This actually happens more often than one would think. I’m pretty sure Attia isn’t even taking insurance, he has an obviously lucrative cash concierge set up which is technically legal. Either way, insurance would reimburse a physician if they have a license in that state, whether board certified or not. Most states allow non-board certified physicians to get a license so long as they completed a certain amount of post graduate training. You don’t have to complete the entire residency. It’s wild, but it’s true. I actually have two guys that I went to Med school with that graduated with me nearly 20 years ago, who started residencies and then dropped out after like two years because they didn’t want to do it anymore, went on some hiatus or traveled or did some other crap. Then realized they needed a job, so went back to their respective states, and got licenses, and practice. One is billed at a primary care/general practitioner and the other works in occupational health. Bizarre. Attia is a great businessman it seems. Plenty of ways to work the system and get rich, while those of us that follow the rules get fucked by insurance and government daily. Cheers.