The Root Cause Medicine Podcast · Rupa Health

The Triangle Approach to Root Cause Testing with Dr. Devan Szczepanski

·54 min·3 clips

Dr. Devan says genomics, estrogen, and gut testing can explain why Lexapro helps or fails.

Dr. Kate Kresge introduces Dr. Devin Skopansky, owner of Newell Clinics and founder of Reformative Medicine, and presents the triangle method as a practical way to make sense of complicated symptoms. Skopansky starts with the idea that patients can feel stuck in a loop when anxiety, medication use, hormones, and gut issues all seem to reinforce each other. She points to an example where genomics suggest hindered serotonin handling, estrogen looks off in blood work, and the gut is also struggling. In that setting, she says Lexapro may help, but it may not be the full answer. The conversation treats the medication response as one clue rather than the final word. From there, the episode shifts into how Skopansky thinks about combining different kinds of testing and care. The goal is to see the body as linked systems instead of separate complaints. She describes being energized by the chance to do better for patients once the pattern becomes clear. That motivation shaped the way she wanted to practice medicine. Rather than fitting care into an insurance-first structure, she wanted a model that could use the triangle framework consistently. The conversation also spends time on how that clinic model came to life. Skopansky talks about delays, COVID interruptions, and the frustration of waiting to build something she believed would work better. The story moves through that process and eventually to Florida, where the model took root. Once the clinic opened, she made the triangle part of the standard way of thinking, whether someone arrived for wellness care or sick care. That structure became part of the practice identity. Kresge and Skopansky keep circling back to the idea that the business model should support the medicine, not the other way around. Skopansky explains that the triangle is not just a slogan at Newell Clinics. It shapes how the team thinks about care across ages and conditions. The episode presents that philosophy as an ongoing commitment rather than a one-time framework. It ends by pointing listeners toward a live question-and-answer opportunity with Skopansky and her team, reinforcing the show’s focus on useful education and real-world problem solving.

As heard by us

A grounded look at anxiety, hormones, and gut health through a root-cause lens.

The Root Cause Medicine Podcast treats anxiety, Lexapro, hormones, and gut trouble as parts of the same picture instead of separate complaints. Dr.

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Why you'd press play

You want a clinic-style way to connect anxiety, hormones, and gut symptoms without losing the big picture.

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