Episode #118: Creating a Mindset Shift in Healthcare with Dr. Shantanu Nundy

Friends,

In this episode, Dr. Shantanu Nundy shares with us his thoughtful reframing of healthcare. His book, Care After Covid, is a practical exposé on the misalignment of healthcare – offering a guideline for how to reframe the healthcare system moving forward. What you’re going to love about this interview (and his book) are the stories that he shares – transporting us from an inner city clinic in Washington DC, to the plains of Africa with community health workers in villages, to the university hospital where he discovered the power of caring relationships.

Dr. Shantanu Nundy MD, MBA, is a primary care physician, engineer, technologist, and business leader who serves as Chief Medical Officer for Accolade, which delivers personalized navigation and population health services to companies. Previously, Dr. Nundy served as a senior health specialist at the World Bank Group where he advised developing countries on health innovation & technology. Prior to that, he was Director of the Human Diagnosis Project, a healthcare artificial intelligence startup which he successfully built into a medical project spanning 80 countries. He is also co-inventor of SMS-DMCare, an automated text messaging software for individuals with diabetes, one of the first mobile health interventions to be adopted by the World Health Organization.

He attended MIT for undergrad, the Yale School of Medicine & completed his residency in Internal Medicine at the University of Chicago, where he also obtained a MBA.

In this episode, we’ll discover:

• The maladaptive aspects of our healthcare system that the pandemic has exposed and magnified.
• The 3D model – distributed, digitally-enabled & decentralized – that Dr. Nundy believes can transform healthcare
• How Dr. Nundy views ‘connected care’ as being ‘beyond technology’, but also how digitally-enabled care can create greater access, more personalized care, and greater patient engagement.
• The largely untapped opportunity we have to include patients as part of the healthcare team, and the tremendous potential that has to transform care.
• Real life stories that demonstrate how providers’ professionalism, empathy and overall value proposition are being constrained by our system.

Dr. Nundy’s ability to leverage divergent perspectives is remarkable. He shares a story of conducting research on automated reminders for improving medication taking. What he discovered in interviewing patients was that it wasn’t the digital reminder that motivated them to take their pills. Instead, it was the caring research coordinator, Marla, and the relationship that patients had formed with her, that compelled them to take their medications. Plainly put, they didn’t want to let Marla down. The lesson – caring relationships are not just more empathetic care, they’re also more effective care.

Another example of Dr. Nundy’s ability to balance divergent perspectives is his notion of decentralized care – that healthcare decisions are best modulated as close to patient care as possible. He shares a poignant story of a patient with heart failure. His patient kept on being admitted to the hospital because she didn’t have a scale to weigh herself. (People with heart failure are susceptible to water retention, which causes their lungs to fail. Having a scale allows them to detect fluid retention and take appropriate medications to reverse it). During one post-hospital visit, Dr. Nundy realized that his patient did not own a scale because she couldn’t afford one. So, he handed her twenty dollars to buy one. She bought the scale and did not have any further hospital admissions after that. It’s important to note that Dr. Nundy was actually breaking rules and regulations in giving her the money to purchase that scale. He did not, as a primary care doctor, have the decentralized decision-making or authority to personalize care and do what was right for his patient.

Dr. Nundy’s goal in authoring this book is to create a mindset shift in healthcare delivery. As he states in our dialogue, ‘words create worlds’. So, I’ll conclude by sharing some of his profound words. One phrase that struck me was, “Digitalizing poor care isn’t enough. We need to reinvent care”.  Another, “We need to do population health one patient at a time”. Dr. Nundy envisions a world in which both providers and patients are much more empowered and connected by the healthcare system. I believe that words do create worlds, and I hope this is the case with the words that Dr. Nundy has shared with us.

Until next time, be well.
Zeev Neuwirth, MD