May 20, 2024

Clinical Team Spotlight: Paving the Way for Proactive Care

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Written By


photo of Vinita Tandon, MD

Medically Reviewed By

Vinita Tandon, MD

Lifeforce Medical Director

Clinical Team Spotlight: Paving the Way for Proactive Care

We sat down with Lifeforce Medical Director Vinita Tandon, MD, ABIM Board Certified in Endocrinology and Metabolism, and Chief Medical Officer Kurt Hong, MD, PhD, Professor of Clinical Medicine and the Executive Director of the Center for Clinical Nutrition and Applied Health Research at the University of Southern California, to learn more about Medicine 3.0, their journey into this next evolution of medicine, and how they view the future of their profession.

What do we mean by Medicine 3.0 and how does it differ from prior generations of medicine?

Vinitia Tandon, MD: Medicine 3.0 focuses more on longevity, prevention, and personalization. It’s unfortunate that in the US, the leading cause of death is still something so preventable, which is heart disease, the same as it was 50 years ago. Medicine 2.0 has focused on treatment and fixes — once you have heart disease, we have great cholesterol and blood pressure medications to help mitigate worsening of disease and death. Or, once someone has diabetes, we have very effective treatments to help balance blood sugars. However, where we fall behind is that we have not put any emphasis on preventing these conditions in the first place. 

Medicine 3.0 will start to proactively address preventable conditions earlier, with more sophisticated testing and emphasis on holistic interventions which are not just pharmacological, but include recommendations for diet, exercise, stress, social, and emotional health which are personalized. We know it’s hard to make lifestyle changes and often much easier to take pills but that’s why testing and showcasing a person’s biometric data can be empowering, and give them the motivation to make changes that are not always intuitive. 

In 2.0, we would only treat cholesterol once levels were clearly “out of range.” In 3.0, we are not only checking cholesterol levels but also five other cardiovascular risk factors that might include biomarkers, imaging, and genetic testing, that when looked at together, give us a much clearer picture of someone’s risk for developing ASCVD. If this picture looks concerning, we would not recommend waiting for things to be floridly out of range. Rather, we’d start interventions right away to prevent a cardiac event and early death.

Proactive Care Clinical Spotlight: Dr. Hong on why medicine should evolveWhy do we need medicine to evolve?

Kurt Hong, MD: Medicine must adapt to stay relevant. The threats we face to staying healthy are constantly shifting, from changes in pathogens (i.e. Covid), environmental exposure, to challenges from cultural barriers and health literacy. To stay ahead, medicine needs to embrace a more dynamic approach.

Traditional treatment algorithms were developed based on large population studies. However, one-size-fits-all approaches are becoming increasingly inadequate. We are a diverse population with unique genetic predispositions and different lifestyle exposures. To truly optimize health, medicine needs to be personalized. This means leveraging cutting edge technology and new biomarkers to predict individual disease risks and tailor preventive measures. It also means incorporating social and environmental factors, understanding how pollution, stress, and access to resources all impact health outcomes.

Personalization goes beyond treatment plans. It extends to patient engagement. We need to evolve from a paternalistic model, where doctors dictate, to a truly collaborative relationship, where patients are empowered partners in their health journey. This requires transparent communication, shared decision-making, and tools that put patients in control of their data and health choices. By embracing this evolution, medicine can truly become a proactive force, not just reacting to illness but preventing it, while empowering individuals to thrive.

Proactive Care Clinical Spotlight: Dr. Tandon on Mainstream Medical System and Lifespan and HealthspanIs the mainstream medical system set up for this shift in focus from lifespan to healthspan? 

VT: The way standard medical education (and health insurance reimbursements) are today, we are not set up for a shift from lifespan to healthspan. People and the medical community will have to demand a change so that 3.0 practitioners are providing mainstream care and we can leverage the medical technology and advancements for more preventative and personalized care. Medicine has historically been slow to adopt change but I think the younger generations of physicians are going to demand changes and if their own medical school or residency programs don’t provide the necessary education, they will seek it out themselves. More and more people want their physicians to have this knowledge base so things have to change. 

What’s something that you have learned on your journey that has surprised you? 

KH: Having been a practicing physician the past 20+ years, I’ve appreciated that true empathy and effective communication are learned from experience. It is not taught in medical school. In order to achieve effective patient-centered communication, it is not just about conveying medical information, it's about connecting with patients on a human level. Medical schools focus on the technical aspects of communication, but they don’t adequately emphasize empathy, active listening, and cultural sensitivity. These skills are essential for building trust, understanding our patients' perspectives, and providing compassionate care.

As we see more people gain access to Medicine 3.0 services, do you think we’ll see a shift in our understanding of what optimal health looks like? 

KH: One major shortcoming of traditional metrics is their static nature. A single blood pressure reading tells us little about long-term trends or the body's dynamic responses to various stimuli. Similarly, BMI, a crude ratio of weight to height, fails to capture individual variations in body composition or muscle mass. 

Furthermore, traditional metrics often focus on disease detection rather than proactive health optimization. This reactive approach puts us on the back foot, constantly chasing after problems instead of preventing them in the first place.

The good news is that we have the emergence of new biomarkers along with powerful new technologies — like wearable sensors — to provide us with an unprecedented level of personal health data. This information, along with the burgeoning field of machine learning, opens doors for us to utilize next-generation biomarkers, metrics, and scores that are dynamic, predictive, and truly personalized.

A lot of the elements that contribute to optimal health exist outside of our bodies — things like being engaged in a community and having meaningful friendships. Can Medicine 3.0 account for those?

KH: Medicine 3.0 focuses on Predictive, Preventive, Participatory, and Personalized health. It recognizes that true health optimization isn't just about treating symptoms, it's about fostering well-being in all its dimensions, including the social and emotional.

It’s been well studied that social and emotional support and friendships can impact one’s health. Take for instance the concept of social network mapping. Imagine your doctor having a map not just of your body, but also of your social and emotional landscape. This map could reveal the strength and quality of your relationships, your level of community engagement, and even your social media activity. By analyzing this data, machine learning tools can identify potential social isolation or lack of support, which are major risk factors for depression and anxiety. Early detection allows for proactive interventions, like connecting you with local community groups or social activities. Essentially, community engagement and friendship are not just "nice-to-have" aspects of life; they are important elements of holistic health. It’s these connections that help to provide a sense of belonging, support, and purpose, all of which contribute to one’s overall well-being.

Proactive Care Clinical Spotlight: Dr. Tandon and Dr. Hong on their personal Lifeforce journeysWhat was your personal journey into Lifeforce? 

VT: I was in private practice for 10 years and definitely felt frustrated with diabetes and weight management care, in particular. As an endocrinologist, my days were filled with diabetics whose diabetes was addressed too late and when complications had already developed. There was never enough time to talk about the fundamentals like diet, fitness, sleep, or stress management. It felt very rushed and an incomplete way of treating people. We were treating numbers, not people. 

Do you foresee the work we’re doing at Lifeforce being something that will influence mainstream medicine?

KH: Over the next decade, our public health systems will face a multitude of challenges, including rising costs, an aging population, and increasing chronic diseases. Proactive care and the advancements of Medicine 3.0 offer a promising path to address these challenges, including improved health outcomes, reduced healthcare utilization, and optimized resource allocation.

Proactive care in Medicine 3.0, on the other hand, emphasizes early detection, risk assessment, and tailored treatment recommendations, along with real-time feedback on health behaviors. Tools such as remote consultations, virtual digital health monitoring, and self-management apps can extend care beyond the walls of hospitals and clinics, making it more accessible and convenient for patients. All this helps to prevent the need for costly hospitalizations and emergency department visits. But the goal of proactive care is not just cost savings, but the optimization of health outcomes and overall well-being of our patients.

What are your personal health ambitions? 

KH: I keep it simple — I want to stay active and happy and be healthy enough to enjoy activities with family and friends. I love being able to keep up (on most days!) with my three kids in their sports, whether it’s playing soccer, running, or snowboarding. I’ve also learned to slow down and enjoy the simpler things in our daily experience. I truly believe an attitude of positivity and gratitude goes a long way to improving longevity and health.

In prioritizing self-care, I do my best to check in with my doctor regularly, focus on optimizing my nutrition (including more home cooked meals), adding exercise whenever possible (even if it means just 25 minutes on certain days), and maintaining adequate sleep. It’s easy to forget that achieving your personal health ambitions is a journey, not a destination. I do my best to celebrate progress along the way, and try not to get discouraged by setbacks.

VT: My mantra has always been everything in moderation (except that I’m a bit of a workaholic). My health ambitions are to have the stamina and endurance to travel the world, keep up with my kids (and one day, grandkids!) and I want to avoid ever being hospitalized. 

I prioritize sleep over everything, aiming for seven to eight good quality hours nightly. I also follow a plant-based diet, and meditate regularly to manage my stress. I have a great network of friends that I also invest in, which keeps me happy and grounded. I love regular strength training and Pilates but I don’t beat myself up if I can’t get to it on certain days. I’ll do an exercise “snack” instead, or just walk the dog. 

It takes time to build healthy habits so I reiterate to people that the most important thing is just starting — small changes lead to big results. You don't have to completely overhaul your diet or sign up for 100 kickboxing classes. Start small and keep building from there.

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