Dear Doctor: Shirin Peters
The New York City primary care specialist and founder of Bethany Medical Clinic on providing accessible and flexible care that accommodates the specific needs of New Yorkers.
Dr. Shirin Peters is the first to admit the important influence her family had on inspiring her to choose a career in medicine. Through her journey to internal medicine, Dr. Peters found a passion for preventive medicine that soon led her to start a private practice focused on offering accessible, efficient, and superior care. In addition to supporting the needs of city-dwellers, Dr. Peters prides herself on building a team of diverse specialists that offer personalized care for the groups who are often overlooked in traditional healthcare, including women, minorities, the differently-abled, and the LGBTQI+ community. Read on to learn how she champions accessibility at every turn and how she believes the pandemic will improve public health by prioritizing preventive care.
How did you get started in medicine and how did you find your specialty?
I grew up in a big Indian family in London, and was taught from an early age that medicine was a noble profession. I naturally gravitated toward science in school and found biology and chemistry particularly interesting. My dad was a gastroenterologist who owned a private practice in North Carolina — I idealized his work and wanted to be just like him.
When it came to choosing a specialty, I owe a debt to my grandmother, who helped inspire my passion for primary and preventive care. During our time in London, she was committed to living a “healthy life.” She clipped health articles out of the newspaper and shared them with anyone who would listen. I have fond memories of her cooking with fresh, whole foods at home long before there was a clean eating movement, and talking about self-love and self-care before they became popular memes. She recently developed dementia, but is otherwise in amazing health. She celebrated her 100th birthday earlier this year and continues to be my biggest inspiration for helping my patients live healthy lives.
What inspired you to found Bethany Medical Clinic?
Living in New York as a young person, I found it challenging to connect with a primary care team that really understood the specific needs of New Yorkers. I looked for an affordable practice that could be flexible and accommodate my schedule, like offering weekend appointments, but my search turned up empty. My husband, who is also a physician, works in disability medicine, and has a visual impairment faced the same challenge I did in finding high-quality primary care that would understand and meet his needs. There were, and still are, boutique concierge models, which serve an important purpose, but few take insurance and most are out of budget for the average New Yorker.
That’s when I realized — if we as health care professionals can’t find this kind of practice, it must mean there’s a serious gap in New York City care that needs to be filled. I opened my practice because I knew that physician-led practices can offer superior care, especially after witnessing what my dad was able to accomplish with his practice in North Carolina. But I also believed that these kinds of practices didn’t have to be inaccessible and unaffordable to many.
Another reason I started the practice was to help provide specialized care for the groups of people who are often overlooked in traditional healthcare, including women, the differently-abled, the LGBTQI+ community, and black and indigenous people. I wanted to build a care model that offered very personalized care as a means to meet each of our patients where they are and address their unique needs. My husband and young sons give me ongoing daily inspiration to continue to push for change and improvement in primary care. I want a better, healthier city and world for them.
Can you tell us more about how your care model accomplishes this?
When it comes to women’s health, there are a lot of holes in traditional care because women tend to have vague, nonspecific symptoms that present differently than in men. Heart disease, for example, shows up differently for women. But as medical practitioners, our education focuses on the classic, what they would call “typical” symptoms, that men present with, like chest pain, shortness of breath, dizzy spells, and swelling of the ankles. The vast majority of women don’t experience any of those symptoms, and as a result, can develop severe heart disease long before it’s diagnosed.
Another example would be breast and ovarian cancers, which can often present with hormonal symptoms that many doctors overlook. Subtle changes like fatigue and abdominal bloating after meals can be signs of serious diagnoses that many doctors can miss before it’s too late.
To prevent these unfortunate outcomes, we train all our providers in comprehensive physicals and history taking to tease out these important diagnoses that often go unchecked.
What about the LGBTQI+ community?
A lot of it comes down to staying informed and keeping our services accessible.
Right now, there is an entire area of medicine that has been built out around care for transgender patients. But since it’s fairly new, too many practices just don’t have that information or have been out of training so long that they didn’t learn about it in medical school. We’re committed to providing all of our patients with up-to-date care that includes the latest protocols of preventive care.
What’s more, we try to offer every patient our personalized attention, taking into account who that patient is and what their needs are.
Overall, the biggest thing that differentiates us is accessibility. We want everyone to be able to get this care. Our focus is not as much on having the longest possible visits we can with patients, but on building relationships with them. In our visits, we see that our patients need efficiency. We treat a lot of younger working people who often want to address a concern or get their check-up and then get back to work. While we value complete and thorough personalized care, we also value everyone’s time. And by focusing on the right things, we’re able to offer efficient care to everyone.
Your practice focuses on the unique health challenges of New York city-dwellers. How has your comprehensive and preventive model adapted to the Covid-19 landscape?
We offer a complete, preventive, and primary care model by housing multiple specialties and supporting specialties, including primary care providers, endocrinologists, dermatologists, nutritionists, and psychotherapists. We all work together to optimize our patients’ health.
Our model has been especially useful during Covid in that we incorporated telemedicine early on and were able to offer to our patients a very effective connection to preventative care.
Of course, it was challenging, too. But because our care model is inclusive and essentially a one-stop-shop, we were able to use the advantages of telemedicine to help our patients keep up with their healthcare in a virtually accessible way.
Recent data found that one-third of Americans currently show signs of clinical anxiety or depression. How have you seen this manifest with your patients, and how are you helping them to cope during these uncertain times?
Anxiety and depression are epidemics of their own right, particularly in our millennial, Gen X, and Gen Y patients. Unsurprisingly, the stress and unknowns associated with Covid and the lockdowns have significantly increased anxiety and depression rates at my practice.
Thankfully, for the last two years, we’ve had therapists as part of our team, and as a result we’re able to offer psychotherapy to our patients that’s fully billed to insurance — which is a huge win for all our patients. I know how difficult it can be to recommend getting therapy outside the practice and then watch as patients struggle with the many barriers to care. Being able to bring in therapy as a core part of our practice has been a game-changer — especially during Covid. In fact, most of our patients have already taken advantage of this service, particularly with telemedicine, since they’re able to access therapy from the comfort and safety of their home.
With the pandemic, wildfires in the West, and looming flu season, it’s safe to say that health is now a top priority for many Americans. How do you think our shifting priorities will shape the future of healthcare?
Now, more than ever, Americans are thinking about optimizing their health proactively, instead of simply reacting to health problems as they develop. The unpredictable nature of this disease has underscored the reality that if your health is already in good standing, you’ll have a better chance of beating this virus (and others).
Shifting priorities have highlighted the importance of preventive care. Preventive care is a great way to reduce the risk of Covid or flu exposure, but it can also reduce the cost associated with reactive healthcare. If this trend continues, more attention and resources will be focused on preventive care — which I believe will benefit everyone.
Even though it can be hard to see any positives about the year 2020, this is one shift that’s already happening and, if it continues beyond the pandemic’s course, will be really good for the people and general public health.
Vital Signs
What’s the best meal you’ve eaten at home recently? Chicken curry. I use a recipe typical of Kerala — the state in India where both of my parents are from — and it’s a powerful comfort food for me.
How do you de-stress?
I play with my kids. I have two young sons, aged two and five, and though they’re super high energy, they are also a great distraction from anything that’s stressing me out. Playing and spending time with them helps me to refocus on what matters. Also, before my husband and I had kids, we loved to de-stress by walking around the city. Now, we do a masked version with our kids. The ability to wander the city and constantly find new adventures is still one of the best things about living in New York.
For those who live alone, what are some safe and effective ways to feel less lonely?
Get on the phone and use apps like FaceTime or Zoom to connect with the people whom you love or whom you’ve lost touch with. It’s important to use the incredible technological resources that we have at our disposal to find time to connect with other people — which will help all of us feel less alone. For seniors who may be more disconnected now than ever, you can sign-up to request regular friendly phone calls from volunteers at Mon Ami.
How should we start thinking about and planning our upcoming holidays during Covid?
I advise everyone to celebrate the holidays with your “pod of people” that you are already in regular physical contact with. Understandably, it’s very tempting to use this time of year the way we usually do to travel and visit family and friends, but that behavior will only increase Covid risk for everyone. Unfortunately, rates are continuing to rise across the country right now, which means the safest option is to celebrate the holidays with the people you’re already in contact with and have virtual connection time with friends and family elsewhere. If we all do our part now, we will hopefully be able to return to our normal holiday routines this time next year.
What’s one healthful habit you’d love to see patients adopt?
I would love to see my patients learn more about highly processed foods and make specific plans to remove them from their regular diet. There are a lot of great resources online, but the most beneficial way to learn more is by connecting with a nutritionist. Having a nutritionist is kind of like having a personal trainer for your insides. Not only are they experts in their field, but building a relationship with a nutritionist will help hold you accountable to your goals. That said, if you decide to start by sourcing your information independently online, a good tip is to make sure that the author of any content you find is verified in the field, and not just an influencer or popular on social media.
You can learn more about Dr. Shirin Peters here.
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