Shutting Down

Within hours of launching our async prescription service, we had to shunt away the traffic.

Real patients found us: people trying to refill Prozac after an insurance change, a woman on Climara whose PCP's next opening was five weeks out, someone on venlafaxine who moved states and couldn't find a doctor taking patients.

These are not outliers.

Our AI agents read thousands of social posts per day identifying struggles with medication access. Not just GLP-1s. Everyday drugs. Chronic meds. Acute meds. Hundreds of people our system sees – left hanging. Plus the thousands checking us out after our commentary on TrumpRx. The gaps in care access for prescriptions alone are still staggering.

It takes a lot of work to provide telehealth legally. We're scrambling to put in the work to connect the legal and clinical infrastructure to serve all the potential demand.

And I’ve never been more optimistic.

The first federal prosecution of a telehealth company — Done Global, with reckless auto-refills to deceased patients. Hims directly in regulators' crosshairs, with waves of FDA scrutiny and DOJ investigation. The "do right on paper, enable in practice" playbook is being dismantled in real time.

All the while, the industry is trying to minimize clinical interaction, accelerate visits, and pare down to the absolute minimum standard of care. But our patients showed us something we didn't expect: They call us at 7:00AM sharing details. They proactively message us photos. They email us wanting to have a conversation with the doctor. Even for refills, patients don't just want cheap access. They want quality care.

The Wild West days of unregulated, bare-minimum telehealth are over. The winners will be the players that figure out how to provide superstandard care at scale. Without compliance shortcuts and FDA loopholes.

The players of this new chapter need new core competencies to win the race to deploy production clinical AI under legally defensible technical workflows. I know the shape of the problem well from my time deploying the first LLMs into healthcare at Ambience. But the stakes are higher this time — instead of sharing risk with the nation's top health systems, we're owning the full clinical responsibility of the patient journey.

The only piece between us and serving patients is standing up multi-state practice infrastructure. Normally this runs $300k+ annually in legal fees. We're on track to do it for under $80k — possible only with our founder, legal, and clinical friends layering their skills with my experience in GRC. If you know mega-PC owners, MSO-PC operators, or clinicians who've practiced multi-state telehealth — I'd love to hear their story.

Utah just became the first state to approve AI-powered prescription refills, with more states watching. The regulatory window for AI-driven care is opening new stages as we speak.

With inflection comes immense opportunity. I can’t wait to build the new foundations of telehealth with all of you.

Immense thanks is owed to our many advisors, supporters, and believers. This is a very short list that fails to capture the groundswell of support that keeps building:

We are grateful for so many giants to stand on the shoulders of.