their symptoms, without having to meet them in person. “You don’t investigate a headache every time,” he said. “If you go to the emergency room that is exactly what they will do. They will give you an MRI or a CAT scan, a two-week prescription for Fioricet, and a five-thousand-dollar bill.” With RX Limited, he was doing the same for a fee of $2 a prescription. Adopted on a wide scale, he believed it could revolutionize the country’s healthcare system.

Tumpati was captivated enough by the idea that he leaned on RX Limited to let him improve the business. He attended meetings of the American Telemedicine Association, networking with com- panies innovating in the field, and tried to connect them with his RX Limited contacts. (One RX Limited representative had told Tumpati he was based in Detroit, and once supplied an address there.) Tumpati proposed they look into adding video conferenc- ing, so that the patients could be viewed remotely by RX Limited’s doctors, rather than relying on questionnaires. He suggested they find a way for patients to upload their medical histories to the sys- tem.

The reps at RX Limited were noncommittal, and Tumpati began to sense that they dreaded his calls. “They acted like they were going to talk to their manager, or board, or whoever the person is, and get back to me,” he said. “I never gave up hope, I thought they would come back, that they would improve the system.”

Meanwhile, he told himself he was following in the footsteps of his heroes. Growing up in India, he’d read about a famous doctor who performed more than a hundred thousand eye surgeries to restore children’s sight. “That was something that stuck to me, saying, ‘If one doctor can reach out to that many people, one day maybe I will be able to.’ When I saw this opportunity, I was like, Wow, look at this, I am helping a lot of people.” Sure, he was get- ting paid handsomely for those prescriptions. But he was saving a poor person with no insurance hundreds of dollars on medications to treat their pain.

Tumpati soon proved eager to spread the beneficence, and the wealth, by recruiting colleagues into the network. “Hi Aaron, I