Deepika Pradhan Shrestha, M.D., serves as Division Chief of Endocrinology at Lancaster General Hospital. We asked Dr. Pradhan Shrestha about growing up in Nepal, the Division’s current priorities and how she spends her time away from work.
What is your background?
I was born and raised in Nepal. I was into science from an early age and always wanted to be a physician. I completed medical school in Nepal. I am the first physician in my family. After getting married, my husband and I moved to the United States. I completed my Internal Medicine residency at The Reading Hospital in 2012. After residency, I completed my fellowship in endocrinology at Penn State Hershey Medical Center in 2014. The same year, my husband also completed fellowship in Infectious Diseases, and we both joined Lancaster General Health. I practice at Diabetes & Endocrinology.
Why did you choose endocrinology?
I really enjoyed biochemistry and physiology in medical school, so endocrinology was an obvious choice. This specialty allows me to build long-term relationships with patients, and I really get to know them well. I love educating my patients about their condition, motivating them to do their best and celebrating success with them, knowing how hard they work to achieve their goals. The endocrine system is complicated yet simple in many ways. I like interpreting lab results in the clinical context and seeing a patient get better with the right treatment.
How did you get into a leadership role?
During residency one of my attendings told me that one should always strive for growth, and when you stop growing, you are old. That statement has stuck with me. Personal and professional growth is very important to me. When the opportunity to serve as Division Chief was presented to me about two years ago, I thought of it as an opportunity for growth. I have always been very curious, and I like to multitask. I felt I could contribute further to our specialty in a leadership role. This position is always challenging me to think outside the box and add layers to my intellect.
What are some of your Division’s current priorities?
Our focus is on providing excellent care, as well as strategies for prevention. We have been working to improve retinopathy and neuropathy screenings in our diabetic population. Teleretina has been a great tool to improve retinopathy screening.
We have also been developing clinical pathways for common endocrine issues. The pathways provide evidence-based guidelines to help reduce variability between providers, bring uniformity for management strategies and improve quality of care. So far we have created pathways for evaluation and management of hypo-hyperthyroidism, hypogonadism, adrenal nodule and pituitary adenoma. Our next step is to strategize the use of these pathways among different medical and surgical groups. The pathways will ensure that referrals are appropriate and help expedite access for patients with the greatest needs.
The Division is also very excited about our new Diabetes Prevention Program. Finally, we are just beginning to look at how social determinants of health can impact our diabetic patients' ability to receive the care they need.
What are some challenges you face?
There is a lot of demand for endocrinology services. According to the CDC 2020 National Diabetes statistical report, more than 1 in 10 patients now have type 1 or type 2 diabetes. The ratio is expected to change to 1 in 3 by 2050. Therefore a focus on prevention is a must. Access is our biggest challenge, and we are constantly exploring ways and ideas to optimize access. The good news is that this is getting better as new providers, both physicians and nurse practitioners, join our Division. The high cost of medication is another challenge for our diabetic patients. Like other Departments and Divisions, provider burnout is a concern for us. We try to be very proactive by offering flexible work schedules for our providers. We are also very good at communicating with each other. Having that support from colleagues really goes a long way toward preventing burnout.
What do you like to do when you’re not at work?
My husband and I have a 12-year-old daughter and an 8-year-old son. I am fairly busy taking them to different activities—swimming classes, violin lessons, soccer practices, etc. I like helping them with their projects and homework, especially since my daughter is into science now. Otherwise I consider myself a homebody. I really enjoy staying home, listening to music and reading. My best day is when I can relax with a book. I also tend to a fairly sizable collection of indoor plants.