Improving diabetes care in underserved communities: A conversation with Anne L Peters, MD
From an early age, Anne L. Peters, MD, professor of clinical medicine at Keck School of Medicine of the University of Southern California, knew she wanted to be a physician.
Peters recalls attending P.S. 40 in New York City when she was 6 years old and sitting next to a classmate from a poor neighborhood. After being asked to help her classmate with reading, Peters quickly learned one of the reasons he struggled in school was because of his poor health.
“He was sick all the time, much more often than I was sick,” Peters said. “I realized that being underserved and not having access to whatever it was he needed to be healthy made him not able to learn. It was then I decided that I would be a doctor.”
Peters has spent much of her career focusing on research and care in underserved populations. Some of her current work focuses on health disparities and using diabetes technology to improve outcomes in lower-income communities. Peters’ dedication to underserved communities was recognized when The Endocrine Society announced she would be the recipient of the 2021 Outstanding Public Service Award as part of the organization’s Laureate Awards.
Healio spoke with Peters, an Endocrine Today Editorial Board member, about her journey into medicine, how COVID-19 has changed the field of diabetes, and advice for students in medical school today.
Healio: What was the defining moment that led you to your field?
Peters: My next-door neighbor’s sister, Sarah, was born with some sort of brain injury. I decided I wanted to be a neurosurgeon and fix Sarah, but after time passed, I decided being a neurosurgeon was not my thing. I’m not that good with my hands. Then I decided I was interested in hormones because hormones circulated in your body and affected your brain and your mood and everything else. Then I decided I wanted to do diabetes because that was public service and it allowed me to take care of a disease that was disproportionately affecting the underserved, so that’s how I got to where I am.
My dad had actually wanted to be a doctor, but only applied to one medical school and didn’t get in, so he decided to be an administrator. He taught me how to say “subacute bacterial endocarditis,” so when other kids were saying “supercalifragilisticexpialidocious,” I was saying “subacute bacterial endocarditis.” I think there was a little push from my dad, just pointing it out.
Healio: What area of research in endocrinology most interests you right now and why?
Peters: One is that we know that there are tremendous disparities in the use of diabetes technology in the underserved. I just got a big new grant from a foundation to do research in East Los Angeles in the poorer part of town, bringing in technology and figuring out how to use it in a way that improves outcomes.
It’s hard to give insulin, and it’s hard to give insulin being a construction worker and not being allowed to give insulin at work and all those other things that are barriers. We’re going to basically build an in-clinic remote monitor so that the data comes to us and we’re going to try to pick out people who are having particular problems and then reach out to them via telemedicine.
The other thing I’m interested in and have always been interested in is how to help people exercise and the barriers with type 1 diabetes. Doing things like using mini-doses of glucagon or balancing it to make exercise an easier feat for people with diabetes.
Healio: What do you feel is the biggest way COVID-19 has changed the field of diabetes?
Peters: I’ve always believed that diabetes was the perfect disease for telemedicine — you don’t have to be with me in person because I don’t have to touch you. The caveat is that particularly in people with higher-risk feet, I need to look at their feet. And it’s hard for a senior who’s arthritic to get their foot up so I can look at it. You can’t discount the need for in-person visits for foot exams, for thyroid exams. But for most of my patients with diabetes, I can do their visits entirely remote because they are numeric, especially my patients who have access to technology. They can upload to the cloud, and I can look at their data. I can do visits that are maybe even better than in-person because the patients don’t have the hassle of coming to see me. I can look at their data, I can make adjustments, and then I can see them more often because it’s so much easier for them to do this.
You have to have an infrastructure for the telemedicine, but it is certainly something that I hope remains. I am planning on being back in the office half the time and doing telemedicine the other half of the time. And the other thing that I want is for the rules that you can’t do telemedicine in different states to change. Medicare needs to use the telemedicine visits to count as in-person visits.
Healio: What advice would you offer a student in medical school today?
Peters: I would tell them that being a doctor is the best thing in the whole world, and don’t ever let someone tell you that you’re not going to succeed. Everyone always told me I was too idealistic. You have to believe in your own capacity. People should not narrow down their choices, but expand as much as possible. When you’re done with medical school, go to the best residency you can and get the job that’s most interesting because you’re not going to necessarily be working in the same place your whole career.
The other thing is to find a mentor. I love mentoring young people, and I have a ton of connections and I’ve just been through it. People need to realize, it’s OK to have your own path. If you’re a woman and you want a family or you’re a man and you want a family and you don’t want to work full time all the time, there’s so many different ways to be a doctor. You don’t have to do it the way that someone else tells you. I spent a lot of time just helping people think about what their goals are and how to fit into medicine vs. making medicine taking over everything. It’s wonderful to be a doctor. That’s what I would tell medical students. But find a mentor who supports you in that.
Healio: What does the 2021 Outstanding Public Service Award from the Endocrine Society mean to you? Is receiving awards something you ever think about or imagined when you were younger?
Peters: Well, no. I tell people that I’ve lived the best life even though I’ve certainly had my share of tragedy and hardship, but that I’ve done better than I ever imagined.
I don’t make a 5-year plan. I barely make a 1-month plan. I just look at what’s in front of me and I’ve never been someone who wins awards because I’m not that interested. Awards should come organically out of doing what you love. The thing about awards is that there’s so many good people who never get awards. There are so many people who are as deserving as I am who didn’t get it.
People don’t need to give me awards, but I’m very grateful for getting it. It’s very dear to be recognized, but I just want people to know that there’s so many other people I know who deserve the same award.