Transcript
Great. Well, I’m here with Dr. Partha Karr. Partha, great to have you here. Thanks for joining us. Thank you. Thank you for the invite. And maybe I can kick off with this. Could you tell us about what’s your current location? What’s the view from your chair?
Well, the from the chair is not very pretty at the present moment. It’s spitting with rain. Not quite spring, but you know, I suppose it’s all throughout the UK at the present moment. yeah.
Lovely British weather. Indeed. Indeed. Maybe you could tell us a little bit background to you. Tell us what you do, how long have you done it and how did you get into it?
Yeah. So, I mean, many roles, many hats. the one relevant for, for now is, I’m just sort of, I’m the type on diabetes technology, lead for NHS England on that sort of aspect. I’m also a consultant in diabetes and endocrinology in Portsmouth. I’ve done that for about 15, 16 years now. Yeah, so I’ve been doing the national role for about eight years. Apart from that, I’ve got other roles with the General Medical Council, Royal College of Physicians, do a lot of other stuff. But our main focus has been in getting greater access to technology to people living with type 1 diabetes. That has been sort of a big focus going forward. So that’s been the role. yeah, it’s been a long time going on. So that’s probably a gist of the journey.
And how did you get into that? What sort of attracted you to the area of diabetes?
I I always say that the two reasons for it. mean, one is the people I interacted with much younger in my career. So I had consultants like Tony Salin, I had consultants like David Jenkins, who are very sort of inspirational in their own way. And I think what I also liked the fact that they could be, it was like they were part of a person’s journey through their life. It wasn’t just, you know, one particular episode, it was They were trying to sort of be there for them, a hook to the whole chronic disease pathway. So that attracted me in its own right. And I think that’s brought me into the specialty and the rest is history as they say.
Wow. So you actually inspired by how you saw other consultants working and what you saw in their work.
Yeah, 100%. And today what’s kind of most exciting you about advances in the treatment of diabetes? So I think if you look across the board, mean, I would say in type 1 diabetes, it’s got to be sort of the hybrid closed loop, which has come through, is, you know, taking a lot of the day-to-day working out of the person’s hands and they’re doing a lot of it automated. That’s in type 1 diabetes. I think in type 2 diabetes, there’s some interesting medications which have come through now, which has got real good potential about prevention. So those are the, probably I would say the two areas, but in the world where I inhabit mostly in the policy space, type 1, is definitely technology and technology, is driving the whole focus of self management. That’s what I would say.
We saw just this week some you know, significant amount of news coverage in the UK about what’s been headlined as the artificial pancreas being available to type 1 diabetes patients, certainly across England. And really, I was interested to see how the media really picked up on that. Tell us a bit about that. And I mean that’s a major milestone right?
It is. I I think I always say, you know, type 1 diabetes has three parts. You you prick your finger, the number comes up, you think about what to do with the number, mental maths, and then you give yourself some insulin or glucose as maybe needed. And now here we have a technology that automates a lot of that. We already had continuous glucose monitors, which was basically you don’t have to prick your fingers. It just comes on your phone. And I think doing the next step of delivery of insulin is quite exciting. It’s still not quite the final product that makes sense. An artificial pancreas can sometimes be a misnomer because it conjures up images that it was just going to be done for you. Not quite. You still have to do a fair bit of work on it. But it’s a quantum leap from the days of you know, you have to draw up your insulin and do some thinking as to how much it is and look at the food and make a guess and then inject your insulin. So lots of progress forward. Still not the finished article. But no, and think that’s why it’s caught the attention, but mostly because we are probably one of the first, if not the first country to roll it out at this level of scale in a public health system. So think that’s what’s been exciting for a lot of people.
Amazing. So what do you think now are the biggest challenges facing, let’s say type one diabetes therapy area, locally, nationally, globally?
So, well, if I start locally and then go out to globally, I think locally, would be about access to these sort of technologies on a more uniform basis. I think with continuous glucose monitors, it took us a good three, four years to get cut across the variation of post-codes and deprivation ethnicity. So I suspect there’ll be a very similar challenge with this particular technology as well, because there’s a training need involved and everything like that. So that probably will be the biggest challenge to make sure that it’s done evenly. And I don’t expect it to happen probably in the first year or two, I think year three or four, you’ll start to see that all sort of evening out as things progress. Then if you go outside locally, think globally the bigger problem is access simply, you you even talk about basic stuff like insulin and cost price that is available to everybody. So I’m doing a work nowadays with JDRF, on India, which is very much about access, insulin, glucose strips and all that sort of stuff. So it’s a very different cry away from what we’re talking about technology, but different countries with the different economies and different sort of views of healthcare have got different challenges. And that’s where we are at.
But it sounds like from what you’re saying, that the local challenges and the sort of global level, different international challenges, access to whatever the kind of current cutting edge treatment or approach is available in that nation is still probably the challenge. And you talked about the locally in the UK that, you know, it may take some time for everybody really to get access to what’s available. What do you think needs to happen? How do we address that? Because that’s the kind of, it’s a health equity issue, isn’t it?
100%. And I think it’s the same strategy which we’ve adopted with glucose monitors, continuous glucose monitors, and then how we tackle it in pregnancy. I’m a big believer in data, right? I think if you want to do change implementation and change management, you need to understand and reflect data and you need to reflect it with a degree of boldness. I think if the data shows something is not right, I think hiding away from it is probably the wrong step, right? Trying to couch it in nice words and say, if it’s not right, it’s not right. And I think after that comes the issue, don’t just put the data, I think a strategy of here is some data, can you please do better? is not a strategy. That’s just, you know, you’re hoping on other people’s goodwill to do the work for you. And if they don’t have the same ethos as you, don’t see the problem that you are seeing. That’s not going to work. It will work for some people, but not for all. So I think that’s where you need the data. You need the accountability. You need regular sort of reviews as to where you’re progressing with the data divided into deprivation, quartiles, et cetera. Give targets for people to reach and, you know, where you need to, you need to sort of invest accordingly to say, right, okay, if this is the problem, let’s try and see what we’re going to do close the gap. So I think that needs a very clear strategy going forwards where you go with it, but it’s very doable, I would say it just needs a bit more bravery around it.
So that’s really interesting that you’re talking about data and what I’m really hearing is it’s about communication, right? Achieving a good health outcome is ultimately about good health communication. 100%. And you, know, for your role as a not only a physician treating patients, but actually a policy shaper, a policy leader for the UK. That communication has played a really important part as I see in your work. How do you see that?
100%. mean, leadership to me is about two or three things. I think first of all, leadership needs to be about accountability. I think a lot of leadership has become here are some documents, here are some papers, here are some policy, I’ve done my bit. I don’t think that’s leadership. Leadership is about implementing those documents and policies. And I don’t think it’s always about success when implemented because I think people respond to you if you have tried. I think if you tried and then you failed, that’s fine, you know, because leadership is also about failure and you need to own that failure. Look, guys, I tried my best, it didn’t work. I think the problem happens when you don’t have either of those and you just produce a document and say that’s done. And I think the second thing, which I really believe in leadership is the ability to come out and be honest with your communication. And I think the majority of people respect that. If you come out and say, look, I can do this, but I can’t do this. And this is the obstacles. I think people respect that far more. So my style has always been to communicate where we are. What are we doing? Why is it going at it? So for example, we were talking about hybrid closed loops. It’s not available to everybody with type one diabetes, according to the guidelines yet, but I made it very clear guys, this is where we are at. But I promise you in two years time, we’ll try and make it to everybody, but that’s the process. And people understand that I haven’t had any negativity about that throughout my career from people living with type one. So I think my leadership style has always been about communicate, communicate openly and communicate using different channels. Don’t be shy of social media. Don’t be shy of blogs and podcasts and all of that, you know, come out and speak. You know, and I think it’s important. So, yeah.
Great. Well, let me ask you about social media. at Creation, we ranked you among the world’s most influential healthcare professionals in the diabetes space on social media. How important has social media been for you in your work?
I don’t think without social media, the technology would have exploded the way it has in the UK, full stop. I mean, there’s absolutely no debate about it. There is absolutely no way we would have tackle deprivation, the, all the postcode lottery, it just would not have happened. can tell you that because there are many, many leader colleagues in other spaces who don’t use social media, try and use different channels, you know, the official formal channels and know, coaxing, it doesn’t work. And that’s why they have all the gaps. We don’t have any gaps in continuous glucose monitor uptake because we have been very open and very, very clear about using lots of different channels. So I think without social media, I don’t think the success of the type one diabetes world, you we have gone from being one of the laggards in technology access globally, amongst all the European countries and all these sort of, you know, countries with good economies to pretty much one of the leaders. And I think we would undersell social media if we said that it didn’t have a major significant part to play in here.
So what does that look like for you practically? Talk us through like your approach to using social media to actually bring about that change.
So I so I think social media to me is I use it for two or three things about from the sort of Usual sort of some frivolity of a picture of my dogs and what I had all that sort of stuff On a policy role. I would do two or three things one is there will be something which is factual So which is raising awareness, right? So for example type one diabetes can’t be cured by diet and all that sort of stuff It’s factual Reinforcing sort of messages to raise the profile of type one diabetes. The second one probably would be a bit of science to say, are some trials come out, here are some things that are, listen, immunotherapy is coming. Look at the trials and it’s very important. So you’re sowing the seeds for people to think about it. And thirdly, and more importantly, it’s wrapped up with the policy space. I would come out and, back for somebody or some people with type one diabetes. So if they have had a problem, I would go like, right, what’s the problem? And I would correct people directly, clinicians or systems. Sorry, that’s not the rule. And I think that is a very, very strong plus of using social media. was the people with type 1 diabetes know the come hell or high water, I will not duck behind a corporate emblem and say, I’m not helping you. So if they say, I can’t get access to this. I was like, all right, what’s the name of your team? Tell me or drop me an email. And I will then pick it up and talk to them. So those approaches, I think that personal approach does help. People shy away from it, I know, but I have found it to be incredibly productive. So I think I use social media, so raising awareness, a bit more science, a bit of what’s coming, a bit of sort of batting for the people who type on diabetes, all of them have a bearing as you go forwards.
And are there particular social media channels that are sort of more important to your work that are more effective for you in your work, do think?
So everything has got a slightly different nuance. think Twitter or X, Facebook, LinkedIn and Insta, those are the four that I use and they’ve all got slightly different audiences. And I think that’s quite important. Right. So LinkedIn would be, for example, very much be about my professional connections. It’s about what we have done professionally, policy, what’s rolled out, what’s coming. There’s that. X or Twitter is more instantaneous. It’s more, emotional, if that makes sense. So you need to have that sort of wraparound. It just having papers doesn’t attract the people. It’s more angsty, if that makes sense. needs to be more, pay, pay, pay toss in it. What are you talking about? That sort of stuff. Facebook is very much provocative. Would you say provocative? 100 % provocative. Absolutely. The whole thing. That’s what Twitter and X is. And to be honest, that’s what Elon Musk has created. can criticize him for it, but that’s, that’s the platform he’s created. It’s own niche of the whole provocation. and all that, right. That, sort of whole field Facebook is also, is again, very different. They are very much about me reaching out to people, to a diabetes type one that directly information cascade to them. It’s where LinkedIn is an information cascade of policy makers. Facebook becomes an information cascade to people living with type one and their parents and their carers. Right. And then finally, Insta is very, Insta is very quick. quick fire in the sense of it’s less provocative because it’s very much about pictorial, very much about visualization. So there’s a bit of reels, bit of videos, bit of here’s what’s coming and a picture of somebody, type one who’s lived with it for 52 years and has got a medal, that sort of stuff. So I think it’s got very different audiences and I think you need to slightly amend your outputs accordingly, I would say.
Right. Yeah, yeah. Amazing. So what advice would you give if there’s a doctor physician who is looking to kind of see, well I’d like to make an impact online, I’d like to grow my knowledge and impact online. What advice would you give them?
I think the first thing I would do is I wouldn’t do anything but observe a few big guns. When I say, and you shouldn’t observe just the people you like, I think that’s important, right? You should also observe people who you will go, I don’t like their postings and stuff. But then you need to think about why is it that they have this sort of level of engagement? What is it that they’re doing? Is there anything I can learn? in the sense of that’s something I will not do, but that’s something I really like. OK. And I think that’s important. So I always say go and pick 10 people, five you really like, five you don’t, and just follow them for a bit and just see what they’re doing. And then after that, you need to start building. You know, need to, for example, what And then think about what is it that you’re trying to sort of push? What is your specialty area? How confident are you about your own area? Because you don’t want to come across and say something and get absolutely ripped apart in day two. So, and then I think that’s how you build your audience with a bit of respect, with a bit of sort of understanding going through. And I think you build your kudos and then you can reach out and start sort of doing a little bit more provocative stuff, pushing the boundaries a little bit of saying, well, I don’t agree with, example, this medication being, then you have lots of, why, why would you say that? You know, all the rest of it. So I think you have that sort of mixture of things as you go along, but I would I, my advice always is try and observe people first, learn from their styles, what you would do, what you wouldn’t do, and then decide on that.
Brilliant. Brilliant. So what would you do differently if you were sort of starting over, you know, getting online now for the first time, you can imagine that, what would you do differently?
I think I really, I don’t think I would do anything much differently because I think I felt my way very much as I’ve gone along. Right. And I’ve always said this, you know, and I think people use social media policy guidelines as some sort of beating stick in the sense, if you do this, then you’ll get in trouble. That’s not true. And I think people misunderstand. mean, there is a legal rules around your freedom of expression. Right. I would say, you know, if you’re going to use social media and you’re not doing something, a don’t tweet and do stuff when you’re drunk. And secondly, I think if you’re going to bring out on a public forum your sexism, racism, homophobia, or any of that sort of protected characteristics, quite rightly, you should be punished for that, right? But otherwise it’s a free society where you can actually, you can have an opinion because I, and I’ve had this discussion with many people who’ve gone like, well, I don’t agree with you. I said, that’s, but that’s okay. It’s a democracy. supposed to disagree. Yeah. As long as we’re doing it respectfully. I have no problem. And I think some people take it to other edges. go, you know, I don’t like you because of what you say. I said, but that’s okay as well. It’s fine. Nobody can universally lighten. If you’ve got to make your judgment about me based on some tweets I’ve made rather than meeting me in person, that’s your choice, not mine. But I don’t have anything to say to that. So I think it’s about people understanding what you can and cannot do, right? So, and finally, would say people have asked me that, can you speak against an organization you work for? I do it regularly. As long as it’s done with respect. There is a term which is called grit and oyster, right? I have been a national for eight years and I’m as provocative as you speak against my own organizations all the time. But as long as you’re not doing things which are silly, if I come out and said, my chief exec is X and Y and doesn’t, of course you can be disciplined for that. But I think if you say, I don’t agree with the policy they’ve decided on democracy. know, it’s not you’re not you can’t. So I think people need to understand the rules better.
Do you think there’s something in that of being being feeling free to be outspoken and express your view with respect is actually does that do you think that there’s something there that actually brings authenticity?
100%. Authenticity is a very important thing. People need to know that what they are seeing is what it is. So one thing I always make pains to do and you met me in person is that I am who I am. That’s who I am, right? The way I come across on social media is the way I am, I’m passionate, I’m exuberant, I’ll be try and be humorous and all that sort of stuff. But I’ve also bring in face-to-face setting with lot of people the Marmite factor. They don’t like my style, they don’t like my drive. You’ll have people who grudgingly like me, people who don’t like me, but that’s the package. So what you see on online is not different from that respect is what I always say. I think that is very important to be authentic.
Absolutely. There should be no surprise when someone meets you in face to face and realize it. Yeah. They don’t see something different, right?
Yeah. They go like, my God, he’s a shrinking violet. What’s going on?
No, absolutely. Okay. Great. Thank you so much Dr. Karr for sharing your experience for all you’re doing online we’ve, I’ve certainly learned a lot from you as I’ve kind of observed you and, and, and what you’re doing in the diabetes space. where, just to finally, where can people find you? If they want to find you online, follow you.
I always say, just on Twitter, I’m there, ParthasKarr, I’m on Facebook, I’m on LinkedIn, I’m on Instagram as NHS sugar doc. write blogs. I do podcasts like this. So I am, I’m pretty freely available. And, know, my email’s out there in the public domain. I’m always happy So to communicate with people and give tips and advice, no problem.
Brilliant. Well, thanks again so much for sharing your experience.
Pleasure. Thank you
