Running Codes Over a Screen | How Telemedicine Is Saving Rural America | OON Ep. 16

Rural hospitals are closing. Doctors are burning out. And in many small towns across America, there's no MD in the building at all. In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth explore how telemedicine is revolutionizing rural healthcare: running emergency codes over a screen, catching a life-threatening STEMI from 100 miles away, the technology keeping critical access hospitals alive, why 5+ years of experience is required, and the real-world challenges of licensing, credentialing, and providing 24/7 coverage to communities that would otherwise have zero access to hospital medicine.

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What You'll Learn in This Video:
The reality of rural hospitals with no doctor on-site—only NPs or PAs running the show.
How telehealth hospitalists run emergency codes and rapid responses remotely.
The dramatic "gray patient" story: 3/10 chest pain that turned out to be a full STEMI with critical left main stenosis.
Why clinical experience (5+ years minimum) matters more than technology in telehealth.
The actual technology: telehealth carts with built-in stethoscopes, HD zoom, and real-time EMR access.
Why these hospitals are the "lifeblood" of small-town communities—and what happens when they close.
State licensing nightmares: credentialing in 20+ hospitals and navigating IMLC (Interstate Medical Licensure Compact).
How concierge practices use telemedicine for patient convenience and efficiency.
Documentation requirements, billing modifiers, and legal considerations for telehealth.
The future: AI integration, remote patient monitoring, and what's next for rural healthcare.

Timestamps:
00:00 – Introduction: What if there's no doctor in the building?
01:00 – Dr. Seth's journey into telehealth hospitalist work
02:30 – What are critical access hospitals and why do they matter?
04:00 – The technology: Telehealth carts, stethoscopes, and zoom capabilities
07:00 – Why rural hospitals are the lifeblood of small-town America
08:00 – The gray patient: Catching a life-threatening STEMI remotely
10:30 – Why experience matters more than technology in telehealth
14:00 – The business model keeping rural hospitals financially viable
18:00 – State licensing requirements and legal considerations
21:00 – How Dr. Parker uses telemedicine in his concierge practice
24:00 – Documentation requirements and billing for telehealth visits
26:00 – The future of telehealth and AI integration
28:00 – Final thoughts: Why telemedicine is revolutionary for rural America

Connect with Out of Network:
🌐 Website: https://www.outofnetworkpod.com/
📱 Instagram:   / outofnetworkpodcast  
▶️ YouTube:    / @outofnetworkpodcast  
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Connect with the Hosts:
Dr. Ryon Parker →   / dr.ryonparker  
Parker Medical: https://parkermedical.org/
Dr. Rishi Seth →   / drrishiseth  
Seth Premiere Medical: https://sethmedical.com/

Resources Mentioned:
Ave (Telehealth Company) - Providing telehealth services to rural hospitals
Interstate Medical Licensure Compact (IMLC): https://www.imlcc.org/

Enjoyed the Episode?
If this conversation resonated with you, please like, comment, and subscribe. Share it with someone working in healthcare or living in a rural community.

🎙 About Out of Network
Out of Network is a bold, physician-led podcast hosted by Dr. Ryon Parker and Dr. Rishi Seth. Each week, they challenge the broken healthcare system and explore how medicine can be reimagined—through patient-first care, prevention, and real human stories.

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