Latest / Becker’s Healthcare Podcast / Harminder (Mindy) Grewal, MD, MBBS, DGO, DiplABOIM, FAAFP, Chair of the Department of Family Medicine at the Wright State University Boonshoft School of Medicine and Whole Health Clinical Lead at the Dayton VA Medical Center

Transcript

Harminder (Mindy) Grewal, MD, MBBS, DGO, DiplABOIM, FAAFP, Chair of the Department of Family Medicine at the Wright State University Boonshoft School of Medicine and Whole Health Clinical Lead at the Dayton VA Medical Center · Becker’s Healthcare Podcast

• 0:00
  This is Laura Dierdahl with the Becker's Healthcare
• 0:02
  Podcast. I'm thrilled today to be joined by
• 0:04
  doctor Harminder Grewal, who is the chair of
• 0:07
  the department of family medicine at Wright State
• 0:09
  University, Boonstraff School of Medicine, a physician at
• 0:12
  Premier Health, and the Whole Health Clinical Lead
• 0:15
  at Dayton VA Medical Center. Doctor. Grewell, it's
• 0:18
  a pleasure to have you on the podcast
• 0:19
  today.
• 0:20
  Thank you so much. Good morning, and, thank
• 0:23
  you for this opportunity to share my journey,
• 0:25
  in medicine.
• 0:27
  Absolutely. Absolutely. Well, let's get right into it.
• 0:29
  Could you tell us a little bit more
• 0:30
  about yourself and your background, what's really brought
• 0:32
  you into the role you have today, and
• 0:34
  what inspires you to keep delivering great care?
• 0:37
  Absolutely. Absolutely. Yeah. So I currently serve as
• 0:39
  academic chair for the department of family medicine
• 0:41
  at Wright State University, Moonchild School of Medicine.
• 0:43
  And my clinical practice, as you mentioned, is
• 0:45
  at Premier Health with Premier Physician Network.
• 0:48
  And I'm also the whole health clinical lead
• 0:50
  at Dayton VA Medical Center.
• 0:52
  I am a servant leader, and I do
• 0:54
  wish to bring positive change in the communities
• 0:56
  that I serve.
• 0:57
  Regarding my background, it's somewhat unusual and unique.
• 1:01
  I was born in India, and,
• 1:03
  my journey in health care, like, spans between
• 1:06
  three countries in three different continents,
• 1:09
  to this point in my career,
• 1:11
  you know, India, United Kingdom, and US.
• 1:14
  And,
• 1:15
  my training spans three specialties. So, like, I
• 1:17
  started with OB GYN, then I did pediatric
• 1:19
  medicine, pediatric surgery, and then
• 1:22
  family medicine was my final resting place. And,
• 1:25
  so I've worked also in three different types
• 1:27
  of health care systems. As you're, you know,
• 1:29
  aware, you know, systems in India, UK, and
• 1:31
  US are very different. So this international experience
• 1:34
  has informed my current thoughts and belief system.
• 1:35
  I'm a systems thinker. As a child,
• 1:37
  system. I'm a systems thinker.
• 1:39
  As a child, I was fascinated by the
• 1:42
  logic and beauty of mathematics and physics and
• 1:44
  nearly actually decided to train in physics or,
• 1:46
  like, specialize in physics, but somehow, you know,
• 1:49
  as the universe would have it, it wanted
• 1:50
  me to go in medicine.
• 1:52
  I wanted to find the same foundational truths
• 1:54
  in medicine. So that has been difficult to
• 1:56
  find.
• 1:57
  It's not just advancement in pure sciences that's
• 1:59
  going to change health care for all of
• 2:01
  us, but, you know, the collective of the
• 2:02
  people that need this health care. So there's
• 2:05
  also another layer of extreme complexity of the
• 2:07
  health care systems, you know, which operationalize the
• 2:09
  delivery of care. So all that is gonna
• 2:12
  affect how medicine
• 2:13
  advances, but I'm still hoping
• 2:15
  to be able to found those foundational truths
• 2:18
  finally, you know?
• 2:19
  So I completed my medical degree at University
• 2:22
  of Delhi,
• 2:23
  obgyn training as well.
• 2:25
  And then I was in UK where I
• 2:27
  did, you know, obgyn, pediatric medicine, pediatric surgery,
• 2:30
  moved to US for family reasons, pursued a
• 2:32
  residency in family medicine, and completed my residency
• 2:35
  at the Ohio State University in Columbus,
• 2:38
  Ohio.
• 2:39
  So after completing the residency, I was in
• 2:42
  different roles, both academic, non academic. I was
• 2:44
  in Upstate New York, Portland, Oregon, and now
• 2:47
  I'm in Ohio.
• 2:48
  I've had exposure to practicing medicine in various
• 2:51
  private and public healthcare settings.
• 2:53
  And,
• 2:55
  I would just talk with some transformational
• 2:57
  things that happened during this practice. So my
• 2:59
  practice as a women's health medical director at
• 3:01
  Syracuse VA Medical Center was transformational as
• 3:04
  I learned not only to treat my female
• 3:06
  veteran patients as patients, but also to advocate
• 3:09
  for the best healthcare for them. And I
• 3:11
  realized the limitations of what I had to
• 3:13
  offer, you know, with my traditional medical training.
• 3:15
  And I pursued to increase my toolbox by
• 3:17
  initially getting board certified in integrative medicine.
• 3:20
  Started applying for some grant funding to support
• 3:22
  development of high value healthcare system for our
• 3:24
  patients. And that started my journey towards the
• 3:26
  whole health systems of care.
• 3:29
  We were successful in getting grant funding from
• 3:32
  for CERQ's VA to become a design site
• 3:34
  for whole health. And some of our wins
• 3:35
  were development of a strong foundation of a
• 3:37
  whole health pathway with the recruitment and training
• 3:39
  of whole health coaches, whole health partners,
• 3:42
  in addition to development of whole health wellness
• 3:43
  options and clinical care for our patients.
• 3:46
  There were some amazing people who joined me
• 3:48
  in this journey and they were my team.
• 3:51
  I will always cherish them.
• 3:53
  At around the same time, I was also
• 3:55
  recruited to be vice chair of medical student
• 3:56
  education at SUNY Upstate Medical University, Department of
• 3:59
  Family Medicine.
• 4:00
  Did the foundational work
• 4:01
  which was needed to, you know, develop a
• 4:04
  new residency program in family medicine, and we
• 4:06
  were successful. It started in 2019. It's been
• 4:08
  very successful since then.
• 4:11
  Then we were also
• 4:13
  interested to develop a rural residency. So we
• 4:15
  were successful
• 4:20
  for a rural
• 4:21
  residency program at Auburn Community Hospital, which also,
• 4:24
  you know, our first metrical learning class was
• 4:27
  in 2022.
• 4:28
  So during my work as a PI of
• 4:30
  this grant, I also ended up, you know,
• 4:32
  kind of doing a deeper dive in, you
• 4:34
  know, the state of rural health, you know,
• 4:35
  rural interprofessional,
• 4:38
  you know, faculty development, and, you know, also
• 4:41
  to look at how to provide equitable care
• 4:43
  to our rural communities.
• 4:45
  Subsequently had some extra training in, you know,
• 4:47
  leadership. I was nominated by SUNY Upstate for
• 4:50
  executive leadership in healthcare at Drexel and completed
• 4:52
  my fellowship in 2023.
• 4:55
  I've had some wonderful mentors, colleagues in my
• 4:57
  journey at SUNY as well who helped me
• 4:58
  grow and become useful member, you know, of
• 5:00
  the community.
• 5:02
  So my next big transition in life, I
• 5:03
  was recruited to be chair of family medicine
• 5:05
  at, you know, Wright State University, BESAM, in
• 5:07
  February 2023 and have been very fortunate to
• 5:10
  have had some very gifted and accomplished,
• 5:13
  faculty members and mentors as well. And, since
• 5:16
  the beginning of my tenure as chair here,
• 5:18
  we have seen significant growth and development of
• 5:20
  a rural residency at Greenville, Ohio,
• 5:22
  Addiction Bass and Fellowship.
• 5:24
  Our department of family medicine has supported global
• 5:26
  health education for our medical students, and now
• 5:28
  we are developing lifestyle medicine education for our
• 5:31
  medical students. And, so this comes this is
• 5:33
  in my wheelhouse. And so we also have
• 5:35
  a brand new street medicine program that, we
• 5:38
  care a lot about. So that, in a
• 5:40
  nutshell, you know, summarizes where I am.
• 5:44
  Well, that's amazing to hear. And what a
• 5:45
  unique career journey you've had, but that passion
• 5:48
  for medicine and helping people and really making
• 5:50
  sense of the complexities in health care,
• 5:53
  shines through. And so that's amazing to hear,
• 5:55
  you know, all the things you've been able
• 5:56
  to accomplish so far and then what you're
• 5:58
  working on today. And speaking of that, what
• 5:59
  are some of the opportunities and headwinds that
• 6:01
  you have your eye on right now?
• 6:03
  Yeah. So there's been a lot of change
• 6:05
  here, so since I joined. Yeah. So the
• 6:07
  most exciting change has been that Premier Health
• 6:09
  and RightSearch University closely aligned their operations under
• 6:12
  a new long term affiliation agreement in April
• 6:15
  2024,
• 6:16
  which enhances Dayton region's access to state of
• 6:18
  art medical care. So this new agreement highlights
• 6:20
  the institution's shared commitment to excellence in education,
• 6:23
  workforce and economic development,
• 6:26
  research, clinical program development, and community health. The
• 6:29
  partnership is obviously transformational, and it prioritizes producing
• 6:32
  more clinicians, nurses, or the health care providers
• 6:35
  that would support our community, spurring new research
• 6:38
  opportunities, providing patients better access to vital medical
• 6:40
  care, like closer to home so they don't
• 6:42
  have to drive, you know, away to other
• 6:43
  places to get their care.
• 6:45
  And also, you know, formally establishes a primary
• 6:47
  academic affiliation,
• 6:49
  between,
• 6:50
  Wright State and Premier Health, including all Wright
• 6:53
  State's colleges
• 6:56
  sites of care.
• 6:57
  So this provides us new opportunities, you know,
• 6:59
  for federal funding to support clinical activities, teaching,
• 7:02
  research. And this
• 7:04
  will also position Premier Health and Wright State
• 7:06
  to develop a comprehensive collaborative approach to meet
• 7:09
  the needs of the community for the future.
• 7:11
  For the Department of Family Medicine, it will
• 7:13
  support our missions of education, clinical care, and
• 7:16
  research by supporting innovation, community engagement on a
• 7:19
  much larger scale.
• 7:20
  We'll also be able to have increased access
• 7:22
  to interdisciplinary, inter professional collaboration.
• 7:25
  BSM already has strong track record in primary
• 7:27
  care medical student education, and this agreement will
• 7:30
  likely give access to more educators, you know,
• 7:32
  for the medical students at Premier and greater
• 7:34
  access to quality and high value care for
• 7:36
  our community.
• 7:38
  We are also very excited about,
• 7:41
  introduction of, AI. So it's introduction of ambient
• 7:44
  AI Daxko pilot at Premier Health. It's, starting
• 7:47
  this month, and it's gonna allow us to
• 7:49
  focus more on what we do best, that
• 7:51
  is take care of patients not having to
• 7:52
  spend twice as much time on documentation. So
• 7:55
  it will help us position wellness.
• 7:57
  The next one I would like to, you
• 7:59
  know, specifically,
• 8:01
  you know, mention is,
• 8:04
  Premier's
• 8:05
  partnership with Agilon. So this is
• 8:08
  a health care tech company which helps to
• 8:11
  improve health outcomes for seniors with resources like
• 8:14
  new technology and care navigators.
• 8:16
  So Premier Health is a nonprofit health care
• 8:18
  system which has five hospitals, more than 100
• 8:20
  locations across seven counties.
• 8:22
  Agilent Healthcare offers resources to physician partners to
• 8:24
  practice value based care through its total care
• 8:27
  model. So this is a more holistic approach
• 8:29
  to Medicare Advantage patients. So it gives them
• 8:31
  a high value,
• 8:32
  enhanced total system.
• 8:35
  And
• 8:37
  so,
• 8:38
  it kind of, provides technology, people, capital, process
• 8:42
  access to a peer network of more than
• 8:44
  2,700
• 8:45
  primary care physicians.
• 8:46
  So one of the benefits of partnership is
• 8:48
  additional care managers to help our patients navigate
• 8:50
  the health system between appointments.
• 8:52
  Agilent's tech platform connects multiple peers, patients, and
• 8:56
  physicians into a single platform to create a
• 8:58
  single experience for patients and physicians.
• 9:00
  Physicians also experience data integration and clinical programs
• 9:03
  through Agilent's platform.
• 9:11
  Very closely aligned with my concept of whole
• 9:13
  health and whole person care. So, you know,
• 9:15
  I'm very excited to participate in this.
• 9:18
  Other one is our development of street medicine
• 9:20
  program that we were very,
• 9:23
  you know, fortunate to get grant funding for.
• 9:25
  And I will talk a little bit more
• 9:27
  about that later. But it's in collaboration with
• 9:28
  Premier Health, and it is to meet the
• 9:31
  underserved members of a community where they are
• 9:33
  and to get them established in regular healthcare.
• 9:35
  Regarding education of America students, we are excited
• 9:38
  about our new elective, which we started offering
• 9:40
  to our students in food as medicine.
• 9:42
  And we are planning for another elective next
• 9:44
  year, which is going to be exercises medicine.
• 9:46
  So
• 9:47
  that's our beginnings of our, you know, foundational
• 9:49
  work in lifestyle medicine here.
• 9:52
  I'm also looking
• 9:54
  very closely at rural health transformation program funding.
• 9:57
  And it'll be interesting to see, you know,
• 9:59
  if,
• 10:00
  you know, Ohio gets funded and then, you
• 10:02
  know, what innovative solutions are going to be
• 10:04
  coming, you know, our way,
• 10:07
  to help with the problem of healthcare access
• 10:09
  and capacity in rural America.
• 10:11
  Now headwinds. So headwinds are same as everyone
• 10:14
  in healthcare and education. It's a very complex
• 10:16
  healthcare landscape
• 10:18
  and same actions do not always translate to
• 10:20
  same results in different situations, in different locations.
• 10:22
  And you know, so we have to always,
• 10:25
  you know, plan, you know, for that.
• 10:28
  AI and healthcare is another wild card. I'm
• 10:30
  very optimistic, but unethical use of AI can
• 10:33
  be disastrous.
• 10:34
  So I participate in, DATNV's Vision ten AI
• 10:37
  Committee to support the ethical use of AI
• 10:39
  in healthcare. And it's very interesting to see
• 10:41
  all the different projects that are coming our
• 10:43
  way.
• 10:44
  Rural health landscape is obviously a bit unpredictable
• 10:47
  at this time despite our best efforts.
• 10:50
  And then
• 10:51
  I'm I'm really looking forward to see what
• 10:53
  happens next.
• 10:55
  Absolutely. It's just so many factors, as you
• 10:57
  said, coming together to really create
• 10:59
  a, bunch of opportunities, but also some challenges
• 11:03
  and especially thinking about the technology and AI
• 11:05
  and really where, you know, that can converge
• 11:07
  into a space where you can get to
• 11:09
  more of that predictive,
• 11:11
  holistic care and value based care too. Now
• 11:13
  when you think about value especially, how are
• 11:15
  you looking at growth in the future, adding
• 11:18
  value to the organizations that you're working with?
• 11:20
  What does that really look like for you,
• 11:21
  and how are you thinking about that at
• 11:23
  a strategic level?
• 11:25
  Absolutely. So the big goal of Red State
• 11:27
  University, based on the Department of Family Medicine,
• 11:29
  is to align with the current healthcare environment,
• 11:32
  mission, value, and vision of our organizations, and
• 11:35
  also still trade stay true to our own
• 11:37
  mission and values. So we have our own
• 11:39
  vision, which is preparing tomorrow's family physicians to
• 11:42
  enhance the health and well-being of the communities
• 11:44
  they serve by defining and providing state of
• 11:47
  art healthcare.
• 11:48
  Our mission is to lead the way in
• 11:49
  educating the next generation of physicians by modeling
• 11:52
  the patient centered principles of family medicine, serving
• 11:54
  our community's health needs, and contributing to the
• 11:56
  scholarly advancement of medicine.
• 11:59
  So we have to support rural medicine and
• 12:00
  support rural residency. We have to learn how
• 12:02
  to leverage, you know, technology and AI to
• 12:04
  support, you know, rural health. So we'll continue
• 12:07
  to, you know, strive for that. And I
• 12:10
  am working with Premier Health, and I am
• 12:12
  actively participating in that.
• 12:14
  We have to continue to do community outreach,
• 12:16
  which we do both from, you know, Bucharest
• 12:18
  School of Medicine as well as from Premier
• 12:20
  side,
• 12:22
  and the VA side. And, we support street
• 12:24
  medicine program and addiction medicine program for health
• 12:27
  equity to support the community. And,
• 12:30
  you know, these are new programs for us,
• 12:32
  and we are very excited, you know, to,
• 12:34
  you know, support their growth.
• 12:37
  We also have an MD in three program
• 12:39
  for family medicine, in which our medical students
• 12:41
  can graduate in three years if they decide
• 12:43
  to go in family medicine or pediatrics, and
• 12:45
  then,
• 12:46
  you know, go into a residency in family
• 12:48
  medicine. And this is, you know, one of
• 12:49
  the initiatives at, Montreal School of Medicine to
• 12:52
  support primary care.
• 12:54
  We also support our family medicine interest groups
• 12:56
  and students so that we can continue to
• 12:58
  have a robust pipeline of our primary care
• 13:00
  providers that stay in the area and that
• 13:02
  serve our communities.
• 13:04
  And with my specific background in integrated medicine
• 13:06
  whole health, you know, developed the UME and
• 13:08
  GME in education about lifestyle medicine, especially nutrition
• 13:11
  and exercise and,
• 13:13
  you know, and and and fine arts, you
• 13:15
  know, and how to build health and not
• 13:17
  just treat disease.
• 13:19
  And how to engage with leadership, you know,
• 13:20
  to support ambient AI, Agilent partnership, you know,
• 13:23
  implementation in primary care,
• 13:25
  how to help with recruitment of strong primary
• 13:27
  care workforce, which not only provides excellent care,
• 13:29
  but is curious, right, and loves to teach.
• 13:31
  How to support our faculty, you know,
• 13:34
  how to do robust research and how to,
• 13:36
  you know, engage in clinical trials, how to
• 13:38
  use lean principles to optimize current processes, build
• 13:41
  capacity, higher value care,
• 13:44
  and then innovation and sharing of knowledge. Right?
• 13:45
  We have to disseminate knowledge as well and
• 13:48
  publish, you know, to develop and also,
• 13:50
  you know, develop innovative processes in clinical care.
• 13:54
  Engage in philanthropic activities, which support the mission
• 13:57
  of my department. And,
• 13:59
  I think the most important one is that
• 14:01
  we have to create
• 14:03
  a replicable, patient centered, high value, whole person
• 14:06
  care model in outpatient setting, which is powered
• 14:08
  by digital tools,
• 14:10
  agentic and ambient AI, as well as high
• 14:12
  touch and humanistic,
• 14:14
  and community based tools, such as health coaching,
• 14:16
  health partners, primary care mental health integration, nutrition,
• 14:19
  lifestyle medicine, group visits, which are financially sustainable.
• 14:23
  So develop whole health and lifestyle medicine all
• 14:25
  the way from in vitro trials in the
• 14:27
  lab to clinical care and the community with
• 14:29
  a lofty goal to create a mini bruzone
• 14:31
  and engage local communities and organizations. And I
• 14:34
  think I worked very hard to gather some
• 14:36
  of the tools, you know, to help with
• 14:37
  this goal, and I'm just hoping that I
• 14:38
  could be the spark.
• 14:41
  I love that. There's so much you said
• 14:43
  there that really truly was inspiring to think
• 14:46
  about how health care is changing, the possibilities,
• 14:48
  and, you know, just having someone like yourself
• 14:50
  being that spark, being that person who can
• 14:52
  think it and dream it, and then actually
• 14:55
  implementing, go start doing it is amazing and
• 14:57
  incredible to see,
• 14:59
  you know, how you've been able to manage
• 15:01
  all these factors coming together to really truly
• 15:03
  support the communities that you're serving.
• 15:06
  I know resources are tied. We've kinda touched
• 15:08
  on it briefly here in our conversation now,
• 15:09
  but
• 15:11
  hospitals and systems and organizations
• 15:13
  are, looking at tight margins now and the
• 15:15
  potential for even more tighter,
• 15:18
  financial situations in the future. So when you
• 15:20
  think about all of these things, what is
• 15:21
  one risk or investment that is still worth
• 15:24
  making in the next year or so,
• 15:26
  even as resources are are tight?
• 15:28
  Absolutely. So right now, I think it is
• 15:30
  gonna be the street medicine program for us.
• 15:32
  You know, we just launched it, you know,
• 15:33
  in January '25, and the lead institution is
• 15:36
  Wright State University, Bunchal School of Medicine. Our
• 15:38
  key partners are Premier Health,
• 15:40
  Dayton Dream Center.
• 15:41
  You know, we have full funding from the
• 15:43
  federal government for this. We also have a
• 15:45
  two year one Ohio Recovery Foundation award for
• 15:48
  nearly, you know, dollars 300,000.
• 15:51
  We have a new HRSA Street Medicine Training
• 15:53
  Grant, which is a five year federal award,
• 15:55
  you know, supporting expanded training, capacity building, long
• 15:58
  term program sustainability.
• 16:00
  And so this is gonna be, you know,
• 16:01
  it's a mobile community based clinical initiative, and
• 16:04
  it is designed to bring low barrier primary
• 16:07
  care,
• 16:08
  behavioral health support, and substance use services directly
• 16:11
  to the individuals that are experiencing homelessness or
• 16:13
  housing instability in the Dayton region.
• 16:16
  So this program integrates our community service with
• 16:18
  robust, federally supported clinical training through the HRSA
• 16:21
  award.
• 16:22
  We'll be providing primary preventive care delivered at
• 16:25
  mobile clinic sites, behavioral health services, including counseling
• 16:28
  support, substance use screening, you know, brief intervention
• 16:30
  referral to treatment,
• 16:32
  care navigation, you know, case management,
• 16:35
  and sort of low barrier engagement for patients
• 16:37
  without transportation or insurance. Right? Same time, we'll
• 16:40
  also be educating,
• 16:41
  you know, our residents. So, so there's gonna
• 16:43
  be structured training for about 50 right stage
• 16:46
  students across medical behavioral
• 16:48
  science disciplines,
• 16:50
  to enable them to have deeper competency,
• 16:52
  you know, in
• 16:54
  this work.
• 16:56
  So the training elements are going to be
• 16:58
  street medicine foundations, which is low barrier care,
• 17:00
  trauma informed practice, harm reduction, then clinical skills
• 17:04
  in the field, patient assessment, how you wound
• 17:06
  care, chronic disease management,
• 17:08
  substance use disorder curriculum,
• 17:10
  social determinants of health education, interprofessional
• 17:13
  collaboration with behavioral health community workers,
• 17:16
  documentation, continuity of care in mobile settings, reflective
• 17:19
  practice and team debriefing.
• 17:22
  And then, you know, also different enhancements like
• 17:24
  faculty development, evaluation infrastructure,
• 17:27
  you know, sustainability
• 17:28
  planning.
• 17:29
  So community impact. So this program will increase
• 17:31
  access to care for individuals often who are
• 17:34
  disconnected from the healthcare system and experiencing homelessness,
• 17:37
  substance use disorder,
• 17:38
  and behavioral health challenges. Hopefully, it'll reduce ED
• 17:41
  reliance and improve,
• 17:43
  linkage to ongoing care. So strategically strengthens, you
• 17:46
  know, Ryerson University's mission in community engagement and
• 17:49
  primary care education and also
• 17:51
  expands our workforce training and underserved population medicine,
• 17:54
  with, these HRSA,
• 17:56
  supported competencies.
• 18:00
  Got it. Wow. That's amazing to hear. And,
• 18:02
  you know, certainly such a a needed service
• 18:04
  for the community and especially thinking about how
• 18:07
  you can bring care to people and make
• 18:09
  sure that, you're you're hitting all the boxes,
• 18:11
  bringing those community workers and everybody,
• 18:15
  on board so that you can have such
• 18:16
  a a functional and, beneficial program. I think,
• 18:19
  you know, looking ahead with our last couple
• 18:21
  of minutes here, where do you see some
• 18:22
  of the best opportunities for that continued growth
• 18:24
  in the future? How are you looking even
• 18:26
  further ahead, to really build the the blocks
• 18:29
  of foundation for the programs that are so
• 18:31
  important to you,
• 18:33
  in in in those next few years?
• 18:35
  Absolutely. So,
• 18:37
  you know, chronic disease management and population health.
• 18:39
  Absolutely. You know? So with rising rates of
• 18:41
  diabetes, heart disease, CKD, multi, you know, morbidity,
• 18:44
  primary care is the center of management. Right?
• 18:47
  So future is in value based care pivoting
• 18:49
  towards providing best, fastest, most successful primary care
• 18:52
  in the most cost effective manner by leveraging
• 18:54
  technology,
• 18:55
  such as telehealth, remote patient monitoring, Adientiq AI
• 18:58
  that supports triage,
• 19:00
  documentation in in addition to revenue cycle management,
• 19:03
  generative AI, which empowers patient providers at the
• 19:05
  same time.
• 19:07
  And then,
• 19:08
  you know, again, you know, as we see,
• 19:12
  you know, AI and health care explosion and
• 19:14
  digital health growth is gonna redefine, you know,
• 19:16
  interest in value based care for all populations.
• 19:18
  So the future is,
• 19:20
  you know, where the patient is, not just
• 19:22
  caring for the sick where the providers are.
• 19:24
  Right? So virtual chronic care clinics, you know,
• 19:26
  building hybrid outpatient models inside healthcare systems are
• 19:29
  gonna be needed. Care of the elderly, you
• 19:31
  know, we're gonna need that, right, as more
• 19:33
  of our patients are getting older. So all
• 19:35
  these senior care primary care models are very
• 19:37
  useful.
• 19:38
  Obesity medicine, lifestyle medicine, you know, rural underserved
• 19:41
  primary care models.
• 19:43
  And then preventable lifestyle medicine. So high patient
• 19:46
  demand, low supply, you know, because of demand
• 19:49
  reimbursement mismatch at this time, which may get
• 19:51
  corrected with new payment models, such as direct
• 19:53
  payment to pay to to people to purchase
• 19:55
  their own health care and decide where they
• 19:57
  wanna put the money. Right? So in the
• 19:58
  they can put it in health savings accounts
• 20:00
  and use it the way they wanna use
• 20:01
  it. So whole person care model, you know,
• 20:04
  for all with a clear definition of what
• 20:06
  it means, Right? And then a clear implementation
• 20:08
  plan with AI support. I think it'll be
• 20:10
  an honorable goal for any company that can
• 20:12
  develop it and scale it up. Yeah. So
• 20:14
  medicine still hasn't found its beautiful, simple, basic
• 20:16
  equations, but we can strive for whole person
• 20:18
  care that can be scaled up. And we
• 20:20
  have to strive for health while taking care
• 20:21
  of the sick. And we have to strive
• 20:23
  for happiness and good health for everyone while
• 20:25
  taking care of those who are less fortunate.
• 20:27
  And we have to support patients and provide
• 20:29
  autonomy and goal sharing.
• 20:31
  And, you know, opportunities for growth are gonna
• 20:32
  need policy support and advocacy for the same,
• 20:34
  and it takes a village, you know, to
• 20:37
  to do this. And,
• 20:38
  I mean, that's, that's all I would like
• 20:40
  to say.
• 20:43
  Fantastic. Well, you know, this is amazing. And,
• 20:45
  this vision of health care that you have
• 20:47
  is truly incredible. Doctor Grewell, thank you so
• 20:49
  much for joining us on the podcast today.
• 20:51
  This has been a really fun conversation for
• 20:53
  me. I've learned a lot and I'm inspired
• 20:55
  by your passion. I look forward to connecting
• 20:57
  with you and continuing this conversation in the
• 20:59
  future.
• 21:00
  Thank Thank you so much. Thank you so
• 21:01
  much for this opportunity. And, I would like
• 21:03
  to also thank, you know, all of my
• 21:05
  colleagues, my faculty, you know, who who who
• 21:07
  do this work and who make the make
• 21:09
  this happen. You know? Thank you.