Rosy Sandhu, MD - Med Spa Owner & Internal Medicine Doctor in Boston, Massachusetts

Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome back to Meet the Doctor. My guest today is a board certified internal medicine doctor. Her name is Dr. Rosy Sandhu. Tell us where you are in the world and give us a little bit about your practice, Dr. Sandhu. Thank you.

Dr. Sandhu (00:44):
Thank you so much for having me on here today, Eva. So my name is Dr. Rosy Sandhu. I'm, as you mentioned, board certified in internal medicine, presently practicing cosmetic medicine, aesthetics, and a new emerging field, which we like to call as longevity medicine, where we try to help patients live, not just a longer lifespan, but hopefully a longer health span as well. And we'd love to touch on that as time goes. I'm based in Boston. We are slowly expanding our footprint to Southern New Hampshire as well, and we're in the greater Boston area here in the northeast.

Eva Sheie (01:25):
The lines between aesthetics and wellness and even internal medicine have really gotten blurry over the last few years. Would you agree with that?

Dr. Sandhu (01:35):
Oh, 100%. And the reason is that most doctors now understand that you can't just treat one concern like you have to treat the whole individual. So even when you practice aesthetics, you can't really take care of the skin if the rest of the internal body and the mind are not functioning in synergy. So I feel more and more doctors are understanding that it's the whole continuum that we have to focus on. And over the years I feel so much attention, well deserved attention has been given to the specialty.

Eva Sheie (02:09):
Well, you didn't start here. How did you end up here? What were you doing before?

Dr. Sandhu (02:13):
Yes, so my first about seven years of my career after I finished my training were in the acute care hospital setting. So I would be that doctor taking care of patients on the floors, in the emergency room, and in the ICU who were acutely ill with multiple health conditions. And I enjoyed it. I loved the action. I loved the instant gratification and the thrill that it gave me and also felt very, very humbled when patients got better. But what increasingly as time went, and I also recognized that we saw so many, what we in medicine called frequent flyers, who unfortunately are patients who keep coming in with the same health condition, be it complications, diabetes, heart failure, multiple other health conditions because of lack of preventative care or lack of really self-love and taking care of their body as a whole. I felt so many of these conditions and chronic diseases were actually due to underlying obesity and hormonal imbalances that I had decided after spending a chunk of time in acute care medicine, that I wanted to go into preventative care and obesity medicine.

(03:33):
And as I started to envision that ultimate healthcare destination or the wellness practice, I would have, Neem came, it just conceptualized as a practice where we would take care of men and women. I would say still about 80% of my patient populations women. Increasingly more and more men are definitely welcoming of the idea of taking care of overall their wellness needs and skincare. So we created a practice where we would take care of weight loss issues in a safe medical evidence-based way along with hormone balancing and aesthetics as well. And once I started with zero patients and just goodwill and a goal to do well, take care of people, there was no turning back.

Eva Sheie (04:21):
Were you on the early side of seeing what was happening with the GLP-1 medications?

Dr. Sandhu (04:27):
So I had of course, being in internal medicine, definitely a good amount of experience prescribing the earliest GLP-1 that we had. It was called Byetta to treat diabetes, and this was in 2005-06. But at that time we knew that maybe for people with some insulin resistance, this could be a novel medication down the lane, but GLP-1 agonists over the last couple of years, totally, I would say this was the best innovation and medical discovery of the century, if not the millennium. It's been a miracle medication for so many people and it's heartwarming to see and hear how many new indications keep coming with all the clinical studies that are ongoing and so many more to come. It's almost like a Christmas surprise every time when we hear about top of the line data that's coming for kidney protection, heart protection, not even in addition to heart and diabetes and weight loss benefits as well. So I was definitely one of the early adopters that saw the benefit that patients were having and I definitely prescribed them each every day. And big believer in the GLP-1 agonist.

Eva Sheie (05:46):
You don't have to answer this, but have you tried it yourself?

Dr. Sandhu (05:49):
No, I haven't needed to, thankfully, yes. But I have tried it, my family has been on it. My mom and my sister-in-law have tried it and my own sister as well.

Eva Sheie (06:02):
Do you have any success stories you can share?

Dr. Sandhu (06:05):
A lot of success stories. I feel like for the first time patients have found a medication which has actually worked consistently. They have been able to lose a lot of weight. There have been some challenges along the way because people are losing so much weight that there's more, I wouldn't say in my patient population I've noticed or witnessed it as much because I haven't really had many patients who needed to lose more than 50 or 60 pounds. But if there's so much news on social media and even on television about Ozempic face and people looking older, which I wouldn't say is necessarily wrong because as we know, as we age, we need facial fat, and Ozempic or any of the medications, these medications are not going to discriminate, which fat is going to be lost. So people are going to be losing some degree of facial fat as well.

(07:02):
So that has to be discussed and considered. But having said that, still we can address those things with fillers when time comes, et cetera. But the health impact that weight loss has cannot be over scored. And I feel patients have really felt their life being changed and this being the solution they were looking for so forever. And in addition, not just completely for weight loss, I have had some young patients who had these ill-defined autoimmune joints, aches and pains, and they have never felt better. So it'll be very interesting and fascinating as time goes on to follow the clinical studies for autoimmune conditions to see whether it actually has any impact on it. We know insulin resistance stimulates a pro inflammation state in the body, so it is possible as this is going to address insulin resistance, maybe some inflammation related to autoimmune conditions also gets impacted. So it's so much to look forward to.

Eva Sheie (08:11):
It's a very exciting time. What are some of the applications of the medication you're seeing in the future other than weight loss?

Dr. Sandhu (08:22):
At least in my area, diabetes is the number one thing. Obviously these were meant to be diabetes medications and we will more and more as insurances cover them and they become more available. There has been so much of a scarcity of them as well. I believe that they will be the first line of treatment for most patients with at least type two diabetes because these are the patients who have, because of insulin resistance, weight gain problems as well. So in that aspect, I feel like it's already there and it's only going to increase in my world in the wellness and the aesthetic world. I think weight loss is here to stay. I do think what we need to work on is a lot of education about strength training, increasing the protein intake because if not done right, I feel the problem I'm seeing with the GLP-1 agonist in the normal widespread population is something, I guess it's been being dubbed as skinny fat.

(09:22):
But what it actually means is that people are losing fat, but they're losing weight, but they're retaining, holding onto the fat, but losing their muscle as time goes on. And when we are losing a lot of weight, we are losing everything. We are losing muscle and fat. And if these patients are not doing intentionally strength training exercises and increasing their protein intake to at least 90 or a hundred grams of protein, we will see a lot more muscle wastage. So I think education is so important because no matter how much we think we know, when somebody is on these medications, I ask them, how are you trying to get your a hundred grams of protein? As you can imagine, they're not hungry. When we eat a portion serving like three ounces of a chicken breast, that's barely 20 grams of protein. So think about how much chicken you'll have to eat to make up the 90-100 grams of protein. So what's important is that they incorporate one or two protein shakes in the day in addition to the dietary protein intake.

Eva Sheie (10:28):
And then with your weight loss patients, do you do labs? Do you monitor them?

Dr. Sandhu (10:33):
Always. Always. We have to. So we follow all standard guidelines and practices. We have to check their cholesterol levels, their basic metabolic profile, the liver kidney function, because the doses will need to be adjusted if needed. And then we work in conjunction with other specialties. If they are seeing an endocrinologist and their primary care physician to keep everybody in the loop.

Eva Sheie (11:00):
It's fantastic. I imagine there are extra benefits to having an internal medicine doctor help you with this.

Dr. Sandhu (11:07):
Patients do feel safe and secure.

Eva Sheie (11:09):
Yes. It's so important. Well, let's switch to the aesthetic side.

Dr. Sandhu (11:14):
Of course.

Eva Sheie (11:15):
So can you give us an overview of all the aesthetic services that you have there? And maybe tell us which one is your favorite.

Dr. Sandhu (11:23):
Absolutely. I think for sake of maybe keeping it simple, let's just maybe think of three big buckets. So those are going to be our face, body, and then wellness would be weight loss and hormone balancing and just overall increasing, optimizing your energy levels, et cetera. So if I were to target the face first, my approach with overall aging of the faces more often inside out approach and a mind body approach as well, because if you are not feeding the mind and overall how you're feeling, I don't think anything you keep doing, it's funny, I always think about all the US presidents, that if you think about stress aging a person, you just have to look at the current US president and follow their journey over the last four to eight years and how fast their aging happens. So I talk to everybody, how are your stress levels?

(12:22):
What's your lifestyle? So that's important. I feel everybody needs to find ways that work for them for coping with stress management. Once that is done, the nutritional approach and the collagen intake and protein intake is important. And now in the office, I definitely value a lot. So my approach generally is fixing, doing procedures which are going to build the overall collagen levels, and then we address any volume deficits with fillers, and then we finish with lasers, skincare, Botox, neuromodulators, et cetera. So I call it my three F approach or foundation, fill, and finish, because if we don't lay the foundation and work on building your collagen, we are putting bandaids. Again, this will be my frequent flyers and just coming in for Botox and fillers, which is not a job well done. So one of my favorite treatments in each category would be for the foundation.

(13:21):
I really like Sofwave, which is a newer version of an ultrasound device, which helps in building, signaling these cells in our skin called fibroblasts. And these fibroblasts, when they're stimulated, they build collagen, which after the age of 30, we are going to be losing about 1% collagen every year. And that percentage loss really accelerates in the perimenopause and menopause years, especially for women, obviously. And so I think it's very important that when we see somebody over the age of 40, we do educate them about doing an energy-based device for building their collagens being my favorite, zero downtime, pretty effective. And usually you would only need one now for filler. The way aging happens, we are not just losing collagen, we are also losing facial fat. And the muscles and ligaments are getting lax as time goes on and the fat embodiments shift. So for that, my favorite treatment, which I enjoy and I could do it all day if I could, is called the Y Lift.

(14:29):
It's pioneered by Dr. Trokel, who's based in New York City. I think he's genius for having created it. And he trained me years ago. And I love, love, love performing the Y Lift. It's a structural volumization. So we are using fillers to mimic the bone loss and place using it almost like a little pillar between your bone and your muscles so that it creates a lift so that sagging skin and tissues are lifted without creating puffy pillow faces, which people worry about with fillers. So we are not just injecting it in your soft tissues and giving you a lot of fullness. We are actually giving you more of a chiseled and lifted look. And lastly, when it comes to the superficial skin, I think an even skin tone is probably the first sign of youthfulness. So I do believe that if you have discoloration and uneven texture, that definitely makes us look aged. And if we did a laser and use skincare, good, quality skincare products, and they don't have to be super expensive, you just need to use the right ingredients in good percentages, that is the way to go. So I love our Moxie Laser by Sciton and Clear and Brilliant as well. So those would be in each category, like my favorite treatments that I really like people to look into.

Eva Sheie (16:00):
Moxie, it's the best.

Dr. Sandhu (16:02):
Moxie's amazing. And I like them because it's convenient. There's really no downtime. People can do it, they're just flush for a day. And you don't have to take time away from social activities. Because let's face it, who has time these days to hide?

Eva Sheie (16:19):
The funny part about Moxie is it feels like it looks, but something happened. It doesn't look like anything happened.

Dr. Sandhu (16:26):
No, no. I say that you will know nobody else will. Yes.

Eva Sheie (16:30):
So true.

Dr. Sandhu (16:31):
Yes.

Eva Sheie (16:33):
Well, you don't do any of this by yourself, and I'm sure you have an amazing team around you. Can you tell us a little bit about them?

Dr. Sandhu (16:41):
Absolutely. I always say that you're only as good as your team, that makes sense, has your back. So I could never do any of this on my own. I'm blessed and very lucky to have a strong team of very talented and compassionate nurse practitioners, nurses, and aestheticians who are also laser technicians. They show up and we all share the same vision and dream of just making people feel like their best selves and bringing their confidence out. So the nurses and nurse practitioners we have, they're trained in lasers, aesthetic procedures, injectables. They've all had at least 10 years of experience and love doing what they do. So we have a team of 12 providers, and then we are, I can't forget our patient coordinators who are the backbone of every practice. We can't really run without them.

Eva Sheie (17:40):
And you have more than one location?

Dr. Sandhu (17:42):
Yes, I do. We are based in Boston, Winchester and Linfield. So Winchester and Linfield are just two beautiful suburbs outside of Boston. And then we, hopefully within the next month or so we'll be opening in Salem, New Hampshire, and we are very excited about that.

Eva Sheie (17:59):
How is New Hampshire different from the Boston area? Is it just a little quieter, a little more relaxed?

Dr. Sandhu (18:07):
I thought so, and that was my assumption of what New Hampshire would be like. But Salem, New Hampshire is not very different from Massachusetts. In fact, it's right at the border. We will be in the much anticipated and celebrated new development called Tuscan Village, which is almost like a microenvironment in itself. It's its own universe, and it's a beautiful complex which has lots of restaurants and condominiums and offices and stores. So we'll just be planting ourselves there and hopefully that'll be our new community.

Eva Sheie (18:47):
It looks beautiful. Did you grow up in the Boston area?

Dr. Sandhu (18:52):
So here's my background. So I was born in India. I did my high schooling there, and then I came to US. My family had migrated when I was a child, and I did my last couple years of high schooling in the California Bay area region. And then I came back again after finishing my medical school back in India for my residency training. And then we were in upstate New York in Rochester, which has my heart because no matter how cold it is, the people there are really warm and we miss it a lot. But then from finishing our trainings, that's where I met my husband and we decided to move to Boston for his further training as well. And then since then, Boston's home. Once you come to Boston, there's no leaving it. That's the downside.

Eva Sheie (19:45):
I've heard that. Yes. So he's a doctor too?

Dr. Sandhu (19:48):
Yes, he's a physician at Mass General and he's a kidney specialist.

Eva Sheie (19:54):
Can I ask why your parents left India?

Dr. Sandhu (19:57):
My parents actually never left India. They loved India. It was my grandparents and my uncles who migrated to US. So my father who was very forward thinking, he wanted both his kids, my sister and I to get educated in the US and just for better education. That's what he thought. But now that I'm older, I feel like education in India was actually tougher and probably even better just because as you can imagine with the population, there's a lot more competition. So to get into a med school, it's not easy at all. Not to say that it's easy in the US, but it is way harder. There are limited number of spots to get to do that. So I feel blessed, and I'm glad I did my med school there. I feel like the doctor I am today, I will have to give a lot of credit to my med school back there. They kept us up, they made us work. And so we came for our education. My thought at that time was that I'll finish my training and then probably go back. We had a very good comfortable life, but then I met my husband and then this has been home.

Eva Sheie (21:15):
And our plans always get thrown out the window.

Dr. Sandhu (21:17):
Love changes your life's trajectories. Yes. It's these men.

Eva Sheie (21:22):
I know.

Dr. Sandhu (21:23):
Yeah, let's blame them.

Eva Sheie (21:24):
And you also have a beautiful daughter?

Dr. Sandhu (21:27):
Yes. I have a 13-year-old. Yes. And she's in her last year in middle school. We just started.

Eva Sheie (21:33):
She's still nice to you?

Dr. Sandhu (21:34):
She's actually, believe it or not, she has her moments, but over bigger picture, I would say she's amazing.

Eva Sheie (21:39):
Yes.

Dr. Sandhu (21:41):
I hit the jackpot in that department, so far. Yes.

Eva Sheie (21:45):
Yeah, there's a beautiful photo on your website in it. I love that that's there because often women with solid careers don't want to put pictures of their family front and center because those two things can sometimes be seen as competing with each other, but they're not. They're just, we can be more than one thing.

Dr. Sandhu (22:08):
Yeah, I understand that. I think as working women, we have to evolve and not always blame ourselves. We've all been there. We feel that, okay, if you're giving career too much attention, family suffers and the other way. But I feel it's time that we accept and celebrate both aspects. So yes, in fact, my daughter, I have the same feelings as the guilt as any other working mom when she was little that okay, I'm not spending time. I'm focused on my career. Now that my daughter's 13, what she says is that she wouldn't have it any other way because seeing mom work and do everything makes her feel that this is how women should be and she can never imagine being, just staying at home. Not to say, I always say that staying at home is even harder, taking care of kids. I have so much respect for women who choose to take care of kids and stay at home. Because in reality, when you're a young mom, it's easier to escape and go to work because raising a child, as we know, is a lot of work and it takes a village to do a good job. So no matter what you do there's sacrifices in either way, and we all do the best we can. But having said that, I feel we have to prioritize both. I think it's not just, there's no such thing as work life balance in my eyes. It's all one thing. You have to give the same dedication to both aspects.

Eva Sheie (23:38):
How do your patients find you?

Dr. Sandhu (23:42):
So in the beginning it was mostly referrals. We were new in Boston, we had no family, no friends. We just moved to Boston. And I would say my first probably 50 to hundred patients were all my colleagues and nurse friends from the hospital where I was working. And then I must have done something right because they send their friends and their families and slowly we grew by referral base. And over the years, definitely we have gotten a bit better with marketing. And I would say our website is a big resource. And then we participate in local community affairs and events, and we network with neighboring, like-minded synergistic businesses as well. And then traditional, I think we have a lot of room in improving on our social media platforms. I feel doctors are not the best when it comes to social media, but we're learning, I'm learning, getting there. I feel the more expressive and vocal we can be on social media, people have to know you, hear from you to find you. So that is work in progress.

Eva Sheie (24:54):
No arguing from me on that.

Dr. Sandhu (24:55):
Yes.

Eva Sheie (24:57):
That's I think why we're here. I've never heard anyone say that their first 200 patients were their friends and colleagues at the hospital. And I thought that is one way to launch an aesthetic practice that I never thought of. But really smart because everyone trusts their recommendations too, because they're in the field.

Dr. Sandhu (25:18):
And they trust you because the nurses who work with you, they know that you were doing a good job at the hospital taking care of patients. I did a lot of procedures in the hospital as well, not aesthetic procedures, but at least they know that there's a good eye and precision, so they felt safe. I think trust goes a long way.

Eva Sheie (25:40):
It's everything.

Dr. Sandhu (25:41):
That's everything.

Eva Sheie (25:42):
It's brilliant. If someone's listening to this and they've made it here to the end, where should they look for you online to find more information?

Dr. Sandhu (25:52):
They can find us on NeemMedicalSpa.com. We should be easily accessible. And then I also have a DrRosySandhu.com website if they want to learn more about blogs. And I put a lot of educational content on it. But for all our office procedures, to know where we are located, NeemMedicalSpa.com is the place to go. And of course, although we are not as active as we should be, but please follow us on Instagram @NeemMedSpa. And my personal handle is Dr.Rosy.Sandhu.

Eva Sheie (26:27):
Before we go, tell me what Neem means.

Dr. Sandhu (26:30):
Absolutely. So it's NEEM. So Neem is an evergreen South Asian tree, which is age old. If you are from anywhere in Southeast Asia, I think most people would've heard about it because everybody's grandma has used some part of the tree in some herbal recipe. What's fascinating is every part of the tree is used for one indication or another, the bark, the leaves. So there's Neem oil, which is very good for acne, for skin irritations. Neem leaves can be used for as just like an adjunct treatment for diabetes. In fact, sometimes people keep the bark as an insect to repellent as well. It just has a lot of medicinal properties to it. So when I was conceptualizing a practice, I thought about what would I like to bring from the culture where I was born in. I thought that something, it's more symbolic, it's not that we are using a lot of Neem oil in any of the treatments, but it's more symbolic that the evergreen, the perennial nature of it, the ancient, age old wisdom that we believe it carries, and the medicinal benefits from it that are all healing essentially. So that's the symbol. So Neem.

Eva Sheie (27:49):
Thank you.

Dr. Sandhu (27:50):
You're welcome. My pleasure.

Eva Sheie (27:51):
I love doing this. I learn so much every day, and I'm so grateful that you took the time to talk to us today.

Dr. Sandhu (27:57):
Oh, thank you. It's been a privilege. Thank you so much. I loved it.

Eva Sheie (28:04):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links, including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at MeetTheDoctorPodcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, theaxis.io.