Episode 127

Rural Health on the Front Lines: Dr. Manny Sethi on Access, Private Equity, and Prevention

In Episode 127 of DC EKG, Joe Grogan sits down with Dr. Manny Sethi of Vanderbilt and Healthy Tennessee to talk about what rural health looks like up close and what policy changes could actually improve access.

Dr. Sethi shares his story growing up in small town Tennessee as the son of immigrant physicians, then training as an orthopedic traumatologist and treating high-energy injuries that often collide with chronic disease and limited access to care.

The conversation centers on why rural communities struggle to find primary care and specialists, how administrative burden and electronic medical record requirements can crush independent practices, and why private equity and large systems buying clinics can reduce real access for patients.

Dr. Sethi also explains how Healthy Tennessee built a volunteer, community-based model of prevention through health fairs that screen hundreds to thousands of people, partner with food banks, and connect high-risk patients to follow-up care.

If you care about rural healthcare, access to care, private equity in medicine, physician shortages, preventative care, EHR burden, Medicaid, Medicare, and community health, this episode is a practical look at what is broken and what can be done.

In This Conversation
Joe and Dr. Sethi cover:

• Dr. Sethi’s background and why he returned to Tennessee to practice trauma care
• Why Healthy Tennessee was created and how prevention can reduce downstream costs and complications
• How volunteer health fairs work, who shows up, and why many attendees now have insurance but still cannot get appointments
• The role of insurers, employers, food banks, and community partners in scaling prevention and screening
• How private equity consolidation can narrow access and accelerate monopolies in rural markets
• Policy ideas that could move clinicians to rural communities, including better reimbursement and stronger incentives

Timestamps (Audio platforms)
0:52 Intro
1:14 Meet Dr. Manny Sethi (Vanderbilt, Healthy Tennessee)
4:38 Why he launched Healthy Tennessee
6:59 Volunteers, screenings, and what the health fairs deliver
12:09 Who shows up and why access is still hard even with insurance
21:51 The biggest rural health problems and the access crunch
24:18 Private equity buying practices and what changes for patients
28:24 What policy fixes could actually move doctors to rural areas
31:41 Follow-up care for uninsured and high-risk patients
34:09 Trauma care realities and why we pay for sickness, not wellness
40:27 Faith, meaning, and why he keeps doing the work

Key Takeaways

• Rural access problems are not only about coverage; they are about workforce, consolidation, and appointment availability.
• Administrative and EHR burdens can push small practices toward sale, accelerating consolidation.
• Prevention works when it is local, trusted, and paired with real follow-up pathways.
• Incentives matter; better rural payments and stronger recruitment tools can move clinicians where they are needed.

About Our Guest
Dr. Manny Sethi is an orthopedic traumatologist at Vanderbilt and co-founder of Healthy Tennessee, a nonprofit he launched with his wife in 2011 to bring prevention and screening to underserved communities through volunteer-driven health fairs and partnerships across the state.

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Show Sponsor: Survivors for Solutions – https://survivorsforsolutions.org

Executive Producer: John “CZ” Czwartacki, DC EKG Podcast

Producer: Julie Riga, Stay on Course Studios – https://www.stayoncourse.studio