In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth dive deep into the explosive world of GLP-1 medications—exploring the realities of semaglutide, tirzepatide, Ozempic, Wegovy, and Zepbound. With a projected $200 billion market by 2029, these drugs have transformed weight management, but they've also created chaos in the healthcare landscape. From med spa injections to proper medical supervision, this conversation sheds light on what safe GLP-1 treatment should actually look like.

What You'll Learn

• The difference between proper medical weight loss programs and dangerous "syringe-in-a-fridge" clinics
• Why tirzepatide (Mounjaro/Zepbound) outperforms semaglutide (Ozempic) in most patients
• Real strategies for patients who plateau or don't respond to GLP-1 medications
• Insurance coverage realities and the new $50/month Medicare pricing
• Serious side effects to watch for, including pancreatitis and gallbladder issues

Timestamps

• 00:00 – Introduction: The $200 billion GLP-1 economy
• 03:15 – Wild West of GLP-1 prescribing: Med spas and strip mall clinics
• 10:42 – Proper patient screening and medical supervision
• 24:30 – Insurance coverage, pricing, and access issues
• 32:00 – Tirzepatide vs. Semaglutide: Which is better?
• 42:55 – The future of GLP-1s and closing thoughts

Connect with Out of Network:
🌐 Website: https://www.outofnetworkpod.com/
📱 Instagram: https://www.instagram.com/outofnetworkpodcast/
▶️ YouTube: https://www.youtube.com/@OutofNetworkPodcast
🎵 TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts:
Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/
Parker Medical: https://parkermedical.org/
Dr. Rishi Seth → https://www.instagram.com/drrishiseth/
Seth Premiere Medical: https://sethmedical.com/

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If this conversation resonated with you, please like, comment, and subscribe. Share it with someone who cares about the future of healthcare.

🎙 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.

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth dive into AI's rapid integration into healthcare—exploring how artificial intelligence is transforming medical documentation, diagnostics, and patient care. With a mix of personal experiences, honest concerns, and evidence-based insights, this conversation sheds light on both the promise and perils of AI in medicine, and how physicians can harness its power without losing the clinical skills that make them effective doctors.

What You'll Learn

• How AI scribes are changing medical documentation (and why one doctor got "see Brad Pitt movies" as a treatment recommendation)
• The risk of "de-skilling" physicians when AI handles too much of the diagnostic process
• Why AI chatbots for patient triage could be dangerous—and when they might be helpful
• How AI bias can reinforce physician mistakes and create dangerous feedback loops

Timestamps

00:00 – Introduction: AI's rapid rise in healthcare
03:15 – AI scribes: Making doctors better or lazier?
10:42 – The de-skilling concern: Are we training lazy physicians?
16:00 – AI liability and the Brad Pitt diagnosis story
21:30 – Patient self-diagnosis with AI: Benefits and dangers
24:30 – Why concierge practices should resist AI automation
27:20 – Closing thoughts: AI oversight and physician responsibility

Connect with Out of Network
Website: https://www.outofnetworkpod.com/
Instagram: https://www.instagram.com/outofnetworkpodcast/
YouTube: https://www.youtube.com/@OutofNetworkPodcast
TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts
Parker Medical - Las Vegas, NV → https://bit.ly/parkermedical
Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/
Seth Premiere Medical - Tampa, FL → https://bit.ly/sethpremiere
Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth dive into the overwhelming world of wellness trends—exploring what's helpful, what's harmless, and what patients should avoid. From IV vitamin drips and NAD injections to hyperbaric chambers and supplement claims, they break down the science (or lack thereof) behind popular wellness treatments. With honest physician perspectives and real patient stories, this conversation sheds light on how to navigate wellness confusion while maintaining trust in evidence-based medicine.

What You'll Learn

• How to approach patients who've received conflicting wellness advice from other providers
• The real science behind popular treatments like IV vitamins, NAD, and hyperbaric oxygen therapy
• Why the wellness industry thrives on aging fears and how to address patient concerns compassionately
• Red flags to watch for in wellness claims and when treatments cross into dangerous territory

Timestamps
00:00 – Introduction to wellness world confusion
01:12 – Navigating conflicting advice from different providers
08:09 – IV vitamins and NAD: separating hype from science
11:50 – Hyperbaric oxygen therapy: medical vs. wellness applications
15:15 – The supplement industry and "nutraceuticals"
16:43 – Why people seek wellness solutions: aging, fear, and social media
25:32 – Dangerous wellness trends: chiropractic overreach and chronic conditions
30:40 – The importance of staying in your lane as healthcare providers
33:37 – Final thoughts on evidence-based wellness

Connect with Out of Network
Website: https://www.outofnetworkpod.com/
Instagram: https://www.instagram.com/outofnetworkpodcast/
YouTube: https://www.youtube.com/@OutofNetworkPodcast
TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts
Parker Medical - Las Vegas, NV → https://bit.ly/parkermedical
Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/
Seth Premiere Medical - Tampa, FL → https://bit.ly/sethpremiere
Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth explore the world of telemedicine and reveal how it's revolutionizing healthcare access in rural America. Dr. Seth shares his firsthand experience as a telehealth hospitalist—running emergency codes from hundreds of miles away, managing critical patients over a screen, and keeping small-town hospitals alive. From a patient with "3 out of 10" chest pain who turned out to have a life-threatening heart attack, to the technology and expertise required to provide remote care, this conversation uncovers the hidden infrastructure that's changing medicine as we know it.

What You'll Learn

• How telehealth hospitalists manage critical emergencies remotely—including running codes over a screen
• The reality of rural hospitals where there may be no doctor on-site at all
• The dramatic story of catching a full-blown STEMI (heart attack) from 100 miles away
• Why telemedicine requires 5+ years of clinical experience before going remote
• The technology behind telehealth carts and remote patient monitoring
• How small-town hospitals stay open thanks to telehealth coverage
• State licensing requirements and the Interstate Medical Licensure Compact
• Best practices for using telemedicine in outpatient and concierge settings
• The future of AI integration in telehealth

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: https://www.instagram.com/outofnetworkpodcast/
YouTube: https://www.youtube.com/@OutofNetworkPodcast
TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts
Parker Medical - Las Vegas, NV → https://bit.ly/parkermedical
Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/
Seth Premiere Medical - Tampa, FL → https://bit.ly/sethpremiere
Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth dive into the FDA's recent removal of the black box warning on hormone replacement therapy—exploring the realities of what this change actually means for women's health. With a mix of bold truths, real stories, and evidence-based insights, this conversation sheds light on the complex nuances behind HRT, the original Women's Health Initiative study, and why headlines rarely match the science.

What You'll Learn

• Why the FDA removed the black box warning and what it actually means (spoiler: it's not a universal green light)
• The real story behind the Women's Health Initiative study and why Premarin vs. bioidentical hormones matters
• How to navigate HRT decisions based on age, symptoms, and individual risk factors

Timestamps
00:00 – Introduction
01:15 – FDA removes black box warning: What does it really mean?
03:28 – The concerning conflicts of interest behind the decision
07:25 – Breaking down the Women's Health Initiative study
12:00 – Estrogen types: Premarin vs. bioidentical hormones
16:00 – The age factor: Why timing matters in HRT
24:00 – Real patient case: Factor V Leiden and HRT complications
30:47 – Key takeaways for patients and physicians

Resources & Links Mentioned
Women's Health Initiative Study > https://www.nhlbi.nih.gov/science/womens-health-initiative-whi

Connect with Out of Network
Website: https://www.outofnetworkpod.com/
Instagram: https://www.instagram.com/outofnetworkpodcast/
YouTube: https://www.youtube.com/@OutofNetworkPodcast
TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts
Parker Medical - Las Vegas, NV → https://bit.ly/parkermedical
Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/
Seth Premiere Medical - Tampa, FL → https://bit.ly/sethpremiere
Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this candid episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth step away from discussing broken healthcare systems to share the raw, unfiltered lessons from their medical journey. From the struggles of foreign medical school to the challenges of starting a practice, they explore the wins, mistakes, doubts, debt, and grind that shaped them as physicians, husbands, fathers, and business owners.

What You'll Learn

• Why comparison truly is the thief of joy in medical practice
• The reality of starting a concierge practice with limited capital and massive student debt
• How attending a Caribbean medical school (Ross University) actually made them better doctors
• The importance of taking notes during residency rotations and learning from attendings
• Real talk about practice startup costs, renovation delays, and staffing challenges

Timestamps

00:00 – Introduction: The journey no one tells you about
03:15 – Starting humble: Learning not to compare yourself to others
10:42 – Ross University experience: Would they do it again?
24:30 – Residency lessons: What they wish they'd done differently
42:55 – Practice building mistakes and wins

Connect with Out of Network

Website: https://www.outofnetworkpod.com/
Instagram: https://www.instagram.com/outofnetworkpodcast/
YouTube: https://www.youtube.com/@OutofNetworkPodcast
TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts

Parker Medical - Las Vegas, NV → https://bit.ly/parkermedical

Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/

Seth Premiere Medical - Tampa, FL → https://bit.ly/sethpremiere

Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this episode of Out of Network, Dr. Ryon Parker and Dr. Rishi Seth tackle a topic most people never see but every healthcare worker knows too well—abuse inside the medical system. From physical assaults and verbal attacks to intimidation and impossible expectations, they break down the shocking reality that nurses, doctors, and staff face daily. This isn't about rare incidents; it's about systemic abuse happening in hospitals and clinics nationwide, and what needs to change to make healthcare feel human again.

What You'll Learn

• The staggering statistics: 52% of ER nurses report physical violence, and 1 in 7 physicians have been physically assaulted by patients or families
• How to distinguish between patients who are genuinely confused/delirious versus those with manipulative agendas
• When and how healthcare providers can legally terminate difficult patient relationships without abandonment charges
• Why the "customer is always right" mentality is destroying healthcare and what leaders can do instead

Timestamps

00:00 – Introduction: The hidden abuse crisis in healthcare

03:00 – Physical violence against healthcare workers: real stories from the frontlines

10:00 – Patient abandonment laws vs. provider safety: where's the line?

17:00 – The review system dilemma: when bad patients leave bad reviews

24:00 – Why healthcare violence is escalating and what's driving patient frustration

27:00 – Closing thoughts: stopping the normalization of abuse

About the Violence Crisis

Recent studies show that healthcare workers face violence at alarming rates, with 42 states now working to make violence against healthcare workers a felony. The Buffalo, Minnesota mass shooting by a disgruntled patient serves as a tragic reminder of how serious this crisis has become.

Resources & Links Mentioned

• Emergency Nurses Association 2024 workplace violence study: https://www.ena.org/news-publications/newsroom/emergency-nurses-association-launches-new-study-workplace-violence
• JAMA physician assault survey: https://pmc.ncbi.nlm.nih.gov/articles/PMC9707179/
• "From Worst to First" by Gordon Bethune (Continental Airlines customer service philosophy): https://www.amazon.com/Worst-First-Continentals-Remarkable-Comeback/dp/0471356522
• Nurse Blake's social media advocacy for safe staffing

Connect with Out of Network

Website: https://www.outofnetworkpod.com/

Instagram: https://www.instagram.com/outofnetworkpodcast/

YouTube: https://www.youtube.com/@OutofNetworkPodcast

TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts

Parker Medical - Las Vegas, NV → https://bit.ly/parkermedical

Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/

Seth Premiere Medical - Tampa, FL → https://bit.ly/sethpremiere

Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.

In this episode of Out of Network, Dr. Rishi Seth sits down with Andres Ayesta, registered dietitian, CEO of Planos Nutrition, and producer of this very podcast. Together, they explore the broken connections between physicians and dietitians, the wild west of social media nutrition advice, and the entrepreneurial challenges of building healthcare businesses outside traditional systems. From GLP-1 medications to the importance of evidence-based practice, this conversation reveals how nutrition and concierge medicine can work together to truly serve patients.

What You'll Learn

• Why the referral system between doctors and dietitians is fundamentally broken—and how insurance makes it worse
• How to navigate nutrition misinformation on social media and identify evidence-based advice
• The real story behind GLP-1 weight loss medications: benefits, risks, and how to use them safely
• Essential lessons from 10 years of healthcare entrepreneurship, including the importance of "imperfect action"

Timestamps

00:00 – Introduction to Andres Ayesta
03:00 – What is Planos Nutrition and the blueprint approach to health
10:00 – The broken physician-dietitian referral system
18:00 – Insurance challenges for dietitians and patients
24:00 – Social media nutrition wars and misinformation
35:00 – GLP-1 medications: the good, bad, and ugly
42:00 – Healthcare entrepreneurship lessons learned
50:00 – The marketing reality of healthcare businesses

About Our Guest
Andres Ayesta is a registered dietitian, CEO of Planos Nutrition, and healthcare entrepreneur. Originally from Venezuela, he's built a thriving nutrition practice focused on evidence-based care and holistic health approaches. Connect with him here:

Website: https://planosnutrition.com/
Instagram: https://www.instagram.com/andresayesta/
YouTube: http://youtube.com/c/andresayesta

Connect with Out of Network
Website: https://www.outofnetworkpod.com/
Instagram: https://www.instagram.com/outofnetworkpodcast/
YouTube: https://www.youtube.com/@OutofNetworkPodcast
TikTok: https://www.tiktok.com/@outofnetworkpodcast

Connect with the Hosts
Parker Medical - Las Vegas, NV → https://parkermedical.org/
Dr. Ryon Parker → https://www.instagram.com/dr.ryonparker/
Seth Premiere Medical - Tampa, FL → https://sethmedical.com/
Dr. Rishi Seth → https://www.instagram.com/drrishiseth/

Enjoyed the Episode?
If you liked this conversation, please subscribe, leave us a review, and share this podcast with a friend—it helps more people discover a new vision for healthcare.