In this episode, Arti sits down with Brian Klepper, a nationally recognized healthcare analyst, strategist, and entrepreneur, to discuss the deep-rooted challenges within the healthcare system. They examine how financial incentives shape care quality, why chronic disease management—particularly for conditions like diabetes—often falls short, and the overlooked role of primary care in improving outcomes.

Brian, who advises healthcare organizations and employers on high-performance solutions, shares his perspective on the dysfunction of traditional insurance models and how data-driven approaches can realign incentives to benefit both providers and patients. He and Arti explore the public’s misconceptions about healthcare costs, the hidden barriers preventing physicians from fully understanding their own performance, and why endocrinologists must actively demonstrate their value in patient care.

This insightful discussion sheds light on the systemic issues at play and offers a vision for a more effective, patient-centered healthcare system—one where collaboration, transparency, and smart data tracking drive real change.

Key Topics & Timestamps:

• 03:00 The State of Chronic Disease Management
• 05:54 Understanding the Healthcare System's Failures
• 09:09 The Role of Data in Patient Care
• 11:58 The Impact of Financial Incentives on Care Quality
• 14:58 The Importance of Primary Care
• 18:02 The Need for Collaboration in Healthcare
• 20:58 Tracking Outcomes and Patient Engagement
• 24:11 The Future of Healthcare Solutions
• 40:49 The Hidden Incentives in Healthcare Systems
• 44:08 Challenges in Traditional Insurance Models
• 48:00 The Perception of Healthcare Costs
• 51:40 The Role of Endocrinology in Patient Care
• 56:55 The Future of Endocrinology as a Specialty
• 01:01:58 Demonstrating Value in Endocrinology
• 01:06:42 The Drive for Change in Healthcare

Episode Highlights:

• The Healthcare System is Failing Patients: Chronic disease management, especially for conditions like diabetes, remains inadequate, with only 10% of patients under control.

• Financial Incentives Prioritize Profit Over Care: The current system rewards volume over value, limiting patient access to the best treatment options.

• Data is Key to Better Outcomes: Tracking patient health metrics can improve care quality, but physicians often lack the time or tools to do so effectively.

• Primary Care Must Go Beyond Gatekeeping: Physicians should act as patient advocates, ensuring comprehensive and proactive care rather than simply referring cases.

• Collaboration Among Providers Leads to Better Care: A team-based approach improves patient outcomes and efficiency across the system.

• Physician-Led Solutions Are Underutilized: Doctor-run companies could transform healthcare delivery, but barriers prevent their widespread adoption.

• Endocrinology is Undervalued and Underfunded: Despite its complexity, the specialty faces inadequate reimbursement and limited recognition.

• Aligning Incentives Can Drive Meaningful Change: When providers and patients share goals for better outcomes, the healthcare system functions more effectively.

• The System Must Prioritize Patient Well-Being: Until structural changes shift focus from financial gain to patient health, achieving sustainable, high-quality care will remain a challenge.

Resources & Links:

• Connect with Brian:
  • LinkedIn

Connect with Dr. Arti: 

Instagram: @drartithangudu

LinkedIn: Arti Thangudu, MD 

YouTube: @drartithangudu

In this episode, Dr. Ruchi Gaba, an Associate Professor of Medicine at Baylor College of Medicine, renowned thyroid expert, and thyroid cancer survivor, shares her unique perspective on thyroid care. From her personal journey navigating a missed thyroid cancer diagnosis to her work as the Director of the Thyroid Therapy Center at Baylor, Dr. Gaba highlights the pressing need for empathetic, patient-centered approaches in endocrinology.

Tune in to hear Dr. Gaba’s insights into bridging the gap between endocrinologists and their patients, tackling thyroid care challenges, and fostering a collaborative and compassionate approach to endocrinology.

Key Topics & Timestamps:

• 3:12 - The Importance of Listening to Patients - How thoughtful listening and empathy transformed Dr. Gaba’s approach to care.
• 6:45 - Challenges in Thyroid Care - Why nonspecific symptoms and a TSH-centric approach can leave patients feeling dismissed.
• 10:30 - Diagnosing Hypothyroidism - Key tests for hypothyroidism: TSH, free T4, and free T3. When additional testing like reverse T3 is necessary.
• 15:20 - The Role of T3 in Treatment - When T3 therapy can benefit hypothyroid patients, and why it’s essential to use it responsibly.
• 21:00 - The Dangers of Overtreatment - Potential complications of unnecessary thyroid hormone therapy, including cardiovascular risks, anxiety, and bone loss.
• 25:40 - Addressing Misinformation - Navigating the challenges of alternative practitioners, supplements, and patient misconceptions.
• 30:55 - Functional Medicine and Patient Support - Acknowledging the value of functional medicine while ensuring evidence-based care.
• 35:10 - Shared Decision-Making and Trust - Building trust through empathy, education, and collaboration with patients.
• 40:00 - Holistic Approaches to Thyroid Care - How lifestyle, nutrition, and referrals to other specialists can complement thyroid treatment.

Episode Highlights:

• Listening to Patients as Whole People: Dr. Gaba discusses how her experience as a thyroid cancer patient reshaped her approach to patient care, emphasizing thoughtful, empathetic listening.
• Complexities of Thyroid Care: Understanding hypothyroidism, its nuanced symptoms, and why a TSH-centric approach isn’t always enough.
• Testing and Diagnostics: The role of TSH, free T4, free T3, and when additional tests like reverse T3 may (or may not) be useful.
• The Role of T3 Therapy: Exploring when and why adding T3 to treatment plans can benefit certain hypothyroid patients.
• Addressing Misinformation: Challenges posed by alternative practitioners, overemphasis on supplements, and unproven therapies. Dr. Gaba shares strategies for guiding patients through the noise of misinformation.
• The Importance of Connection: How endocrinologists can rebuild trust with patients by focusing on empathetic listening, patient education, and collaborative decision-making.
• Dangers of Overtreatment: Potential complications of excessive or unnecessary thyroid hormone therapy, including cardiovascular risks and bone health concerns.
• Leveraging Functional Medicine Strengths Responsibly: Recognizing the value of nutrition and lifestyle counseling while addressing the lack of standardization in some alternative practices.

Resources & Links:

• Learn more about Dr. Gaba’s work at the Thyroid Therapy Center at Baylor College of Medicine

Connect with Dr. Arti: 

Instagram: @drartithangudu

LinkedIn: Arti Thangudu, MD 

YouTube: @drartithangudu

This episode features Dr. Sandra Sobel, a board-certified endocrinologist, lifestyle medicine specialist, and obesity expert based in Pittsburgh. With a passion for metabolic health, Dr. Sobel shares her journey from practicing in traditional clinical settings to founding her direct care practice, Summon Health, where she delivers comprehensive, patient-centered care.

Dr. Sobel also highlights the need for cultural and systemic change in the medical field, encouraging physicians to explore innovative models to better serve their patients.

Learn more about Dr. Sandra Sobel and her work at Summon Health and discover how lifestyle interventions can lead to better outcomes for patients living with metabolic diseases.

Key Topics & Timestamps:

• 06:30 Challenges in Traditional Practice: How administrative pressures hinder patient care.
• 12:45 Lifestyle Medicine in Endocrinology: The importance of addressing nutrition, sleep, and exercise.
• 20:15 Moving Beyond Diabetes Management: Why focusing on root causes can lead to diabetes remission.
• 27:00 Direct Care Benefits: How personalized care improves patient outcomes.
• 33:45 Barriers in Insurance-Based Systems: Why lifestyle medicine struggles in traditional models.
• 40:10 Personal Health Transformation: Dr. Sobel’s own experience with lifestyle changes.
• 47:15 Advice for Physicians: Encouraging exploration of nontraditional practice models.
• 54:00 Closing Reflections: The critical need for systemic change in healthcare.

Episode Highlights:

 • The limitations of traditional endocrinology practices, including time constraints and administrative pressures.

 • The role of lifestyle medicine and nutrition in improving metabolic health, diabetes care, and overall patient outcomes.

 • The lack of formal nutrition training in medical education and its impact on endocrinology practice.

 • How direct care enables deeper patient relationships, personalized care, and the flexibility to address root causes rather than merely managing symptoms.

 • The challenges and rewards of transitioning to an alternative practice model, focusing on aligning patient care with professional values.

Resources & Links:

• Follow Dr. Sobel
  • LinkedIn
  • Instagram
• https://www.summonhealth.com/

Connect with Dr. Arti: 

Instagram: @drartithangudu

LinkedIn: Arti Thangudu, MD 

YouTube: @drartithangudu

In this thought-provoking episode of Endocrine Matters, we are joined by the insightful and compassionate Dr. Wendy Dean to explore the concept of moral injury in healthcare. Dr. Dean is a physician, leader, author, and podcaster whose work has illuminated the emotional and ethical challenges physicians face in today’s healthcare systems. Together, we discuss her groundbreaking book If I Betray These Words, the complexities of moral injury, and actionable ways to reclaim humanity in medicine.

Key Topics & Timestamps:

 • 03:12 Defining moral injury and how it differs from burnout.

 • 09:46 The systemic factors that perpetuate moral injury in healthcare.

 • 18:15 Dr. Dean’s personal journey from psychiatry to moral injury advocacy.

 • 29:03 The impact of hospital consolidation and vertical integration.

 • 41:27 Patients’ misconceptions about billing and the challenges of transparency.

 • 54:12 Why direct primary care is a win-win for physicians and patients.

 • 01:10:45 How physicians can address moral injury and advocate for change.

 • 01:22:18 The power of collective action and building coalitions in healthcare.

Episode Highlights:

 • Moral Injury vs. Burnout: Burnout suggests exhaustion from the work itself, but moral injury stems from systemic pressures forcing physicians to compromise their ethical commitment to patient care.

 • The Cost of Healthcare Systems: Hospital consolidation, vertical integration, and profit-driven motives have created barriers to ethical care, leaving physicians struggling to fulfill their oaths.

 • Direct Care as a Solution: Dr. Dean advocates for direct patient care models, which offer transparency, stronger relationships, and better outcomes for both physicians and patients.

 • Building Trust in Healthcare: The importance of restoring the physician-patient relationship and challenging the systemic issues that harm both.

Resources & Links:

• https://wendydeanmd.com/ 
• Dr. Dean’s Book: If I Betray These Words
• Dr. Dean’s organization: Moral Injury of Healthcare
• Moral Matters Podcast: Explore deeper conversations about moral injury
• 43 CCs Podcast: Healthcare insights with a twist of humor 
• Follow Dr. Dean: 
  • LinkedIn: Wendy Dean, MD

Connect with Dr. Arti: 

Instagram: @drartithangudu

LinkedIn: Arti Thangudu, MD 

YouTube: @drartithangudu

In this episode of Endocrine Matters, we delve into the transformative impact of empathy and collaboration in diabetes care. Dr. Vidhya Illuri, an endocrinologist and type 1 diabetes expert, joins diabetes advocate Mila Clark (The Hangry Woman) to discuss Mila’s journey from misdiagnosis to proper treatment, the challenges of navigating healthcare, and how endocrinologists and patients can work together to achieve better outcomes. This episode is a must-listen for anyone navigating the complexities of diabetes care—offering insight, inspiration, and actionable advice for patients, caregivers, and healthcare providers alike.

Key Topics & Timestamps:

 • 01:31 Celebrating women in medicine and their unique contributions.

 • 09:36 Dr. Illuri’s transition from traditional practice to direct care.

 • 18:30 Mila’s experience navigating systemic barriers in healthcare.

 • 31:13 Understanding LADA and its distinction from type 2 diabetes.

 • 38:28 The importance of empathy and trust in patient care.

 • 51:00 The critical role of female physicians in fostering compassionate care.

 • 58:01 Addressing the shortage of endocrinologists and its impact on diabetes management.

 • 01:18:27 Recognizing and addressing diabetes distress.

 • 01:22:34 Empowering patients through advocacy and validation.

Episode Highlights:

 • Mila’s Misdiagnosis: Misunderstood for four years, Mila shares how persistence and finding the right physician transformed her care.

 • Endocrinologists’ Role: Dr. Illuri explains why nuanced, frequent, and patient-centered care is critical for diabetes management.

 • Women in Medicine: How female physicians, like Dr. Illuri, bring empathy and understanding to improve patient outcomes.

 • Advocacy Tips: The importance of self-advocacy and how patients can empower themselves to achieve better care.

Resources & Links:

• Follow Mila: 
  • @thehangrywoman 
  • https://hangrywoman.com/ 
• Follow Dr. Illuri
  • @dr.illuris.pantry
• Harvard Study that showed patients treated by women doctors had better outcomes
• Explore Mila’s App: Glucose Guide for diabetes tips, recipes, and coaching.

This episode is sponsored by CeQur Simplicity.

Connect with Dr. Arti: 

• Instagram: @drartithangudu
• LinkedIn: Arti Thangudu, MD 
• YouTube: @drartithangudu

Join us for the all new season of the Endocrine Matters Podcast beginning February 5th.

Endocrine matters empowers women physicians to challenge conventional norms and enhance patient relationships. Through deep discussions, we aim to elevate the specialty and inspire future generations of women physicians, driving meaningful change in hormonal health.