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The Doctor · The Pharmacist

2008–2010 . . . Tumpati brings in recruits . . . A booming pharmacy business . . . RX Limited attracts attention

For Dr. Prabhakara Tumpati, the Pennsylvania physician writ- ing prescriptions for RX Limited, the network was proving more lucrative than he could have hoped. He used his own bank accounts to collect his fees for writing prescriptions, and paid taxes on the income, despite the fact that every year RX Limited neglected to send him any official tax forms. “I reported every penny,” he said. He had begun training on the side to practice sleep medicine, and was saving money from RX Limited with an eye toward opening his own clinic.

He was now reviewing hundreds of patient questionnaires a day—an insane number of patients in the context of an ordinary doctor’s office. “I wasn’t worried because I actually reviewed each and every patient’s history and had some set criteria,” he said. If a patient mentioned they were taking other painkillers but were now requesting Ultram, for instance, he would flag the order as prob- lematic. He came to see the model of RX Limited itself as a form of what is called “asynchronous telemedicine,” in which doctors have the ability to evaluate patients remotely, pattern-matching