1 (12:44):
In your experience, and I'm sure it varies, but do a
lot of employers includeemployees only or do they
include family?
Is it just dependent on how theemployer sees their population?
Speaker 3 (12:54):
It does, and typically you see it just for
the employee.
And this is when the virtualpiece would come in handy,
because, to your point, if it'sjust the employees, well what
are you going to do if a familymember or if that employee gets
sick and they're away from work?
So this gives the ability ofhaving that virtual access as
well.
Speaker 1 (13:14):
Is.
You know?
People who've been on thepodcast a number of times have
heard me say that, unfortunately, as an industry, for a long
time we've spent of necessity,we didn't have the tools.
We spent a lot of time lookingout the rear view mirror and not
out the windshield.
Does this help companies andpeople who pay claims be more
proactive rather than beingreactive, and if so, how, and
(13:34):
can you give me an example?
Speaker 3 (13:35):
Great question.
So typically, yes, we wouldlike to say that we think
proactively.
Right, we want to do somethingbefore something episodic
happens.
Right?
The idea of knowing that youhave someone or having they said
well, let me back up a littlebit.
There's a stat that says halfof the American population are
walking diabetics and don't evenknow it until something
(13:57):
episodic happens.
Right?
So the idea that you realizingyou're a diabetic because you
passed out, you're in thehospital and you just racked up
a $100,000 bill.
So if there were ways that youcould actually build continuity
of care with a physician andexplain how you're feeling, have
blood work done?
Now you take the guessing gameout of your health.
(14:18):
They could look at your bloodwork and say okay, you know what
, your insulin levels are high.
Well, these are out of rangeand now you can do something
proactively about your healthbefore something episodic
happens.
Absolutely.
Speaker 1 (14:31):
So I'm a benefit advisor.
How do I start having thisconversation with the groups
that I serve?
Speaker 3 (14:38):
I think it's we fit in and the good thing is we're
not insurance right.
We could be added at any giventime.
So there's no open enrollmentor any special time.
We're not, you know, can bebolted on in any you know, onto
any plan.
These conversations are greatbecause everyone talks about
reducing costs and mitigatingrisk, but that only really
(14:58):
happens if you can keep theemployee out of the ER.
What are you going to do whenthat face-to-face is required?
So the ability of having thaturgent care accessibility is
great.
The ability of having thatvirtual primary care
accessibility is great.
But when that face-to-face isneeded, because x-rays you
cannot do virtually, suturesaren't going to be done
(15:19):
virtually.
So we can now steer thatindividual towards a doctor
network to make sure that theyget the proper care they need at
an affordable rate.
Speaker 1 (15:30):
And as the advisor for this firm do, I have to do a
lot of employee education.
Is that changing?
Is it becoming a more normalpart of what employers offer, or
how do I have to get toemployees to get them to utilize
these services?
Speaker 3 (15:44):
That's a great question and it really boils
down to look.
We always talk aboututilization in this industry,
right, and utilization is onlygoing to be good as awareness
and education.
So it's making the employer aswell as the employee know not
only how the plan works, butwhen and how to use it.
Speaker 1 (16:05):
Do they do this with an app, or do they do this over
the phone, or do you try to meetthem wherever they?
Speaker 3 (16:10):
are.
We meet them on site.
So many times we go on siteeducating and that would be
anywhere from going in person.
Anytime a new group is comingon, we make an effort to be
there during that openenrollment to make sure they're
educated properly.
But then we have Zooms that wecan educate not only the HR but
(16:31):
we can educate the employees aswell.
Speaker 1 (16:33):
Well, that's an interesting question.
How does this sell to HR folks?
Do they see it as one morething they have to deal with, or
do they see it as taking up,generally speaking, as taking a
problem off their plate?
Speaker 3 (16:42):
I would like to see it as an advantage is where we
kind of work with the HR person,because they're juggling so
many balls and they're trying tokeep them from hitting the
ground.
Yes, we work with HR to makesure that this is seemingly
integrated into their plans.
Speaker 1 (16:59):
So put on your crystal ball and, you know,
think a few years down the road.
What are the inroads that thesekinds of services have made and
where do you see it going?
Speaker 3 (17:12):
services have made and where do you see it going?
I think having the ability tohave quality of care, the
accessibility of the care,affordable care.
What I didn't know when I gotin this industry over seven
years ago, I didn't know thatmany of these urgent cares were
owned by VCs.
Was not aware of that untilseven, seven, 10 years ago.
When you have a practice that'sran by physicians and not VC,
(17:35):
the love and the quality of carethat an individual get is
different from just a bottomline.
Speaker 1 (17:40):
Tell me about that.
How might that manifest itselfif I'm a patient?
Speaker 3 (17:43):
Well, look at it this way If we have an onsite clinic
or we have mobile clinics, wehave these in place.
They're not owned by a venturecapitalist.
They're not looking for an ROI.
I mean, they're looking for anROI.
I apologize For us being inthis space.
When we create these clinics,we're making care accessible
(18:09):
right, Whether that be in arural area, whether it be
on-site, whether it be near-site, whether it be mobile, we're
making it just care accessible.
Speaker 1 (18:18):
We haven't talked about that a lot.
I mean, do you see a lot ofplay in underserved areas?
Speaker 3 (18:23):
Absolutely.
I mean many of it.
A lot of it has to do with, youknow, just building a facility
and the cost of erecting thefacility and then the structure
of having the infrastructure forhaving, you know, the internet,
and so many people don't havethat accessibility of, as we
take for granted, just openingup your laptop and having a
video consultation.
(18:43):
Most people don't have that.
So the idea of just going inand physically seeing a
physician, it's still a goodthing.
Speaker 1 (18:50):
Why, in your opinion, why is this a better solution
than urgent care?
Is it that rearview mirror orwindshield thing?
Again, yes, absolutely right.
Speaker 3 (18:59):
And, by the way, there's a stat right now that
states more than 80% of urgentcare visits can be handled
virtually.
So you're thinking of your lowand common acute conditions,
right?
So we're talking about cold flu, fever, pink eye strep, throat,
swimmer's ear, the list goes onand on.
They say more than 80% of ERvisits aren't of an emergency.
(19:20):
So we have the ability ofaddressing those low and common
acute issues.
But then when that face-to-faceis needed, we do provide that
ability for someone to see aphysician face-to-face.
Speaker 1 (19:33):
Well, and that's kind of like a trifecta it's better
care, it's better outcomes andit's way lower cost for the plan
.
Speaker 3 (19:38):
Absolutely, absolutely.
Speaker 1 (19:40):
Have you had any self-funded employers chat with
you about them seeing this aspart of their fiduciary
responsibility?
Speaker 3 (19:48):
Just like you know, we're here at the conference and
they talked about theconference.
There's that line, right, thatwe're fed and so, yes, we fit
well into a self-funded or alevel-funded plan.
Right, because the idea is wewant to reduce costs and
mitigate risk, and we talkedabout earlier.
The only way that's going tohappen is if you can keep the
(20:09):
employee out of the ER.
The only way that's going tohappen is if you can keep the
employee out of the ER, so wecould say, okay, great, before
you go into a hospital and rackup the bill, why don't you go to
one of these doctors within ournetwork?
And there's no additional cost,there's no deductible, there's
no copay.
Therefore, it keeps the claimsbucket clean.
Speaker 1 (20:29):
Yeah, I mean, at the end of the day, the things that
people are gravitating towardstoday, especially the younger
generation, is places wherethere's no friction.
Speaker 3 (20:33):
Absolutely.
Speaker 1 (20:33):
And if you can provide good care without
friction, it's easier to getbuy-in.
I would imagine Absolutely whata great place to end our
conversation.
Lorenzo Amaya, vice Presidentof Business Development at
Integrated Source One.
Lorenzo, thanks for a greatconversation.
Thank you, sir.
I want to give a quick shoutout to our sponsor and our
(20:56):
producer, hatcher Media.
Hey, if you need podcastproduction or professional
graphic design, josh Hatcher isthe expert to contact.
For more information, visit himat HatcherMedianet.
That's H-A-T-C-H-E-R Media dotnet.
Speaker 2 (21:16):
This Shift Shapers podcast is copyrighted content
and may not be reproduced inwhole or in part without the
express written permission ofShift Shapers Solutions LLC.
Copyright 2024.
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