In this episode of Out of Network, Dr. Ryon Parker sits down with Dr. Joshua Goldman (Board-Certified Plastic & Reconstructive Surgeon, co-founder of Vegas Plastic Surgery Institute) to discuss the challenges of modern healthcare, physician burnout, and why so many are moving away from traditional insurance models.

You’ll learn:

✅ How burnout is caused by the administrative burdens of insurance
✅ The broken system that limits time doctors can spend with patients
✅ Why concierge medicine is growing as a solution to care delivery issues
✅ The surgery outcomes that set realistic expectations and prevent patient frustration
✅ Why volume-based models are hurting both physicians and patients
✅ The shift in expectations when it comes to patient care
✅ How healthcare is often about balancing time with quality outcomes

Timestamps

00:00 – Intro: Dr. Joshua Goldman + Vegas Plastic Surgery Institute
03:33 – What craniofacial + microsurgery means
10:47 – What elite surgical training selects for
19:10 – Leaving academia to build a new model
21:33 – Why insurance-based care breaks (admin + overhead)
25:10 – Denials and recoupments: getting paid, then losing it
27:21 – The “third model” (concierge feel without cash-only)
33:30 – Concierge-level experience standards
35:10 – Expectation-setting and why volume kills quality
40:08 – Patient selection: when to say no
01:01:37 – Closing takeaways: access and “time to care”

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/

Dr. Goldman → https://vegaspsi.com/meet-dr-joshua-goldman/
https://www.instagram.com/goldstandardplasticsurgery/

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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.

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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.

#OutOfNetwork #Healthcare #PlasticSurgery #MedicalBurnout #ConciergeMedicine #ReconstructiveSurgery #MedicalCare #PhysicianBurnout #HealthcareSystem

Enjoyed the Episode?
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In this episode of Out of Network, Dr. Ryon Parker sits down with Attorney Adam Garth (healthcare defense attorney) for a behind-the-scenes look at how malpractice cases, board complaints, documentation, AI notes, and telemedicine risk actually play out - and why it’s driving physicians out of certain markets.

You’ll learn:

✅ Why doctors are “under assault” in some jurisdictions - and why they leave
✅ The real cost of a lawsuit: 2–3 years with a cloud over your head
✅ How concierge medicine can reduce risk by giving you time to practice and document well
✅ AI scribing: powerful, but risky if you don’t verify (because the chart becomes evidence)
✅ Why many board complaints aren’t malpractice - they’re billing/respect/front desk issues (and still consume hours and legal fees)
✅ Telemedicine’s blind spot when you can’t put hands on the patient
✅ The simplest legal advice in medicine: “Document, whatever you’re doing.”

Timestamps
00:02 – Who Adam Garth is (healthcare defense attorney)
03:10 – Why physicians are leaving certain jurisdictions
04:37 – The “2–3 year cloud” of malpractice cases
08:34 – Concierge medicine: less volume, more time, lower risk
11:41 – AI scribing: advantage vs liability (verify your notes)
23:45 – Board investigations and what triggers them
24:10 – “Billing / respect” complaints and why they waste time
27:17 – Telemedicine risk when you can’t examine hands-on
47:14 – The best free legal advice for physicians

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/

Adam Garth → https://www.linkedin.com/in/adam-garth-86b00b36/

Enjoyed the Episode?
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.

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.

Modern pediatrics is breaking parents and burning out doctors - and most families have no idea why it feels so rushed, confusing, and lonely.

In this episode of Out of Network, Dr. Rishi Seth sits down with Dr. Lisa Hayes (founder of Hayes Pediatric) for a no-fluff conversation about what changes when pediatric care is built around families instead of throughput.

You’ll hear:

• A behind-the-scenes look at why many pediatric visits feel like a blur (10 to 15 minutes is the reality in a lot of practices)
• What concierge / direct pediatric care actually looks like in real life
• Why Dr. Hayes does home visits within 48 hours of newborn discharge and continues home visits until 2 months
• The baby “products” parents waste money on (and the ones that don’t belong in the crib)
• What’s normal vs not normal in the first months, including crying and sleep
• Why sleep training is not one-size-fits-all and how she frames it without guilt
• How she handles vaccine anxiety in a world where parents are drowning in noise and fear
• What made her leave traditional pediatrics and build a model she would want for her own family

Timestamps

00:50 – What “pediatrics designed around families” actually means
03:49 – What it looks like to join Hayes Pediatric
04:17 – Home visits within 48 hours after discharge
05:18 – The baby product trap parents don’t need
06:50 – The crib setup mistake families don’t realize is risky
09:10 – Crying peaks around 6 weeks and what parents should know
10:30 – Sleep training: when to start and why it’s not one method for everyone
24:53 – The part that breaks doctors: “Did I listen long enough?”
25:00 – The reality: 10 to 15 minutes per child
41:10 – Why you can’t counsel vaccine questions in 15 minutes
42:10 – CDC vs AAP confusion and what parents actually need

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/

Dr. Lisa Hayes → https://www.instagram.com/hayespediatrics/

Enjoyed the Episode?
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.

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.