From Siloed to Synchronized: Building the Multidisciplinary Care Model That MASH Patients Need

In 'From Siloed to Synchronized: Building the Multidisciplinary Care Model That MASH Patients Need,' the Jaime Almandoz, MD delves into the following critical questions:

Do you think the field has been too siloed in how it manages metabolic dysfunction in obesity, type 2 diabetes, and MASH, and how can these gaps be closed?

How often are you co-managing patients with MASH and what can be learned from that collaboration?

Jaime Almandoz characterized the historical management of metabolic disease as paradoxically siloed given how biologically integrated these conditions are, noting that a patient may have their obesity managed by one clinician, their diabetes by another, their cardiovascular disease by a third, and their liver disease, if addressed at all, evaluated in yet another separate setting, while the patient is experiencing all of these as one interconnected metabolic condition, creating fragmentation that delays diagnosis, duplicates effort, and leaves critical windows for intervention unaddressed. He also outlined what he believes the future of metabolic care must look like: a truly multidisciplinary model anchored by primary care for detection and referral, with endocrinology, obesity medicine, hepatology, cardiology, and clinical nutrition working from a shared clinical playbook that integrates emerging pharmacotherapies with lifestyle intervention as a co-therapy rather than an afterthought.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, 'Complementary, Not Competing: How an Endocrinologist Compares Dual Incretin Approaches for Obesity and MASH,' features Jaime Almandoz advancing his conversation on obesity and MASH and focusing on what a dual GLP-1/glucagon receptor agonist adds mechanistically compared to GLP-1 receptor agonism alone, how GLP-1/glucagon co-agonism compares to GIP/GLP-1 co-agonism, and whether certain metabolic patient profiles may be better suited to one dual incretin approach over the other.