In this repurposed episode of Telemedicine Talks, hosts Phoebe Gutierrez and Dr. Leo Damasco welcome Dr. Mark Chmiela, as he describes how COVID turned telemedicine into an essential lifeline, reaching 80–90% of his group’s chronic-pain patients, while also exposing access barriers for elderly and lower-income patients. He walks through the post-2024 shift: insurers stopped or sharply cut reimbursement, credentialing hurdles multiplied, and the practice gradually transitioned patients back to the office, landing at roughly 95% in-person visits. Mark stresses that telemedicine remains valuable for stable medication management, patients with mobility or transportation challenges, and certain follow-ups, but cannot replace hands-on exams when new red-flag symptoms appear. The conversation covers the practical realities of chronic-pain care (opioids, non-opioids, interventional procedures, lifestyle counseling), the risk of fraud that made payers cautious, the human connection that in-person visits still deliver better, and Mark’s optimistic view that technology should augment, not replace, thoughtful medicine when used for the right patients. Top 3 Takeaways: Telemedicine is a powerful tool for continuity and access, especially for wheelchair-bound, transportation-challenged, or stable chronic-pain patients, but reimbursement cuts and regulatory friction can make it financially unsustainable.In-person visits still matter for physical exams, new findings, and the intangible human connection that many patients (and physicians) value.Hybrid models work best: keep the option available, screen carefully, and reserve pure virtual care for the right clinical scenarios rather than treating it as a universal replacement.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: Dr. Mark Chmiela is a double board-certified anesthesiologist and interventional pain-management physician practicing with a multi-physician group in Las Vegas. His practice serves a broad mix of Medicaid, Medicare, commercial, personal-injury, and workers’-compensation patients and focuses on comprehensive chronic-pain care. Website: https://health.usnews.com/doctors/mark-chmiela-1414283 LinkedIn: https://www.linkedin.com/in/mark-chmiela-1a5802194/ 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/ phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com) 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. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
