Telemedicine’s Impact on Endocrinology and Physicians with Dr. Munira Mehta
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🎙 Episode 9 | Endocrine Matters Podcast
Telemedicine is transforming endocrinology—for both patients and physicians. In this episode, Dr. Munira Mehta joins Dr. Arti Thangudu to share how virtual care has opened new doors for patient access, physician autonomy, and work-life balance. They dive into how telemedicine is closing care gaps across the U.S., reshaping career paths for women in medicine, and creating cultures where physicians and patients can truly thrive.
If you’re a physician, healthcare leader, or simply curious about how technology is reshaping medicine, this is a must-listen conversation!
Listen to the Full Episode
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Key Topics & Timestamps
Skip to specific parts of the episode:
PART ONE:
00:00 – How telemedicine gives physicians more control and compassion in patient care
06:30 – Improving patient care and physician well-being through virtual care
12:30 – The shortage of endocrinologists and how telemedicine bridges gaps
19:30 – Overcoming skepticism and building meaningful patient relationships remotely
28:30 – The work-life balance telemedicine offers, especially for women physicians
34:00 – Challenges and opportunities when transitioning into telemedicine
PART TWO:
37:02 – How non-competes hurt physicians and access to care
42:00 – Creating physician-led cultures that prioritize well-being
51:00 – Rethinking patient access, chronic disease prevention, and system flaws
59:00 – How women physicians can design sustainable, fulfilling careers
01:07:00 – Evolving endocrinology to better serve both physicians and patients
01:12:00 – Final thoughts on embracing innovation, autonomy, and leadership
Episode Highlights
Key Takeaways:
The power of telemedicine in improving access to endocrine care
How virtual practice enables more meaningful patient interactions
Challenges women physicians face—from non-competes to work-life integration
The importance of workplace culture in building fulfilling medical careers
Why flexibility and autonomy matter for physician well-being and patient outcomes
How telemedicine is reshaping the future of endocrinology
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Munira: [00:00:00] Telemedicine has allowed me to, it's given me control over who I am as an endocrinologist, who I am as a physician, and I can take an hour with my patients and I can take longer with my patients. I can let them feel heard. Um, I can show them empathy. I can show them compassion, all of these things that You don't have to, just because you're virtual or in front of a computer, that doesn't mean you can't provide all of those things and patients want to be heard.
Arti: Welcome to today's episode where we explore how telemedicine is revolutionizing care for endocrinology patients and reshaping the way women physicians practice medicine. I'm delighted to be joined by Dr. Munira Mehta, an accomplished endocrinologist and advocate for leveraging technology to enhance both patient care and physician well being.
Telemedicine has emerged as a powerful tool in endocrinology, offering patients convenient, accessible, and comprehensive care, often from the comfort of their own homes. But beyond its impact on patients, telemedicine has also become a game changer for physicians, especially women in medicine, helping to create a better balance between their professional and personal lives.
Dr. Mehta will share how telemedicine not only improves care for complex endocrine conditions, but also enables women endocrinologists to Thrive in their careers while embracing work [00:01:30] life integration. In this episode, we'll discuss the unique challenges faced by women physicians, from balancing caregiving responsibilities to navigating systemic barriers in medicine.
Dr. Mehta will inspire us with her vision for how women can reimagine their workspaces to celebrate the privilege of being physicians while living fulfilling lives both in and out of the clinic. Her story underscores how telemedicine can support women in building careers that are not only meaningful, but also sustainable, allowing them to care for themselves, their families, and their patients.
This conversation is a call to action for women physicians to support one another, embrace innovation, and advocate for creating work environments that prioritize well being. Whether you're a physician, a healthcare leader, or simply curious about the transformative potential of telemedicine, this episode will leave you feeling motivated and empowered.
I hope you enjoy the show and if you're looking for any links to anything we discussed, check out the show notes.
Well, Munira, I'm so excited to have you here. Munira is one of our own. She is one of our wonderful endocrinologists that joined our team this year and um, she's just the best. Just N. She takes such great care of her patients and, um, has been. A wonderful addition to our [00:03:00] team, and we are here today to talk about telemedicine, how it has changed our lives, and the interplay between remote work and motherhood, and how, you know, we're, we're really interested in making endocrinology a desirable specialty for people to go into, medical trainees to go into.
And particularly for women, as we know that 70 percent of endocrinology fellows are women, and we need to create environments where women endocrinologists feel supported and feel like they can take care of their patients in the ways that they, they want to. And also they can live their lives because being a woman in medicine is a uniquely challenging and uniquely.
Amazing, also, experience. So, Munira, tell us a little bit about yourself and, um, what brought you to where you are today and your experience with telemedicine and endocrinology.
Munira: I'm so excited to be here and I'm grateful to be part of this team. So, um, you know, my journey started in fellowship, um, I finished fellowship about Yeah, I guess it's been seven, eight years ago and I was in academic medicine for a couple years, um, and then I transitioned into private practice, endocrinology, and you know, I was, I loved my patients, um, but I still felt stuck and I felt [00:04:30] like I wasn't, I wasn't the best, we weren't seeing the best of me, I didn't feel the best of me.
Um, fully, I didn't feel fulfilled in many ways, and so I, I had to, like, really have a moment to myself and then have a conversation with, with my friends and my family, and my husband said, you know, you can, you don't have to have a plan, you can step out of this, you need to kind of reevaluate your, your goals and, uh, what you want from your career and from your personal life.
So, so telemedicine sort of, um, I kind of landed in telemedicine, and I'll explain why. Um, so I, I had been networking with people, um, in the realm for a couple years prior to leaving my private practice job, which was in 2023. And, um, for, for one reason or another, you know, I, I stayed in that role, but I realized that I needed to, Take a step back almost.
Well, not a step back, but a sidestep to be very intentional and where I wanted things to go. Um, and then I left the job. I started talking with the telehealth companies, and I really found people who had these ideas and goals that resonated with mine where I could provide it. high quality care and access to care to endocrine care to patients who wouldn't otherwise never see an endocrinologist and never get that [00:06:00] diagnosis or never get high quality care.
Um, and so that's what landed me in, in the telemedicine realm and And I honestly thought about it as a bridge to go from, you know, one job to the next because, like many other physicians, I was stuck with a non compete where I couldn't practice within a certain radius. So I said, okay, I'll use this as a bridge to go from here to there.
Um, And it, it has translated into so many bigger and better things, and I've met some, um, very, you know, inspiring people along the way, and I've, trailblazers almost, because we're trying to provide care and fill this gap, and where there's a huge, a huge need is, What we're trying to meet in that we're trying to provide care to patients all across the nation, and I've been able to do that, and I'm so grateful that I'm here.
Arti: Yeah, and I think, um, to put it into perspective, 75 percent of U. S. counties don't have a single endocrinologist and oftentimes those are rural communities or places that aren't desirable for people to go live. And so that is a, that's almost the whole country. Almost the whole country doesn't have easy access to care and telemedicine.
Bridges that gap for many people. Is it [00:07:30] perfect? Absolutely not. Is it for every single doctor and every single patient? No, but what we've learned in the diabetes and endocrinology space, there's a huge Almost all of the, the population of those patients can utilize a fully telemedicine, endocrinologist relationship or a hybrid of, of in-person and remote care.
I think almost all of us, especially us working age people, would much prefer an a remote visit if, if possible. And I think it's, it's very important for us to recognize. Not just the clinical needs of our patients, like, what do they need as far as the labs to check and all of that stuff, but also the, the social needs and the economic needs of our patients.
And telemedicine does offer solutions from, from those non clinical outcomes perspectives, but those also translate to clinical perspectives. And we also now, we have this. worldwide pandemic, right? We had COVID that forced us to explore telemedicine as an option and what we learn from it through through studies our own and in our own group amongst our own patients [00:09:00] as well as other groups like the VA that telemedicine outcomes and diabetes are On par, and in some ways better than in person visits, and patient satisfaction is very good.
And actually, they're able to make appointments, and they save money, and they save the system money because, you know, the VA gives travel vouchers. And so, I do think it is a unique opportunity, and an opportunity that we are obligated to explore with our patients. How do you think that endocrinology is uniquely suited for telemedicine?
You
Munira: know, that's a great question. I think, I, I, honestly, I think, um, endocrinology and a lot of other non surgical specialties lend itself to, lends themselves to telemedicine. in some capacity or another and, and to some degree, even non surg, surgical specialties with like post ops and pre ops and consultations and things.
But specifically for endocrinology, I think it's, it's such a, it's such a great tool and I've developed such great relationships with patients and it's, and, and I can say this, uh, with confidence and I was a skeptic before, not gonna lie, but once you're in the space, it's not about, um, It's not about [00:10:30] physically being in the room with the patient at all times because it's, it's sad to say, but with the constraints that are placed on physicians now, with time, administrative burdens and just documentation, all these burdens, the amount of time and the quality of care that you get in an inpatient visit is not always What it used to be or what it should be, but telemedicine has allowed me to, it's given me control over who I am as an endocrinologist, who I am as a physician, and I can take an hour with my patients, and I can take longer with my patients.
I can let them feel heard. I can show them empathy. I can show them compassion. All of these things that You don't have to, just because you're virtual or in front of a computer, that doesn't mean you can't provide all of those things, and patients want to be heard, and it's, it's unfortunate that that's not You're welcome.
Where a lot of, um, clinics and, I'm not saying all physicians don't, are like that, but I think it's hard to find the, the care that most patients need in this day and age, and I'm able to do that through telemedicine, diabetes care, you know, prescribing, um, uh, So many medications and having a multidisciplinary approach to care with with a health coach and a diabetes educator, sometimes even in my practices before where I was in person, we didn't have such [00:12:00] comprehensive resources to offer the patient.
So having it's not about, you know, being in person or Or virtual, it's about finding the, uh, the right fit and the, the team that allows you to deliver the best care and patient people who care about patient outcomes. Um, and we, we can do this not just with diabetes, but thyroid care, um, osteoporosis, uh, just, it, it, it lends itself very well to, to care.
And sometimes it's, it's just diagnosing conditions or cushings, and it's a variety of things that you can. You can do. And if, if, if I hit limitations, I'm the first to say, okay, look, I think you need to go to see someone in person or you need dynamic testing that we cannot offer. And those things come up, but those are the exceptions rather than the rule.
Arti: Yeah. And I think that that is the biggest thing that we, people get concerned about is the relationship. Is it going to feel cold? Is it going to, you know, have that same feeling as, If we were in person and I absolutely love seeing patients in person, I don't do it often right now because it doesn't make sense for my life in my career, but I love seeing patients in person.
I love seeing people in person. We're here together today as opposed to being virtual for a reason, right? Like there is a benefit of being in person. There's a oxytocin rush when you when you give someone a hug. All of those [00:13:30] things are very real. However, we have to weigh the risks and benefits. And with telemedicine and diabetes and endocrinology, even though there is Perhaps some of, of that warm fuzzy loss on that end.
We have the ability to have, maintain eye contact with a patient throughout a 30 to 60 minute visit, which in a traditional setting, I just remember, and it makes me like gag to think about it, but it In my old practice, I had a computer that was at standing level, and my body was, imagine my body like this, and then my patient is like sitting over there perpendicular to me, and I'm typing away, staring at the computer in front of me, and like barely seeing the patient out of my peripheral vision, or like turning my head occasionally, because there's no time to You.
To just be in front of the patient without documenting anything in, in that kind of setting. And so you're forced into this setting. And if the clinic, if the office setup isn't how patient centered, it isn't patient centered and you don't get to decide how to set up your own office. It's this setup for a very cold encounter encounter.
Right. And so. Yes, I can understand that skepticism and that concern that people have about the visit being cold. However, I think [00:15:00] we, the, the traditional delivery of care that most of us are experiencing now is extremely sterile and, um, We are able to connect deeply with people online in, in this day and age, and with endocrinology where there is such a dearth of endocrinologists and there's such a need, finding ways to bridge that gap is, is imperative for, for our communities, the health of our nation, the cost of health care, all of these things.
Munira: I agree. And in fact, I find my patients to You know, they're a bit hesitant at first, or, you know, I can tell from their body language when they first meet me, but I love that challenge, and I love putting them at ease and making them feel like I'm on their side, and it's sad, but not a lot of patients have experienced that.
Like, I am, we're there to empower them, and we're there to help them. We're not just here to play the blame game, or, you know, they've experienced so many, um, stigmas and traumas related to their chronic conditions that that goes away quickly once you really, really just treat them as a person, not as the disease.
And you, you can, I think within the first few minutes, I do my best to set that. Um, tone because that, that patient relation, patient physician relationship is so important. And in fact, I find that my patients remotely are so much more engaged and [00:16:30] they're very motivated because they didn't have to deal with the anxiety of, Oh, I have an appointment.
Am I going to be late? I have to figure out my pickup and drop off for my child and carve out, you know, four hours of my day to get to the appointment and back, wait in the waiting room. They're comfortable. They're at home. It's, you know, it's, Oh, let me do this. I'm not going to try to reschedule this. I can do this.
So it's, I find it, like, I find my patients to really, um, be engaged in their care and tell me exactly what their needs are and we do our best to, I try my best to meet them where they're at. Absolutely.
Arti: And I think in medicine, um, traditionally, we have done a bad job of valuing and prioritizing our patient's time.
And that may be the physician. It may be the clinical staff. It may just be the kind of rigmarole that they have to go through when they go to a clinic that completely devalue a patient's time and that their appointment might be at one o'clock, but they're not seen until three o'clock. This happens all the time.
Everybody has experienced this, whether it's for themselves or a family member. And what that leads to is already a fractured relationship, because even if it's not the doctor's fault, like, maybe they had an emergency right before, right? Um, Or a patient that was really going [00:18:00] through a difficult time and that, that took more time than estimated or, or whatever, the, the relationship is fractured before the patient even walks through the door because they already, whether consciously or subconsciously feel disrespected.
And rightfully so, they are disrespected and with telemedicine, one, it helps us run on time because we don't have to wait on an MA to check on, check in a patient. Our nurse reviews the record beforehand and has everything prepared for us beforehand or we review things ourselves. That patient's appointment time is when the patient is seen.
Yes, sometimes we run five, ten minutes late and we apologize to the patient, but it's never like you're sitting in an office for two hours and they're in the comfort of their home or their office, so they can continue to work or whatever it is that they're doing if they do have to wait that extra five or ten minutes.
Um, and so, Telemedicine enables us to demonstrate to the patient that we value their time, we value not just their time waiting for us, but their time as far as a commute, and that they are the most important person in the room, because I think some doctors, and I hope our generation is getting better, but I know that there are doctors who think they're the most important person in the room, and that's just not true.
That I think that we have to believe [00:19:30] that the patient is the most important person in the room. Otherwise we can't provide the best care centered around them. And so in a way, it sort of takes the ego out of, out of, um. The equation, the equation for, for the, the, um, doctor. Now, let's talk, okay, we've talked about that skepticism with the warm, the, the warm fuzzies of the, the telemedicine experience.
And we've had maybe a couple of patients who haven't liked it, but we definitely, like, The coolest thing to see is to see the skeptics change their mind, because, you know, there are certain people who aren't excited about telemedicine, but we're fortunate that they give it a try. And I always, I like to ask, I like to talk to the patients about it to just see what their experience is.
It's important to me to make it the best that we can. And a lot of them will say, I was really skeptical and I wasn't crazy about the idea. But I tried it, and actually I really love it now. Um, have
Munira: you had that experience? Yes, I think, I, I see it every day, and I just see how relaxed and excited patients are to come to the visits, because they'd, again, you know, we, we try our best to work around their schedule, and they can do it from, sometimes they'll You know, if they're home, they'll do it from home and they'll [00:21:00] provide me with the objective data that I need.
Um, and they, they love that they can be comfortable in a home environment. 'cause oftentimes they're having very difficult conversations and doing that in a, in a, a space that's not their own makes it even harder. And so they, they love the convenience of it and the fact that they don't have to drive. Two hours to get to the nearest endocrinologist or they don't have to wait nine months to see why they have, you know, the symptoms that they're having, or if they have a diagnosis of a thyroid cancer, they don't have to wait six months to see an endocrinologist, right?
So they love once they're part of it, and they see the Type of care that we give and we're their champions. They love it. And and that makes me the happiest doctor ever. And in some of the best, you know, administrative staff and M. A. S. And nurses, um, diabetes educators that I've had and I've worked with have been in this for years.
in this telemedicine realm. And I think it's because people are just more fulfilled. They're, they're happier and they are, they're, they're, they're putting their best foot forward in providing care to the patients.
Arti: Yeah. And, and I think it also gives us that flexibility and freedom too, because we, I remember feeling extremely stressed out because I had no control over.
When my one o'clock patient was actually going to be [00:22:30] in the exam room for me to see them and it relied on so many different factors that were out of my control and so, you know, I was seeing my one o'clock at two o'clock and my two o'clock at 130 and like it was just so Discombobulated and confusing and just very difficult to stay on track and sometimes you think, oh, these are little things, but they are stressful and they get more stressful the busier you get and that stress gets compounded when it happens every single day, day in, day out.
Um. And so I think with telemedicine, there's just this like sense of control and yeah, sometimes patients run a little bit late. They have tech, technical, technical difficulties. Those things happen. Absolutely. And, um, There's no perfect solution, but I do think that it offers patients and physicians a unique sense of control and connection that is actually extremely disrupted in our traditional system now.
You mentioned something that I kind of wanted to circle back to and it was the non compete and without getting into specifics of your, your particular situation, I would love to talk about that because I know that there's been a lot of FTC [00:24:00] talk about non competes and And the enforceability of it, the legality of, of non competes.
And I think it's very interesting because we live in a world where we as physicians provide a service to the community. Um, and we, there's a shortage of physicians and a massive shortage of endocrinologists. Yet. In a community that needs physicians and endocrinologists, a Viable, wonderful, board certified physician is not allowed to take care of patients.
I would just love to hear kind of your perspective on, on that and what it means for our community.
Munira: You know, I honestly, I think it's unethical. Because we are doing a disservice to the community by not prov, you know, we're capable, we're willing, we want to be out there providing care. That's what we do best and what we love to do, but we're, we have these handcuffs and we're not, you know, the, the, we can't do it.
And that's a simple, it's as simple as it is. It's, you're putting dollars over the needs of. of the nation, of the country, of the community and that's not okay. I mean I could have driven out of my [00:25:30] radius but that would not have made me a better physician because it wouldn't have, it would have brought me back to the same position I was in in two years and that would have led to me leaving again and so I needed, you know, it's, it's, it's very disheartening to see that you're not allowing physicians to do what they What they want to do and what they need to do what they're qualified to do for, for, you know, the greed or whatever drives these decisions.
I think it's sad and what it does more harm than good because then they're one either patients don't get care or they get subpar care from. providers or people who aren't qualified enough to deliver specialty care or endocrine care and leads to delay and it leads to, to other morbidities and mortalities down the road.
So I, I find it unethical
Arti: and you know, I, I do understand the idea of a non compete. Let's say you own a pizza shop and like you learn all of the wonderful recipes from this pizza shop and Then you leave and you decide to open a competing pizza shop right next door. I can see how that might feel unfair to the original pizza shop.
Okay, that makes sense to me. But when you're a physician, that [00:27:00] group, especially in endocrinology, you know, with surgery, maybe it's different because there's some hands on training after fellowship and residency that different groups offer to their. new hires, but in endocrinology, when you come out of training, you are a fully trained endocrinologist, there's nothing that you are learning from the practice owner or the hospital system that is an added value for you.
You know, it's they're not giving you something they are giving perhaps. Helping get patients in the door. Absolutely. I see that. I mean, I'm a, I'm a practice owner, right? I, I, I facilitate getting patients in the door for, for you and Dr. Uluri. I get that part of the puzzle. However, in such a shortage, Especially in the insurance model, that actually is not that hard, you know, I think most endocrinologists know that getting patients through the door if they were to open up their practice and they accepted a lot of insurances, that actually wouldn't really be the challenge, especially if you're good.
And so it really begs the question of what is it that we are taking away from you? Yeah, we're taking away. Potential business, but there's enough, there's enough patients to [00:28:30] go around for everybody. And it would make you try to be more competitive, but when they block you, a good endocrinologist from setting up shop, not maybe not even next door, like within several miles, enables those systems to have a very low bar for their care.
Right? Because, well, not only do, am I going to give you subpar care? I'm also not going to let anybody else give you better care close by. So guess what? This, this is it. This is it. Unless you want
Munira: to.
Arti: Yeah, this is what you've got. And you're stuck with it. Which, you know, yeah. I think, yes, businesses do have to protect themselves, but there's also the beauty of healthy competition.
And if somebody is doing a better job than you, then up level yourself, you know, raise the bar. And I think we are in an environment where the bar is so low. Like sometimes when patients tell me things or tell me that they liked something about our practice or something that we did, of course, I'm grateful and happy that we were able to provide that service.
But I'm also like,
Munira: that's a given. Yeah, we should be doing that anyway.
Arti: [00:30:00] Yeah. Why is this? Why is it so bad other places? Like, why can't you get anyone to answer your phone call when you're a patient of their clinic. And it's so crazy to me that the bar has
Munira: gotten so
Arti: low.
Munira: Yes. And it's from the constraints that are being placed on physicians.
And I don't, it's not that they don't care or being in person translates to this every time. It's just, there's too many other factors that are out of physician's control that hinders their ability to provide the time and the, the nuanced care that, that the patient needs.
Arti: Yes, absolutely. Um, what are some challenges you have encountered implementing telemedicine with your patients?
Munira: You know, some of, so I do telemedicine in a few capacities, and I think I should explain that, because each challenge varies from one to the next, and in this, with, of course, with Healthy and Complete Medicine, the patients are at home, and we provide telemedicine. Excellent care to the patients. And sometimes they'll ask questions like, Oh, I need this ACTH stimulation test or, uh, what's your waist circumference or body percentage, you know, fat percentage or RMR.
And it's not that they're motivated. My, our patients are motivated and we usually, I circumvent this by just saying, referring them to places where we can [00:31:30] get that information and use it. as, um, objective data to, to, before you start therapy and to monitor their progress and see where they're getting at.
So, sometimes that can be a, can be a challenge, but it's not a barrier to providing the care that we need to provide. So, it's all, I have that time and I have The, the resources to be able to tell them like this is where you need to go and bring, you know, this is where you'll get what you need and bring it to me and then we continue to provide the care that we need and make a, make progress with our plan.
That's something. And then the other thing I think we should bring up and talk about is, um, sometimes telemedicine can feel isolating because you're, you know, by yourself and you have a team, but everyone's located in different parts of the country or the city or the or the county or the state. But I think finding the right team and finding the leaders who are there to to give you a voice and to make you feel heard is And your needs met, be met as a doctor is very important.
And, and I urge anyone who's considering doing telemedicine is, you know, beach be picky. Like you, there's, uh, there's a need for endocrinologists and you can, you, you can shape the narrative so you decide what you want and if that, if that leader or [00:33:00] that team can't give that to you, then. that may not be the right fit for you.
So you can circumvent, you can work around the piece of feeling isolated or so, or that piece of it by just being with the right team because then you constantly have check ins and You can make things better for, for your group and then also for patients.
Arti: Yeah, absolutely. I think what you touched on is in telemedicine, it's very, it's important in all types of care to view the doctor patient relationship as a partnership.
But in telemedicine, I think it's especially important because, you know, they're not in They're not coming into the clinic with the lab in the same clinic and then, you know, I'll send you downstairs for an x ray or, you know, it's not all in one place. So, the patient does have to take some ownership of, you know, we do facilitate, we tell them where to go, what to take, all of those things, but the patient does have to be an active partner in their care.
To be able to go to their, to make their lab appointment or to do all these things that, they're not hard but the, the patient needs to recognize that they have to take ownership of, of those things and I think most people do and I don't think that In a traditional [00:34:30] clinic, that the patient can just be completely passive and have a successful experience either, um, and, and we do have tools that we try to make the experience as easy as possible for our patients and we actually like, you know, well, Munira will be like, Hey, do you know where my patient can get the best price on a prescription?
fine needle aspiration, um, because they need a thyroid biopsy and then either I know or we do some digging and we find out for that patient, which does not really happen in a traditional setting. And so there are definitely workarounds that we do to facilitate that partnership and make it easy on our patients, but it is important for patients to, to come in expecting to have a role in, in their care and not to be.
Passive about it.
Munira: I agree. And there are other, you know, there, there are different types of telemedicine roles and positions where you are providing remote care and the patient comes into the clinic and there's a nurse who rooms them and it's a very traditional system. The only difference is that the physician is not in the room with you.
They're on it on an iPad in the room with you. Um. And in that case, they can go downstairs and do their labs, and the process is similar, but in, you're right in that this situation, it's a few extra steps, but I find my patients to be so motivated, and they know that we're here to help them, and they're willing to [00:36:00] do what it takes to, um, to get better.
Arti: Yeah, and I think we are also very blessed with amazing patients. And I think that is that is unique because I have I have worked in a similar environment where sometimes patients were. in person with a nurse, and I was the virtual aspect, and so I think that just tells us there's many ways to do this, and there's not necessarily one right answer or right way, and if we're creative and innovative, we can really find great solutions that, that work for our patients and ourselves, and I would love to start it.
To, to move the conversation in, um, a direction of how has telemedicine served you? I think that of course we're in it for the patients and we want to serve the patients and make sure we're, we're providing adequate care. But part of being able to provide adequate care is making sure that our needs are fulfilled, especially as women physicians.
Medicine has traditionally been very toxic to women physicians, and sadly, many women physicians leave medicine altogether or, or work less than they might had, had they been in a more supportive environment, and I think this is an important thing to bring up because a lot of physicians are now women, especially endocrinologists.
70 percent of our fellows in endocrinology are, are [00:37:30] women, and and You More women are going to medical school than men now, and so we need to start thinking about how we can make medicine, and particularly endocrinology, a palatable, desirable specialty for women to go into.
Munira: Wow. I love that question because I have nothing but good things to say in the way that it has served me.
And I think most importantly, it has, um, allowed me to be in a better place, you know, mentally, emotionally, physically. Um, I'm just a more present person because I've been able to meet My needs, which has translated into all my roles, right? As a physician, as a mother, as a spouse, as a friend in all my relationships and that that it allows me to achieve some work life balance.
Um, I feel I feel a sense of autonomy. I feel control. I have that flexibility where I feel like I can, I can choose what I want to do with my time and I control the narrative and that has, that shift in mindset has allowed me to grow professionally because it's challenged me to make contacts like we met and we, we've connected and I've met with, met so many, you know, people.
Trailblazers who are here to change the trajectory of endocrine care, of [00:39:00] specialty care, and just because we are, we are used to this traditional model of care that is not meeting our needs and the patient's needs, that doesn't mean we have to be stuck in it. So it's allowed me to really just be in a much better place than I was in the traditional model, and I'm excited to see where it'll, where it'll take me over the next few years.
Arti: Yeah, I think that it's something I think about a lot, just because it's customary doesn't make it right. And just because we're told that practice is supposed to look one certain way doesn't mean that that is right for our patients or right for us. And it's important to stay curious for, for everybody.
It really enables us to consider all alternative options. Um, and I think that as women who are kind of brought up to become career women, I think we have this mentality of, well, we're gonna have to pick and choose. Mm-hmm . You're gonna have to pick one or the other, your kids or, or your career. And there's this big blaring oar that I feel telemedicine has changed my [00:40:30] perspective tremendously and direct care.
Um, you know, I was reading Simon Sinek's book, Leaders Eat Last, and I love that you brought up control because he identifies control as the highest predictor of job satisfaction. And I think that's very important. I think it also is a lens on why many physicians are not not satisfied at this time because they have lost a sense of control over their schedules, their management, what they can prescribe, how they can perform their clinical duties, how they can live outside of the hospital as well.
And And that loss of control is, it's frustrating, it's challenging, and after some time, it's debilitating too, because we need to have that sense of control. And we've worked very hard to be at the, to be Leaders, right, to lead the clinical team and, um, and we're not given that opportunity and in a lot of clinical settings now.
Um, but that big or like loomed over me and I, I used to think about how I wanted to live my life as, as a doctor, as a spouse, a mom, uh, you know, a daughter, a sister, all of those things. And. [00:42:00] I just had this big belief that I didn't have to pick and like I, my mom, my mom is a physician. She's an ophthalmologist, and I think that the way life was at that time or her interest, perhaps, um, there was a big or question.
And for me growing up, I, I had a, I had a great life and upbringing. But. I wanted something different for how it looked when I had kids for for my kids and I never wanted my kids to have less of me because I was a working mom and this manifested itself in a really uh, big way when I had my daughter.
She's my oldest. And I, um, learned like right around the time that she was born that breastfeeding was this big, important thing that moms are supposed to do for their babies. I was one of the first of my friends to, um, to have a baby. And I just didn't know enough. Um, probably because I was a busy fellow and didn't really knew Think about it too much or read about it or do all the things that you probably should do before you have a baby.
So I had a baby and then I was like, Oh my gosh, this is like something really important that my daughter will benefit from. And there's a lot of things that are [00:43:30] unknown on what I can do. But this is, there's pretty solid evidence that if I, yeah, that I, if I nurse this child, she will. Have the best, like, basis or best foundation for, for a lot of things.
And so, I have a lot of pressure. It's so much pressure, but I, that was a big moment for me. I was like, okay, here I am and I don't want this or. And so I, it was very important to me and I like really worked very hard to, to feed her for a year and I did it and it was extremely challenging and I absolutely understand why many mothers find it challenging or unable to do it, but I really felt like I, I'm a career mom, but like my baby is not going to get less than because of it.
me being a career mom. And that has just been something that always goes through my mind when I make make decisions. And of course, there are some things that I can't show up for, like we're traveling to, to make this podcast and my kids My husband was with my kids during this week. There, there are choices that we make, but they're going to meet us up here today on Friday, and they get to be part of it, and they get to be excited about it.
And I think that the control that telemedicine gives us [00:45:00] and direct care gives us over our own lives and the culture of our company, um, really enables us to not be like 50 percent mom. Yes. And 50 percent doctor. I truly believe that I'm 150 percent a patient advocate, and 150 percent mom, and maybe not quite 150 percent wife, probably more like 100 to 90%, sorry babe, um, but, but I can, I've become more.
Yes. I've, my capacity has expanded, my heart has expanded. And feel like we as women physicians have this incredible capacity for compassion and love for everything in our life and for our patients that if we can put ourselves in positions or create positions for each other to enable that, we will just change the world.
Munira: I couldn't agree. More. 100%. And I think just like you said, like professional and personal lives are just intertwined and you can't have one of you can't have a fulfilled personal life without, you know, I mean, they just go hand in hand. You can't have, you can have both. And it's important to have both because I am, I am a better mother and a more fulfilled mother.
Okay. [00:46:30] Um, doctor, because I have this, this culture and this, this balance that I'm, you know, I'm, I'm, I, it's a privilege and I'm glad that I stepped away to find it because if you don't advocate for yourself and know what's, what you need, you can't meet the needs of people. Of others, let alone your patients, your family, your kids, your husband, your parents, your sister, you know, all of the above.
So, uh, I agree and I, I'm so grateful that I'm here on this journey to find what works for me. And this has really helped me change the trajectory of my life in many ways. Well,
Arti: let's talk about culture for a little bit, because I think, you know, a lot of companies talk about their corporate culture, but in medicine, we don't.
Like, that's not even something that, when we're looking for a job, we're, first of all, in training, we are abysmally prepared to look for a job, and that creates long lasting, a domino effect of problems for all of us and all of the physicians to come. And so that's certainly something that, that we should to work, work for.
But, but culture is like, not even on the table, right? Because, first of all, most physician jobs don't have a good culture. And, two, we don't even No, like [00:48:00] residency, the culture is awful. Like the culture is like beat you down and make you feel horrible about yourself. And fellowship is that except times two.
And so like the concept of a work environment that helps you thrive as a, as a employee or a partner or whatever, as well as a person is, is not even really in our, our vocabulary, but. But it's important in our company, incredibly important, and we talk about it a lot. So let's talk about why that is important and how the culture really enables us to thrive and and live in the way that we want to.
Hopefully educate and inspire other physicians and women physicians to seek that out or create that for themselves.
Munira: Yeah, no, I couldn't you know, I agree with you and and I find these things and I've learned the hard way and you have to we were in careers and in jobs that didn't serve us and we, you know, took the liberty to just take a step back and reassess and It brings, I think, the work culture is so important, it's, it's one of those intangible things, like you can't put a price on it, you can't put a price on, um, you know, you can't pay me enough to, you just can't put a price on the control, the flexibility, people around you who care about things [00:49:30] other, that are bigger than just themselves or the company, right?
You want someone who thinks about the patients and how can we improve The, the quality of care and deliver a bigger message, and that's, that's something you can't put a price on, you just have to seek it out, you have to find it, and you have to, we, and we were, and I'm so proud to be part of a team where we're trying to change the narrative around endocrinology and we can, we can get these bright minds to join us and leverage our skills and our knowledge and our minds to Thank you.
to improve the specialty as a whole. And that's that, that, that comes from what, like the right team, the culture, the, what, what the team fosters, which is just a positive environment, um, for patients.
Arti: Yeah, a positive environment for patients, while also a positive environment for each other, and I think, um, we're lucky to have a team of women, we're all women, um, that are like minded in the sense of we're going to go the extra mile for everybody in our life.
And that is our patients and our families and each other and, you know, I don't have to question if, you know, we had a patient [00:51:00] emergency this morning and I was recording and Vidya just handled it, you know, and we, we can trust each other to, to have each other's backs and to have our patients backs and I never have to worry if I am a patient.
Occupied in some way and Munira has to hop on a call with my patient that she's not going to treat them with the respect that I would expect myself to treat them with. I think that is, is hugely important and also respecting that when Munira's kid has a holiday party, she's going to that holiday party and if that means I have to see her patients.
I am happy to see her patience because seeing a kindergartner or a four year old dance across the stage and sing And the holidays is something that she cannot miss and even if she's like, oh, I'll see my patients. I'll run a little late No, like she's not gonna miss that because that's important and if she has to miss it She's going to feel bad about it.
And her kiddo is gonna make her feel bad about it, too and and I want to show up for my kids too and so I think that We not only do we say, okay, if somebody needs time off or has to make a change for something that is [00:52:30] important to them, we encourage it and we encourage care for you to show up for your loved one and Yes, and what I understand your needs.
Yes, and I think that that that part of the culture because you know being a physician I remember being in my first job and feeling like guilty if I Had to step out to go pee or if I had to eat lunch or like these were things that actually I felt And I look back and I'm like, Oh, you poor thing. You know, I look back on that woman and think that is not something you should feel bad about.
Like, why are you holding so much guilt on, on things that are unimportant and like you should just do, but it's, it's a culture that creates that. It's not like somebody was actually getting mad at me for going pee. It was that I felt like I was being judged for. You know, not being in my exam room all the time, you know, and so I think culture and um, environment and the way that we talk to each other and support each other is, is so important.
And Munira actually introduced me or gave me vocabulary for the, the [00:54:00] word, the intangibles. And I love that so much because endocrinology is a unpopular field. Okay. And it's not because it's not a wonderful field. Endocrinologists, many of us love our work and we're very grateful for it. And we love the patient experience.
The science is very interesting. It's fascinating. It's, there's a lot of technology. There's a lot of new things to learn. It's a really, really fun career. But in medicine, certain fields are disincentivized because of the salaries, frankly. And, um, Endocrinology has, uh, applicants to endocrinology are falling because endocrinology is the lowest paying specialty in medicine and we train as long as some of the highest paying specialties.
So when you think of it from a time perspective, you, if you dedicate five years of your life to a specialty and you can earn two, three times more for one versus another, most smart people will choose the one that pays more. And most, many doctors are smart. So people choose the ones that they get, they get paid more for.
And it's sad that it comes down to dollars, but this is how people are. Like people, anybody would do that in any, not just medicine, but any career. You tell me I have to go to school for four years to do X or Y and I can do either. [00:55:30] I'm capable of doing either. And they'll allow me to do either. Okay. I'm going to choose the one that pays me more.
Right. Mm hmm. And I'll probably like either one of them. But, um, what has happened is applicants have dropped. But since men are more likely to make career choices based on income, the applicant applications for men has dropped more than women for endocrinology. So that has created this shift in So The fellowships to be mostly women and most endocrinologists look like us now, you know, most, most of the younger side of endocrinologists look, look like us.
And on one hand, it, it kind of is like, okay, well with endocrinology being feminized, we're going to face a lot of. Things that will make the pay issue worse, um, gender pay gap, um, occupational segregation that says that when more women enter a field, it is. The wages go down, like teaching is an example of that, the motherhood penalty, where mothers are viewed as less competent and less committed and less likely recommended for raises or higher salaries.
So, all of these things are certainly threats, but at the end of the day, We all knew that [00:57:00] endocrinology didn't pay as much as cardiology and orthopedic surgery when we went into this and we still chose it and and it's not like we didn't have other options, right? And so we chose it because we loved it and there and it gave us the opportunity balance in our life.
So we needed and also as women, since we kind of know that women don't choose things just based on the compensation, that makes it even more important for us to create avenues where women in endocrinology do get those intangibles, right? They do get that control, that patient, that um, Satisfaction from taking great care of their patients that work life integration that that we we can create So I really think the health care system is crazy Like the reimbursement structure in health care is maligned and it's not based on technical difficulty It's not based on what's better for the patients.
It's not based on what's cost effective and so Yes, that's a battle for us to, to, to fight. However, in the short term, for endocrinologists, particularly women endocrinologists, we have some options to create avenues that, that make this a desirable field. Because, Muneera, like, would you [00:58:30] trade this?
Munira: No, I wouldn't, you know, I wouldn't.
You know, my non compete is up in April. It was two years, and I wouldn't. Trade it for anything for no X, no amount of dollars would I say, okay, I'll go back or, you know, I'll, I'll give this up and, and it's exactly because of the intangibles cause it's, it brings me, it allows me to live my life on my terms and I couldn't do that when I was in the traditional model and that brings so much joy and it allows me to be more present and just a better, better person and feel more wholesome.
And
Arti: that being said, it's not like we're, we're paying a low rate, like we're paying, it's not that we're, we're not making any money. And it is important for us to have a viable business and competitive with other, Other endocrinology practices, yeah, endocrinology jobs, however, there's a competitive edge when you can offer, okay, I'll, I'll pay you as much, but I'll also give you this awesome opportunity to like, instead of seeing it.
Patients eight to five on Friday. Let's fly to Denver and record a podcast together, you know, and I think that we find this fun and exciting and as a practice owner, there are some months where [01:00:00] I don't take home any salary, you know, and or very little, but it's okay because we're doing something bigger and better.
And there are some months where I make a lot more than I did in in a traditional practice. And yes, it takes a unique person to be able to Accept
Munira: that. Accept
Arti: that and, and bear that risk, um, and, and that happens to be me on this team, but I think that there are different ways to engage your mind and brain that help you expand in every dimension and when we can offer other women endocrinologists some of those opportunities, like it was fun to be here together and get our hair and makeup done and like do all this that we would never have been able to do in a different practice environment.
So I think that is something that we as a team think about a lot as, as far as the people that we want to recruit to join us. And, um, the, The value that we can provide for this specialty and, and the physicians within it, because we're in a unique position where, you know, the laws of supply and demand don't, they don't apply in healthcare.
There's a massive demand for endocrinologists, yet compensation is, is not going to change [01:01:30] because The market is rigged by the patients are not the market, it's insurance companies.
Munira: And so prevention is not important when that's what we do as endocrinologists. A big part of what we do is prevention, what we should be doing, but we're doing a lot more treatment because we're not allowed to, you know, give the patients the tools they need.
Yeah. And medications they need to. To prevent diabetes or
Arti: yeah, and prevention is possible and it's cost effective. It's good for everybody. People like to have their disease for diseases prevented, but the system doesn't allow for that. The other crazy thing in the traditional setting is that we almost self select the sickest patients, which I find so incredibly baffling, um, and I'm going to share a story that I've shared before, but it's just so ridiculous that I think our listeners would love to hear it.
So, we work with big employer clients, and so whenever we get a new client, I do some reconnaissance work where I try to figure out what, um, the lay of the land for endocrinology is in that part of the country. And we, we got one new client and so I was doing the same thing and I was calling to, to find [01:03:00] out what it would look like for a patient to get into an endocrinology clinic.
And basically the long and short of the story was one, it was extremely difficult to get anyone to answer the phone. Once they did answer the phone. Um, even somebody who was, had a diagnosis of diabetes couldn't get an appointment, which is like. What else do you need to know? Like, what else do you need to know?
And then, the requirement was, even if the patient didn't go through their insurance, because I know HMOs do require a referral, the patient would need to see their primary care doctor to get a referral. Then that referral would be sent to the endocrinology office, and that wasn't even enough. Then that office would determine, Based on the referral, if they met criteria to see the doctor and then the appointment would be scheduled and from that time that the appointment was scheduled to the actual appointment, it was six months.
That's just crazy and makes sense to us as doctors because we understand the shortage. But can you imagine as a customer or not a customer, a patient, a potential patient, how Bad that
Munira: looks
Arti: on the doctor.
Munira: Terrible. It's like we don't care. About your glucose or 300. I'll see you in six months. Yeah, I mean,
Arti: it's, it's bizarre.
It's, it's bizarre. It's just like, the patient [01:04:30] feels rejected. They are rejected, actually. They don't even, it's not just their feelings. It's, they actually are rejected. did from our care until, okay, finally you do meet criteria because now you're on dialysis. You know, when really if we saw that patient up front and didn't make it so challenging that they wouldn't be coming to us in such a dire circumstance that we actually can't reverse, but we could have.
It's highly likely that we could have prevented it, like I don't have very many patients that see me early on and then they end up on, I don't think that's ever happened to me actually. Or
Munira: hospitalized, and I mean, it's, yeah, our job is to keep them out of the hospital, keep them healthy. Keep them well, happy, productive, at
Arti: work, doing all the things that they want to do.
But it turns into this self selection of, we only see the most complicated patients who are extremely sick. And that's hard too, as a doctor. Like, if you're only seeing patients that you can't Fix it. I think that kind of sets us up for failure because the unfortunate thing about diabetic complications is once they set in you, it's, yeah,
Munira: it costs an arm and a leg and it's, it's, yeah, they're not reversible a lot more than if they would have prevented it in the first place.
Arti: Yeah. Or whoever's paying for that patient might be the patient themself. Um, but, but also they're not. Once the [01:06:00] complication has set in, most of them cannot be reversed, but they can be prevented. And when we, when we think about care, a lot of us as endocrinologists are programmed from our training
that,
Arti: Oh, that patient isn't sick enough to see us.
Or like, why are they consulting me on that patient? And I think that is a big flaw.
Munira: And I think that's a big thing that I've learned since this year is. We, we screen through a lot of referrals, maybe because, you know, there's such a huge supply of patients that we say, Oh, just refer that to OB GYN or just refer that to so and so, but we are well equipped and or if we're not, we can easily Learn new things and help our patients and and I've I've seen that paradigm shift a lot recently with in women's health with, you know, in fellowship, you get like a month or two of training for hormone replacement therapy.
If that. If that. And so we would just, we were just trained to say, Oh, we don't do that. Just send to GYN. But when I've taken the step back, it's allowed me time to say, Okay, look, this is something that I would love to educate myself on so that I can feel confident and safely and effectively. Help my patients and they're they're women who really need to talk about it But every [01:07:30] time they've brought it up in the past, it's just brushed under the rug, right?
So we and and this is why I think women do well in telemedicine as patients especially because we can really bring these things up and they feel heard And we can say, look, your sleep is related to this. Your, your sleep disturbance is related to this. Let's try this. Tell me more. And I think it's important to, to challenge yourself and grow as a physician to be able to meet the needs of the patients.
And those are evolving. Yeah.
Arti: And I think it's also, it's very easy to be like, Oh, I didn't learn that in my training, but if. If you're a physician who thinks that way, you're going to really have some problems because medicine is constantly evolving. You didn't see every single type of patient in fellowship.
Luckily, we went to very high volume, heavy fellowships, where we saw a lot of things, a lot of crazy things that we haven't seen since. Um, so that was fortunate for all three of us, but We have to constantly learn and involve and, and see what our patients need and respond to that. And there are ways to do that responsibly, right?
We're not here doing appendectomies. Like, it's not like, Oh, I'm a doctor. I, my patient needs an Appy. Let me just figure out how to do that on YouTube. That's not what I'm talking about. But there are things that we can learn to do within our scope of practice that our patients need. And I love that [01:09:00] menopause example.
I think there's a huge. Lens on, um, women's health and the lack thereof and, and we can't be asking our GYN colleagues to do all of that work. We have to work as a team and we understand hormones. That is what we do. We know how these things work and they might need to spend their time. Okay. Some of them may be interested in doing this or want to do this, but I can't deliver a baby.
Like, nobody wants me doing a c section, but I can provide a woman going through perimenopause or menopause with adequate education and hormonal therapies or non hormonal therapies that will make their life easier and better throughout that transition. And so, when we can do better. We should do better and I think it's very easy to shirk our responsibilities and saying, Oh, that was out of my wheelhouse or it wasn't in my training or even let's not even talk about menopause.
Let's say we're talking to a patient and they have an issue that's not necessarily an endocrine or not an endocrinology issue like they have COVID or they have.
Munira: Asthma exacerbation,
Arti: and they can't get into their UTI. Yeah, something that they can't get into their PCP, or they don't have a PCP, and we have the option of saying, Okay, I'm [01:10:30] a board certified internist.
I took my internal medicine boards, and I have the resources and tools to help you. address this problem. Should I do it or should I not? And nine times out of the ten, nine times out of ten, we can do it, and thus we should. It's, it's so much easier for everyone involved for us to just take care of the patient in front of us.
And I know there's, there's a balance there, like we don't want to be all of a sudden expected to do all of the things that we're not Experts on, um, but, but I think in the correct environment, we, we don't see those things as adversarial or, or a burden anymore. It's just, okay, I have a choice. I can take care of this for my patient.
I might have to look up the Dose like I know this patient needs Augmentin, but I can't remember the dose because I'm a prescribed it in a couple months. Let me look up the dose I I know how where to seek that resource and and I can do it and send it to the pharmacy That's one choice or the other choice is to send my patient to an urgent care where they're gonna see god knows who
Mm hmm, and
Arti: they're gonna get god knows what.
In fact, they are gonna get a steroid and antibiotic Something else, an x ray, like all kinds of nonsense they're gonna, you know, and so I think that creating an [01:12:00] environment where we can do better, and we do do better, is so much better for us and the patient. I agree. Well, this was such a fun conversation.
I want to close with the story of how Munira and I met each other because it's kind, it's, it's very serendipitous. Do you want to tell it?
Munira: You can tell it. Go ahead.
Arti: Um, so. As most of you guys know, I have a, I have a pretty active, um, Instagram and I had gone to, I think my daughter's, I had gone to my daughter's classroom and I was actually uh, This is something that annoys me.
It's that every child knows that February is Heart Month, and there's a bunch of stuff around Heart Month. I think most people in the United States are aware of the American Heart Association, Jump Rope for Heart, and all of that stuff. And heart disease is so important. I'm excited that people are engaged in heart disease.
We have a lot of heart disease in my family. And so I'm not trying to say that that is bad, but it annoys me because November is National Diabetes Month. Did any of you guys know that? There's nothing. And diabetes affects more people [01:13:30] than heart disease in this country and also causes a lot of heart disease and a lot of other conditions.
It also is the most expensive condition our country is facing as far as chronic disease. It is a big deal, but nobody knows about it. So I was like, I'm going to make an impact. My kids. Classmates are going to know about it. My kids are going to know about it. So I went to school and talked to, I think my daughter was in second grade and my son was in kinder at that time.
And I talked to, um, their classrooms about diabetes in a kid friendly way, gave them some coloring sheets and things like that. And I think we'd snapped a photo and I posted on instagram, um, in gratitude for entrepreneurship for giving me the opportunity to yeah. To be able to step away and do that. Yeah.
And do this and work in a out of the box sort of way. And an and for advocacy. And then uni texts or dms, me, she slid into my dms, I should say and . She, um, she was like, oh, that's so cool. I would love to do that, um, for my daughter. I thought I knew a lot of endocrinologists in Texas, and, but I, we had never been introduced to each other, and so I was like, who is this person, and it just, I just had this feeling, like, if somebody is asking me about that, they must be on my vibe, like, they must, we Share values and so then we started, I think we started messaging on Instagram and we were starting to grow the [01:15:00] company and we ended up talking on the phone and we kind of talked back and forth about it and, um, she, you know, we, we jived really well and uh, Munira, even though we jived well, I did do my background research and um, you know, she had like the most glowing recommendations I have ever heard.
Like I was, by the end of talking to some of our mutual colleagues, um, they said things like, she's not only the type of physician you want taking care of your patients. but also the type of person that you want in your life and to be your friend. And I was like, okay, I didn't know this. Yeah. Yeah. Um, so.
At that point, I was like, gosh, all these people. I have to have her. She has to be my friend. And so, um, we were so fortunately fortunate that she decided to join our group. And Munira, having you on our team has been even more than I could have expected after those amazing conversations. And I'm so grateful to have you on my team, but also as a friend, like they said, um, But I share that story because it's a cute story, but also because, um, sometimes it's just going for it.
Right? Like, it could have been easily been like, Oh, I [01:16:30] don't have any resources, but you know, or it could have, or she could have
Munira: easily have even I could have, I mean, I messaged you with no expectation. I mean, it just kind of happened. Yeah. We just clicked. Yeah,
Arti: and she could have thought that was cool, but not reached out about it.
And I think leaning into your curiosity and leaning into those people that you're You're interested in, or those opportunities that may seem out of the box or different, but cool, some of them will be flops, absolutely. Like I've had so many failures and flops, but only through diving into them and experiencing it and trying it will you see if something new.
To change your life.
Munira: I agree.
Arti: And I think in medicine, often we're too afraid to do that and, and understandably so. And
Munira: I think we're taught to ask the wrong questions, but you have to, and that's one thing I've learned is you have to, like when I look for a job, it's like the questions I asked at a fellowship were, when I think about it, I was.
They were so insignificant in some ways because they were about things that didn't, that's not what my life is about. And so I think it's important to truly ask yourself what is important to you and seek that out when you look for new [01:18:00] roles and opportunities. I
Arti: think so. And I also think that medical training for a person like me really made me feel like who I am truly in my heart and soul was not the person I should be.
And by that, I mean, I was not always the most, um, I don't want to say academically oriented, but I, Wasn't the person who scored the highest on our practice boards or I I don't do well in We have this horrible term and I almost feel bad even saying it but in in medicine There's something called pimping on on rounds and that's called put you in your place or put in my place And it's where you're basically You're attending just grills you and the purpose is supposed to be to teach, but maybe that works for some learners, but it's not constructive.
It's absolutely not. Yeah. It's not constructive. And it also for, for someone like me, I like to be prepared. Okay. I, if you ask me to present on something and you give me a. a few hours beforehand, [01:19:30] I will deliver very well and with confidence and all of those things. But if you're going to ask me the number of amino acids and PTH on rounds, and I don't know the answer, and you just keep staring at me like I'm an idiot, this actually happened to me, um, in my fellowship.
I'm not learning anything. And just so you know, like I still don't know the number of amino acids in PTH and it has never impacted any of my patients care and it never will because it's irrelevant. And so I think that the, the idea of teaching is, is Really a mask for for abusing our trainees and in that type of environment where you're made to feel like you're invalid and when you push back against it or you you think about what's actually important to you is like that concept isn't even like allowed or or admired in any way or whatever.
Important like you shouldn't even feel like what you your feelings matter or anything like that That's that's kind of how we're made to feel in in training that it sets us up for these job negotiations that aren't even negotiations and [01:21:00] Potentially, unless we decide to jump off the train, a lifelong, um, failure to know your own truth and to be living a career that maybe doesn't serve, serve you.
And when you're not served, like we've said before, you're not able to serve on the same level. And so for, for other women in medicine who might be listening and medical trainees, I think it's. far past time to be having those conversations and recognizing that one, residents and fellows are people too.
And I am still the person that thought differently from the way my faculty did and I wasn't wrong for it. And so. If you're in, in a situation like that, yes, listen to, to others who are ahead of you, listen to them and, and take what you can to grow, but don't feel that, that what you truly value you. is wrong and that you have to change yourself in order to survive in, in medicine, because actually life is not just about survival.
It's about thriving and you can, but you have to be true to yourself.
Munira: Yes, I agree. I think that's What I've gained the most from being [01:22:30] part of the team and from went from stepping away from what I was doing before is gaining this new perspective, which has fueled me in a different way. And I'm excited to just move forward.
And I encourage people to do that for themselves because it's almost harder to do that than to stay in a position And, you know, be a cog in the wheel. So I challenge you to do that if what's what, what, if that's what speaks to you.
Arti: Yeah, the inertia to change is very difficult. And sometimes the things that people put you down for are actually your strengths.
And that happened to me so many times in training, where people were like, Turn that down a notch, turn that off, actually served me to, you know, not everybody has started two companies and not everybody has a podcast. Not everybody gets to do all of these cool things that I love doing. And it wasn't by turning myself down that I was able to do that.
And in fact, it was by, by turning myself up. So I think listen, learn, and, and ultimately. Be true to yourself and listen to your gut and, and you will find a way and, and like we have and, and, and that path will continue to be windy and change and, and, and I think it's okay to pivot and I'm excited to, to see what the future brings for [01:24:00] us and what kind of commentary that you guys have on this show.
Um, Munira, is there anything else you wanted to add before we close today?
Munira: No, it's just been a great opportunity. I'm so glad that. You know, I was part of this and I'm excited to move forward and I am open to people reaching out and asking questions and learning more about my journey because it has really changed my life.
Arti: Yay. Well, thank you so much for coming on today and for being a part of my journey and I'm looking forward to more fun things ahead and changing the world. Yay. Same here.
Resources & Links
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Connect with Dr. Arti:
Instagram: @drartithangudu
LinkedIn: Arti Thangudu, MD
YouTube: @drartithangudu
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