Voices in Health and Wellness
Voices in Health and Wellness is a podcast spotlighting the founders, practitioners, and innovators redefining what care looks like today. Hosted by Andrew Greenland, each episode features honest conversations with leaders building purpose-driven wellness brands — from sauna studios and supplements to holistic clinics and digital health. Designed for entrepreneurs, clinic owners, and health professionals, this series cuts through the noise to explore what’s working, what’s changing, and what’s next in the world of wellness.
Voices in Health and Wellness
From Fear to Agency: Rethinking Dementia Prevention with Dr Ashanthi Gajaweera
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Dementia is one of the biggest fears people carry quietly, and the hardest part is not knowing what to do with that fear. We sit down with Dr Ashanthi Gajaweera, a neurologist with more than two decades in traditional practice, to unpack why she stepped outside the insurance-based model and founded HealthSpan Neurology, a preventative neurology clinic built around cognitive longevity and dementia risk reduction long before symptoms show up.
We talk through what a real dementia prevention programme looks like when you finally have time to do it properly: longer visits, a clear sequence of assessment and testing, and a stepwise plan that prioritises what matters most for the individual rather than dumping “a million things” on one to-do list. Shashanti shares how she thinks about mechanisms that drive cognitive decline such as metabolic health and inflammation, how she sets expectations for patients who feel subtle change, and why empowerment and agency are just as important as lab results.
A standout thread is menopause and brain health. Ashanthi explains why hormonal change can intersect with memory, mood, migraines, and overall neurological resilience and why women deserve prevention guidance that takes menopause seriously instead of treating it as an afterthought. We also get candid about the “jungle” of brain health claims, how to avoid pseudoscience without becoming cynical, and what it takes to market a prevention service that many people do not even realise exists.
If you care about evidence-based brain health, cognitive longevity, and practical dementia prevention, subscribe, share this with someone who worries about their future, and leave us a review with your biggest takeaway.
Guest Biography
Dr Ashanthi Gajaweera is a neurologist and founder of Healthspan Neurology, a preventative practice focused on dementia prevention and cognitive longevity. After 20+ years in traditional medicine, she transitioned away from the insurance-based model to create a more proactive, patient-centred approach to brain health.
Her work centres on helping individuals understand and reduce their risk of cognitive decline before symptoms appear, using an evidence-informed and personalised framework. With certification in menopause care, she brings a unique perspective to how hormonal changes in midlife impact brain health.
Known for her clear, data-driven approach and her stance against pseudoscience, Dr Gajaweera empowers patients to move from fear to agency, with practical strategies to take control of their long-term cognitive health.
Links
- Website: healthspanneurology.com
- LinkedIn: https://www.linkedin.com/in/drgajaweera/
Subscribe on Substack
Voices in Health and Wellness is published on Substack, as part of The Diagnostician. Every episode lands there with written notes and reflections you won't find in the podcast feed. Free to subscribe.
👉 https://thediagnostician.substack.com/s/voices-in-health-and-wellness
About the podcast
Voices in Health and Wellness features conversations at the intersection of medicine, lifestyle, and human potential, with clinicians, scientists, and thinkers shaping the future of care.
About Dr Andrew Greenland
UK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. Trained in both conventional and root-cause approaches, Andrew helps people optimise health, performance, and longevity, with a focus on cognitive resilience and healthy ageing.
Welcome And Guest Introduction
Dr Andrew GreenlandSo, welcome back to the Voices in Health and Wellness podcast, where we explore the people and ideas reshaping how we think about health prevention and long-term well-being. Today I'm joined by Dr. Ashanthi Gajaweera, a neurologist with over two decades of experience who made a bold shift from traditional medicine to build something she felt was missing. She's the founder of HealthSpan Neurology, a preventative neurology practice focused on helping people reduce their risk of cognitive decline and dementia, often decades before symptoms begin. Her work is grounded in evidence, cutting through the noise of gimmicks and pseudoscience, and she brings a particularly valuable lens through her expertise in menopause and how hormonal changes impact brain health. So with that, Ashanti, I'd like to welcome you to the show. Thank you so much for joining us today.
Dr Ashanthi GajaweeraThank you so much for having me here. This is going to be a lot of fun.
Dr Andrew GreenlandI'm looking forward to it as well, and we have some common interests, so I'm really looking forward to the discussion. But
The Leap Into Preventative Neurology
Dr Andrew Greenlandperhaps to start, could you share a little bit about your journey from traditional neurology into building health span neurology?
Dr Ashanthi GajaweeraYeah, of course. Um so thank you for having me here. Um I love hearing your podcast about how other people are navigating this untread path, right? Um so I am a general neurologist. I've been in practice now for 20, nearly 23 years, and most of that time in Rochester, New York, where I have a brick and mortar practice. I practiced within a traditional insurance-based model for 22 of those years. And then in 2025, I opened my independent practice, health span neurology, where I focus on patients with dementia risk factors, and I have a dementia prevention and cognitive longevity model of care. Getting here has been somewhat straightforward because I've always really been interested in preventive medicine, but it's not really the model of care that is one within an insurance system. But I knew that this was where I wanted to be one day. It was just a question of how I was going to navigate the system we are in to get there.
Dr Andrew GreenlandGot it. So you said 2025, and I'm just really curious to know was there a particular moment or series of moments that made you realize that the traditional model isn't just quite enough for me?
When The System Stops Fitting
Dr Ashanthi GajaweeraWell, I think that started back in 2010, actually. So in 2010, um there were dramatic changes within the US healthcare system. Uh, and I was the within the practice I was in, I was in, I was the managing partner. So I did all the uh I worked with the billing, I worked with the hiring, I did kind of all of the back-end stuff that I don't think most physicians, especially given the dwindling numbers of private practice physicians in the US at least are. I don't think most physicians were acutely aware of the changes that were happening, but I was, and I saw the writing on the wall in terms of this is financially difficult, we're gonna have to change the model of how we work. And if we don't, then we're gonna get overwhelmed with check boxes and just becoming administrators in a and in one more cog wheel of medicine. Um, andor one more cog in the wheel of medicine. And I didn't necessarily initially think I would leave because I felt such a uh responsibility to my patients and my practice and my staff, but I tried to make that work. So I did other things, so I got licensed in medical acupuncture. I um my I myself have a uh a long-standing mindfulness practice, so I became certified in mind-body medicine, and I tried to incorporate these things into my traditional practice, but as much as I tried, it really wasn't practically possible. It was neither something that would be reimbursed, and it was even more importantly, I think it was costing me money because to try to incorporate these kinds of things into a traditional model is just not, it doesn't lend itself to the 15-minute visits that we we are reimbursed for. So, you know, my 45-minute one-hour visits were just not feasible in that in that model. So I tried for a while, but then I think in COVID really strained the most private practices and reimbursement issues. And I think as I saw those issues mounting, I knew that I I was not going to stay happy in medicine. So it was a matter of um losing my joy in medicine, maybe even sort of becoming permanently unhappy in a joyless state. Or um I think what came over me was I am a problem solver and I am incredibly bright. And why deal with this when I can figure out a way? There's there has to be a way out of this. Um and the way for me was not within an insurance-based system because I had tried that. I had tried really hard, you know, in terms of time, money, um, just the the amount of investment I had already put into that was not something I thought I could continue. So I was 52, I think, at the time that I started, 51, 52 at the time that I started thinking about leaving. And I have to admit, it was kind of a question of do you retire? Because you know, you're you're gonna you're it's not to say that life is gonna be easy, but do you just do locums and suck it up once in a while? Or do you um uh do something different, something new, build something? And so I decided let's build something. That's you know, this is my kids were going to college around the same time, they were building something, and it's a good time in life to show them what is possible. So that's what those were my motivators. Fantastic.
Dr Andrew GreenlandSo
Designing A Cognitive Longevity Programme
Dr Andrew Greenlandcould you perhaps give us an overview of health span urology and how you've sort of created a better world in a more holistic approach that you've been talking about just now?
Dr Ashanthi GajaweeraYeah, so I started the practice, like I said, just under a year ago, and I have a cognitive longevity program. So the way that is framed is it's a six-month to one-year program where I see patients over three to four visits, and we start by the first visit uh assessing their goals, their risks, their history, their family history, and then the second and third visits are reviewing their diagnostic testing and then assessing how those uh risk factors, both objectively and subjectively, come together and what strategies we can then put into place in a targeted, effective way to mitigate risk as much as possible. As you know, there's a million things you can be doing for dementia prevention, but to tell people to do these million things is rarely feasible or practical. So it's very much getting to know the patients, getting to know what's important to them and what works in their lifestyle so that we can incorporate a stepwise strategy and then build on it over the course of a year and give them ways to then have a roadmap to follow up whether that's working with me down the road or working with their primary care doctor. Um, I, you know, I just started about a year ago, so I don't have people that have I've sort of let out into the wild, shall I say, um, to see how that that's how that's working, but I'm I think that I at least give them an idea of where their risks are most, where they're where it's most worthwhile to put their efforts. And that way they can stay focused, goal-oriented, and have objective things that they can try to follow over time. I think that I'm a very logical data-driven person. Um, I was once an engineer, so I think like I think in spreadsheets and I think in charts, and I believe that helps patients, but at the same time, I feel like uh my years of experience allows me to give patients a practical, stepwise way of doing things that isn't just a spreadsheet that you need to then follow. It's a it's a game plan that's accessible. So that's that's the crux of what I do. Um I have a mind over menopause program as well, which I think is fun and interesting and useful. Um, you know, neurology and OBGYN don't often fall under the same training pathways, you know, we we rarely consult each other, I think. And I um decided once I started to do a focus in dementia prevention that to really understand it better, I needed to understand menopause better given the increased risk for women. And I became a menopause society certified practitioner, which has been quite elucidating just in terms of my own health, the health of how I've approached patients over the years, whether that's for dementia prevention or anything like migraines and epilepsy. I think that all of these are so interwoven in terms of hormones and neurologic health. So it's really opened my eyes into how to practice and be more holistic in terms of my approach to caring women with neurologic disorders, whether that's from a preventive standpoint or just a just dealing with neurologic disease. Um, so that's the model that I work with. I also try to incorporate some mindfulness into my work. It's a, you know, it's that's a a sometimes tentative path because not all patients want to go that route. But I think it's something that I try to make accessible to them if that's something they'd like to do.
Who It Helps And What Changes
Dr Andrew GreenlandThank you. With the um prevention program, the dementia prevention program, are you are you working primarily in prevention with people who are at risk or are you seeing patients who've actually got some evidence of cognitive decline? Are you seeing that for the full spectrum of patients?
Dr Ashanthi GajaweeraSo, yeah, so it's a great question. And I think that's something I'm actually working with right now in figuring out how to do it. What I've been doing is a prevention model, so patients who are without symptoms but who are concerned based on a family history or brain injury and or having symptoms that they think, for example, are menopause-related brain fog. Um, I am starting to see more patients with the earlier signs of mild cognitive impairment where they don't test within an MCI range on cognitive testing, but they feel like there's a change. And in talking to them and knowing what their either professional or life background is, the subjective functional change is one that makes me think that there is something different about them. So for those patients, I do first an assessment, like part of as just an urologic consultation, and then I incorporate that into my dementia prevention program. If I think that they have the ability to take that on, it is a lot of it is a lot of work and commitment to engage in a dementia prevention program in earnest for a patient, and I want to make sure that they have the wherewithal, the support to do it, rather than feeling overwhelmed or feeling that if they don't do everything, then they are missing out or that they are failing themselves or their family. So I think I don't want to um overpromise to patients that might already be in the lower MCI range or with early dementia. That's that's my way of practicing. I think that others might see it differently. But for me, my dementia prevention cognitive longevity model is really for mostly for the the asymptomatic preclinical patients.
Dr Andrew GreenlandGot it. And what's your hope for these patients at the end of their one year? Is it really to give them the roadmap and to make them self-sufficient? Or and what's also what's their expectations for a program, you know, with for one year with you as well?
Dr Ashanthi GajaweeraI think so. My goal with them is that they feel empowered, that they know what's important in terms, you know, there's like I said, there's a even if you think of there's a million things you could be doing, and those, and there's probably 10 pillars of things you can be doing. So which, and then in terms of those pillars, which mechanisms are most important? So what I really try to do is break it down into not just which pillar of of cognitive health is important, but which mechanisms are going to feed that pillar the best for an individual. So for some that might be metabolic, for some that might be inflammatory. And if you know which mechanisms are most important for your phenotype, then you can focus on that. So that's really my goal is to give them that empowerment. Um, and I will I'll just I I'll be honest, I'll have to see how patients work with that down the road. Um I'm oh I I do have a model of having patients return to see me every six months or a year, depending on how what works for them. But I try to give them a, you know, that that that after that last visit, a a summary of of what I think I'd like them to be looking at in the next year.
Dr Andrew GreenlandThank you. Um so
Dodging Pseudoscience And Quick Fixes
Dr Andrew Greenlandyou've taken a very clear stance against pseudoscience and quick fixes. What are you seeing in the brain health and prevention space right now that sort of concerns you or something you're kind of steering yourself away from?
Dr Ashanthi GajaweeraYeah, so I think it's also there's two parts of that question, and I think it's probably one of the most important questions for somebody who's going down this atypical path, shall I say? And once you get off the beaten track, it's a jungle out there, right? It it just feels like wow, you could be you could be doing so many things, and there's not the ivy tower to rein you in, or the um you've already perhaps art being thought of by your peers as that a that sort of odd doctor doing something a little weird. So you know, sky's the limit in terms of weirdness now, and so to rein yourself in in, I don't mean rein yourself in, but to to to um follow your path, I think for me it has been a question of what feels aligned with my what feels aligned with what I think is true, what I think is morally aligned with how I want to practice, and is something that I uh will feel is not going down a path that's going to be distracting for me. So, for example, many patients will call and ask if I do certain types of infusions or if I do certain types of protocols that I think have, it's not to say that they don't have validity, I think they do. It is just a question of whether that is the pro that I want to take my patients on. And it can be tempting to want to do those things because they are profitable, they are, you know, it when when building a practice and when going outside the system and you don't have this um predictable revenue stream or predictable patient stream, it can easy to go down a path that might be um what your patients are asking for rather than what is true to what you want to do. So, how do I navigate that is really is the evidence for that enough for me to want to recommend it to people? And is it um is it something that I once I go down that route, I'm going to be consistent in in how I feel? Doesn't mean you can't change your mind. It doesn't mean you think about something, but rather that you um you don't go down a slippery path, put it that way.
Dr Andrew GreenlandGot it. So why do you think there's still such a gap between what patients are asking, like how do I prevent this, and what the system, the conventional system, is able to provide?
Dr Ashanthi GajaweeraWell, I think the conventional system isn't able to provide it for a number of reasons, but I really think the biggest beyond the time, beyond the reimbursement, I think in dementia prevention, the biggest hurdle is that this is not intrinsically something that falls under a neurology or psychiatry silo. And we practice in silos of medicine, and within neurology, it's even more siloed. I think that I'm I feel like I'm one of the last of a generation of general neurologists, even though I fellowship trained, I practiced in general neurology. So I saw everything, and seeing everything then allows you to have sort of a confidence to do things that you're not always the expert in, right? So, and that means within a dementia model, dementia prevention model, accepting that dementia isn't just amyloid. There's so much more, if not much, much more than amyloid theory in terms of addressing dementia. So it's being comfortable with managing or assessing cardiac issues, metabolic issues, all those things that I just talked about, which I think most neurologists are a bit shy of doing. And I think that comes from being so subspecialized today that you many, many, for example, epilepsy doctors won't manage migraine. So if you can't manage migraine, how are you going to manage somebody's lipids? So like it's so outside your um bandwagon that I think it it is very difficult to uh I think it's very difficult to get get your arm get your hands around it. So I think that family medicine doctors and internals, internal medicine doctors would do be able to do this really well. And then, but but in that case, it's a question of perhaps understanding dementia better and understanding how to assess it and diagnose it and manage it and imaging and all the biomarkers, but it's not rocket science. I feel like it's something that that we can we can uh build as a model of care if it just became more less less out there, less sort of suspect. And maybe that goes into sorry, I'm just gonna keep going, but I think that patients are asking these questions because and and maybe asking these things that are outside of the science because they aren't getting answers from their neurologists. So they're they're left on their own. So when they go on their own, they're being met fed by sort of the social media and the sort of the fringe medicine that can easily speak where all doctors are stick stuck to their their randomized controlled trials and evidence-based medicine.
Dr Andrew GreenlandYeah, complete that completely resonates. I completely get it. So can
Founder Life And Finding The Message
Dr Andrew Greenlandyou share a little bit about your role now as a on a day-to-day basis as a founder versus when you were in traditional practice before?
Dr Ashanthi GajaweeraYeah, so I spend a lot of my day now managing my time. And that is probably one of the biggest changes for me. So, you know, as a physician, you spend your entire adult life with somebody telling you what to do, right? Whether it's residency or in clinic, you walk in and your schedule is set. And now it's really a matter of um figuring out how to manage my time when I'm not seeing patients. A lot of my time is spent in trying to um, I guess the best word is uh market myself, market my brand, market my product, uh and build my practice as one that is worth patients looking at. So because dementia prevention isn't something people even know they need, it's a Tricky thing to you're I'm trying to basically sell something that people don't even know that they need, much less than it exists. So it's a it's a that's that's actually how I spend a fair amount of time in terms of like social media, YouTube, uh, education, webinars, um, speaking events. It's really outside of my comfort zone, uh, but it is important, it is good for me, it's certainly building my cognitive resilience as well. And I'll be honest, it's actually way more fun than I thought it was going to be. It's it, I would have, I would not have signed up for it, but it has turned out to be one of the most joyful parts.
Dr Andrew GreenlandThank you. And if you don't mind sharing, what's the the secret to the messaging that you've discovered so far? Because like you said, it's all about marketing and just finding that thing that resonates with people. Have you found any key insights that you're happy to share?
Dr Ashanthi GajaweeraGosh, I'd love to know other people's insights because I'm still figuring it out. But I think that when you connect with people, right? So especially when it's something as I'm not selling something pretty, right? I'm not selling uh something that fixes you. I'm selling something that is out in the future. So I I'm my connection with people comes from my, I think, telling stories, whether they're my own personal stories or stories of patients, and speaking to the fear without naming it as fear. Because I think that is where patients connect with me, right? They feel fearful of dementia, they feel fearful of the future. But I don't want to say, oh, it's gonna be dark, ugly, and full of doom and gloom out there, so you better come see me. Then nobody's gonna come talk to you. But if you talk about it in terms of stories of hope, connection, um, family, love, uh, relationship, I think those are really what has connected most. I it's been patients who've said, I read your, I read your website and your story of your family and how you got to doing what you're doing. Or I saw I was at your speaker event and you talked about um a patient interaction that really moved you. So those are, I think those are the stories that you have to tell in order to sell something that does not intrinsically have a beautiful face. Um if I wanted to do some might, so you know, as a neurologist, in my previous life, I did Botox for migraine all the time. And if you do enough Botox for migraine, you can start to get rid of people's wrinkles too, because you just know how to where to put it. And my husband would say, you know, if you wanted something easy, you should have just done Botox. So I'm not doing Botox, I'm doing something that is that has an uncomfortable face that people just kind of want to turn away from. So you have to bring, you have to bring, I think, beauty to the story.
Dr Andrew GreenlandGot it. So you mentioned about being a founder just now, and that involves wearing lots of hats, many of which are non-clinical. Which of the non-clinical aspects of your role do you enjoy, and which are time drains and things you would rather not have to do?
Dr Ashanthi GajaweeraWell, I quickly learned that a time drain was bookkeeping. I tried to do all my bookkeeping myself because I figured I could, but I that that was a complete waste of time. So I quickly that was probably one of the first things I gave up. I still know how to read a balance sheet, so you still need to do all those things. Um, but you can have somebody else to do the mine day-to-day. Um I think things like scheduling, you can have somebody manage your calendar if that's if at the beginning, you don't necessarily need that, but I think those are it's it's more efficient to have somebody manage your calendar with a goal, not just managing it, but saying, I want my schedule filled, and I this is what is is non-um negotiable in terms of my calendar. Um, I think that things I do, but I don't necessarily enjoy. I do my own video editing, and I'm terrible at it. So if you watch my YouTube videos, for example, I apologize in advance. That's my own editing. I'm I'm hoping to have somebody help me with that soon. Um I really enjoy the writing. I enjoy writing blogs and newsletters, and um I do enjoy filming the YouTube videos and figuring out what I'm going to be talking about. I think that's content creation and it's I feel really interested in. So it's more fun than I thought it would be. I love speaker events. I I'm not a person who ever thought I'd like public speaking, but um, if you are talking about something that's important to you and you want to convey its importance to patients, it's it really comes easily, I think. And again, incorporating those stories into that. I like doing that. Um, what else do I do? Um, the part I don't love doing is going door to door to refer and and you know, referrals because it's awkward as a physician and traditional insurance-based practice. I never had to ask people to send me patients. My schedule was booking out, you know, a year, so six months to a year. So now having to find those people, it's not a question of not wanting to speak to them, but most of the time you don't get to speak to them. You're speaking to a secretary or a front desk person, and I don't enjoy that because I just feel like is this is is my is my rack card just going straight into the garbage? But you have to do it because you never know. You you do a hundred of those and you might get a few referrals, and those few referrals end up compounding over time. Thank you.
Dr Andrew GreenlandSo
Referrals Bottlenecks And Virtual Care
Dr Andrew Greenlandyou um health annualogy is a relatively new thing. You've fairly new into it. What are you most proud of so far? What do you um think is going particularly well for you in the business?
Dr Ashanthi GajaweeraUm, I'm most proud of my my practice model. I think it works. I think it's you I've seen the um the when I say the clinical outcomes, I mean both objectively, just following data with patients over time, but most importantly, I think how they have changed their mindset from fear to one of agency. I think that's priceless. And that's really the most joyful thing that I feel I have done. Um and every time I see a patient, I come back out of it, I come out of it just like beaming. I'm just full. Um, so that's perhaps the thing I'm most proud of. I'm most proud, I'm also proud of this, like from a personal level, I'm proud of the speaker events, because like I said, I'm a shy introvert. I don't like talking to people. I mean, I'm that person at the cocktail party who would like rather slink out. Um, but there I am, you know, enjoying talking on a stage sometimes. So that's uh that's well outside my comfort zone. Friends who have seen me do it think that that is a different person than the one that they know who slinks out of the cocktail party.
Dr Andrew GreenlandGot it. And on the other side of the coin, which um challenges or bottlenecks are most impactful for your business at the moment? And what are you kind of working through or trying to overcome?
Dr Ashanthi GajaweeraI think the most impactful are actually those two things that I'm good at because I think the patients then leave me a review, and it's been surprising how patients have actually found me on Google. So I think that when a patient leaves you a Google review, or you know, I have a card that I asked them, that's a tricky thing to do, but I've gotten used to it. So that's been impactful, and then the speaker events are impactful. In terms of what's not been so impactful, I think that was your question. Is that right?
Dr Andrew GreenlandI was interested in any particular challenges or bottlenecks that you're working through as a relatively new business that are most impactful to your business at the moment, and how are you kind of viewing them and how are you trying to sort of solve them?
Dr Ashanthi GajaweeraI think the most um difficult one is I practice in Rochester, New York, which is a wonderful medical community. The University of Rochester is here and is an excellent medical center. Um, but given their excellence, it is also difficult to work within a system that is work within a community that is, I don't want to use the word monopolized, but somewhat monopolized by a university center. And that is challenging. So to talk to physicians within that center, I like I said, I can't get past the front desk. So that is a difficulty. So I just am not doing it as much anymore. Um, and instead going to other sources of where my patients might be. So, for example, you know, a dementia prevention is that's a person who's a forward thinker who's thinking at the long game. So that's going to be things like um, I wouldn't have ever guessed, but things like uh financial planners, estate planners. Um uh so it's it's thinking in outside of the box. So that's how I I got about that. And also then seeing people within the whole of New York State uh virtually, so having doing telemedic, setting up my my practice model so that it's something that can be done uh virtually, so that I can do all my testing through, say, remote cognitive testing and things like that, so that it is available to those throughout the state, so that I'm not uh limited to just a Rochester-based brick and mortar practice.
Dr Andrew GreenlandNow
Scaling The Practice And Growing Awareness
Dr Andrew Greenlandyou've been talking a little bit about your marketing efforts, and I just wonder what would happen if you had a sudden influx of new patients next week. I know 15 new patients next week.
Dr Ashanthi GajaweeraYeah.
Dr Andrew GreenlandWhat would happen? Would anything break? And hopefully not you.
Dr Ashanthi GajaweeraThat's a great question. I've thought about that, but it's never happened. So I um, you know, I currently so the way I've built my practice model is that I ideally see five to 10 new patients a month. Because they come in for three to four visits over the course of six months to a year. That is a very doable model. Um, and I think I I mean 15 new patients next week, if it continued over the next, you know, every week was 15 new patients, I would probably need to hire somebody to help work with me. Um having said that, that is tricky because I have very high standards, but I think that's only a good thing. Fortunately, I think that there are a lot of good people out there that might be wanting to work within a similar practice model. Um I guess I'd have to start recruiting pretty quickly, but I'm gonna hope that that's a problem I have to solve.
Dr Andrew GreenlandNice problem to have for some people.
Dr Ashanthi GajaweeraYeah, yeah, exactly.
Dr Andrew GreenlandUm and if you had a magic wand and you could fix one thing in the business tomorrow, what would that be, if anything?
Dr Ashanthi GajaweeraIt would be that people know that dementia prevention and cognitive longevity are the same thing and they require that you start uh early. That isn't necessarily a business, it's not a it's not a framework of my business, but it certainly is a framework of what my business needs to educate people on. Um so if I could, you know, have a wand, I would have 60 minutes do a one-hour thing, talk. And not 60 minutes, probably like a morning show, because 60 minutes is targeted to those who are older, but a a morning show or something that really would in an alluring way encourage people to start looking at this early. Um, from a practice standpoint, the one thing I would want is to have a means of really reaching out to my physician community, where I am located, where I am, to educate them of what I how valuable what I offer is. And I feel very limited in that because of where I practice and the the kind of uh environment I'm in. But it it could it can change. You just have to peck away at it long enough.
Dr Andrew GreenlandSo it's really an awareness thing, awareness to patients and also an awareness to colleagues about what you can do with that.
Dr Ashanthi GajaweeraBecause colleagues, colleagues also are sending me patients who have dementia uh or significant mild cognitive impairment rather than those that are um who who might have been thinking about it or concerned 15, 20 years prior to symptom onset.
Dr Andrew GreenlandGot it. So thinking to the future, where would you like the business to be in the next six to 12 months? Do you have any particular plans for how things are going to pan out for you?
Dr Ashanthi GajaweeraYeah, these are great questions. Um, so ideally I'd like to see the practice grow in terms of patient volume. I'd like to be able to reach more patients within New York State. Um, and that's interesting because you know, within it's you know, Google and and AI search is is so interesting in how patients are finding me from within from throughout the state. Um, and maybe over time uh branch out to other states as well. I have some family and times that I'd like to spend in other places in the country. So so maybe branch out to other states and and really firm up my practice model so that it has become becomes one that is scalable and and one that I can um help others model as well.
The Advice She Wishes She Took
Dr Andrew GreenlandBrilliant. And finally, if you were to start health span neurology again tomorrow with everything that you know and the benefit of hindsight, which is a wonderful thing, would you do it? Would you do anything differently?
Dr Ashanthi GajaweeraYes, I would. I would have started to brand myself when I started thinking about my exit. So I would have started a YouTube channel and an Instagram presence and um built my website well before so that patients that I had at the time could find me, that they had a landing page, that they could stay uh connected to me. Um, obviously, like most physicians, there are people that I miss from building a relationship with them for 22 years. I think of them often. And you know, I'm not legally able to reach out to them, but they would be able to reach out to me if they knew where to find me. And I wish I had, even if it wasn't as a patient, I wish that they knew where to find me and they still had that connection. And then even if they didn't come to me, see me as a patient, they might spread the word and refer me to others, or if they were in a conversation with their doctor, be able to say, she's out there. So anybody who's thinking about leaving their traditional practice of medicine, build your brand, your face, your voice. You are you are way more knowledgeable and smarter than so many people out there. Get yourself seen, don't be shy, don't be modest. You are a rock star, own it, and eventually you will feel like you are there. I'm not sure I'm there. I know I'm not there yet, but every time I do something, even like this, I feel like I'm uh making, taking baby steps to uh own my greatness.
Dr Andrew GreenlandWhat a point to end on. Thank you for that sage-wise such sage wiseness. I really, really appreciate it. And I really do appreciate this conversation. It's been great to have you on the show, Ashanthi. Really insightful, especially your perspective on prevention and the gap in the current system. So thank you very much for joining me. Really appreciate it.
Dr Ashanthi GajaweeraPleasure, Andrew. Thank you, thank you.