Meet Dr Janani: Clinical Director at Autonomy Health
- 2 days ago
- 8 min read
Updated: 1 day ago
Meet our new Clinical Director: an internationally recognised physician in prevention and root-cause care, on what she investigates that a standard workup can leave out.
Janani, welcome to Autonomy Health and to Auckland. How would you introduce yourself to our community?
Thank you! I’m genuinely excited to be here in Aotearoa New Zealand. I’m a specialist physician, triple-board certified in Internal Medicine, Preventive Medicine & Public Health, and Lifestyle Medicine, and I’m joining Autonomy Health as Clinical Director and Personal Doctor. Over the past 14 years I’ve worked across major academic and clinical centres in California and Texas, focused on improving the quality of and access to chronic disease care, building practical strategies for prevention at both the individual and community levels, and helping people make lifestyle change that actually sticks.
You’ve practised and taught medicine across multiple settings. Why Autonomy, and why New Zealand, at this point in your career?
I’ve been fortunate to care for people across a wide range of ethnicities, communities and socioeconomic circumstances, including in the US, Ecuador, India and the Dominican Republic. Those experiences shaped how I think about culturally responsive, equitable care, and taught me that while every person is unique, some things are universal: we all want to be heard, to feel well, and to function as our best selves. Just as often, it’s familiar, common root causes that pull us away from that.
I’m drawn to clinical care that makes a difference, and I’ve spent years building the skillset to do that at the root-cause level: evidence-based, preventive care that focuses on the modifiable determinants of health. When prevention is under-prioritised, the cost isn’t only felt as avoidable suffering at the individual level; it shows up as higher healthcare spending, lost productivity, and strain on the long-term sustainability of health systems and economies. That’s exactly why I am passionate about advocating for prevention as an economic priority, not just a health one.
New Zealand is a compelling place to do this work. Long-term conditions like cardiovascular disease, diabetes and respiratory illness affect a large share of the population here, which means there’s real scope for lifestyle-focused, preventive care to move the needle for individuals and for the country’s economic resilience. Advanced lifestyle medicine is an emerging field here, and there is growing interest in applying and harnessing the power of this type of medicine to create translatable changes in individuals and populations. I see an opportunity to bring that skillset in as this way of practising becomes more common.
What felt unique about Autonomy?
The first thing I noticed when I visited the clinic was the dedication of the whole team (yes, an entire interdisciplinary team dedicated to each patient) to providing the highest quality of care. There’s an emphasis on getting to know the full picture (habits, lifestyle, context) and a commitment to finding a root cause rather than settling for a diagnostic label. It’s so remarkable watching people visibly relax over the course of a consultation despite their histories of challenges, stressors, and chronic symptoms, even before any intervention is administered, due to the simple act of listening and spending substantial time on listening to their story. The testing and treatments matter, but honestly, it’s the effect of the doctoring here that struck me as truly top-class.
There’s also an undercurrent of humility and conscientiousness at Autonomy that is refreshing in an era leaning so heavily on artificial intelligence. It’s not about pure efficiency; the physician and nurse literally dedicate hours reviewing complex cases so the advice given is genuinely tailored, not generic. The human touch is evident throughout the service delivered, and that is why I wanted to work here. It combines the best aspects of the old-school ideal of being a doctor — spending time with the patient, earning trust, being able to sit and listen — with the accelerated benefits of modern technology.
This unique approach allows us to practise in a way that reflects and respects evidence-based care, which is paramount to high-quality service; however, there is also the ability to adjust for the individual in front of you. In other words, we are not only respecting the population average seen in clinical trials; we’re also recognising that we need to tailor the findings toward the individual person - their culture, values, and precise needs - with the history-taking and assessments to match.
What is lifestyle medicine, really?
“Lifestyle medicine” gets used a lot in wellness marketing. How do you define it as a triple-board-certified physician?
Decades of evidence, across millions of people, keep pointing to the same thing: most chronic disease — the major killers across populations — is rooted in modifiable risk factors: how we eat, sleep, move, cope with stress, and connect with others. Genes, environment and the effects of uncontrollable external events matter too, no doubt. But within each of us, there’s a locus of real control we can exert over our health trajectory, not just years of life, but the quality of those years.
Lifestyle medicine is the formal medical discipline built around that idea: using evidence-based changes in nutrition, physical activity, sleep, stress, substance use and social connection to prevent, treat and, in some cases, change the trajectory of chronic disease. Importantly, the principles of healthy eating, active living, and optimising mental health are not new. They are foundational, universally recommended across international medical guidelines as the first step in treating chronic disease. Yet, these principles are often not able to be emphasised in modern medical practice due to systems constraints, especially the lack of adequate resources, time, and the enormous burden of responsibility and pressure on hardworking primary care physicians. This is so unfortunate, because there is solid evidence that lifestyle medicine improves patient wellbeing and reduces disease burden, potentially lowering healthcare costs and supporting long-term economic and health system sustainability.
For me, lifestyle medicine isn’t a stand-alone “alternative” to conventional care. It’s the missing layer that connects treating symptoms with addressing root cause.
Can you give an example of that intersection — symptom relief plus root-cause work?
Take type 2 diabetes or heart disease. Medications and procedures are absolutely essential for addressing life-threatening symptoms and lowering risk. However, attending to symptoms or a pure pharmacological strategy without systematically the context in which those medications are taken — ie, the diet, movement, sleep, stress and social context — means that we as physicians are often just playing that arcade game of “whack-a-mole” to tamp down symptomatic problems rather than truly changing the trajectory of the disease. My work has focused on integrating rigorous symptom-focused clinical care with lifestyle and community frameworks, so patients can feel better now and build real, lasting change that supports their health.
Who Dr Janani works with
What kinds of health concerns do you typically see, and enjoy working with?
I see a broad range of patients, who usually fall within one of three groups. There are patients who aren’t symptomatic yet but are concerned about risk — family history, an abnormal blood pressure reading, or simply getting older. Others want to optimise their management of existing conditions like type 2 diabetes and cardiovascular disease, possibly seeing if there is a way to improve their lifestyle to reduce pharmacotherapy and secondary risks, as well as functioning at their best. And then, there’s an increasingly growing group of people dealing with persistent or unexplained symptoms despite trying multiple treatments and seeing multiple specialists. These patients often have multiple diagnoses and symptoms spanning neuroimmune and symptom-predominant conditions - these include things like intractable digestive issues, migraines, long COVID and fibromyalgia. For me, this group of people is one of the most rewarding populations to work with because they can actually achieve meaningful, often life-changing improvements in wellbeing with this type of comprehensive approach mixed with personalised coaching.
I’m particularly drawn to helping people who feel they’ve “tried everything” and still don’t have a clear explanation or plan. I have found that a careful, full-picture assessment with personalised coaching and ongoing care can make a real, lasting difference, and it’s one of the most rewarding parts of my practice.
You’ve done research in health equity and community engagement — does that shape your clinical practice?
Completely, it’s foundational. I believe lifestyle medicine principles should be accessible across all populations, and that they actually have real potential to narrow health disparities, given how unevenly chronic disease risk and burden fall on vulnerable communities. My work on community-engaged lifestyle medicine looked at building health equity in low-resource settings through cultural responsiveness, creating momentum for healthful change, and partnering with communities rather than prescribing change from the outside. Those lenses of equity, community, and gender-sensitive care inform every consultation I do, whether I’m working with a senior executive, a young working mother, or a recent immigrant.
What to expect in a consultation
If someone books with you at Autonomy, what will that first visit feel like?
The most consistent feedback I hear is, “No one has ever spent this much time understanding the full picture.” My approach is deliberately unhurried. We look at symptoms and diagnoses, yes, but also sleep, diet, weight history, movement, emotional health, stress, and the broader life and cultural context you’re living in. I spend as much time learning from you, the patient, as I do talking and prescribing. I use advanced testing where it’s actually useful — but just as important is not simply identifying what’s wrong, but co-designing an actionable plan that fits your actual life, culture, and values (not a theoretical ideal).
How do neuroplasticity and mind-body frameworks show up in your work?
Many people living with longstanding pain, fatigue or “medically unexplained” symptoms have nervous systems that have become sensitised over time. It’s a real brain-and-body pattern, not a proclamation of “it’s all in your head.” The path forward from this is often multifactorial, but the most important message is hope: the brain can be retrained, and new networks can be ingrained. Drawing on neuroplasticity and mind-body science, I help patients gradually retrain these patterns through targeted lifestyle change, cognitive and emotional tools, and sometimes structured programmes like pain reprocessing therapy.
From professor and programme director to Clinical Director
Before Autonomy, you held academic leadership roles. How does that background influence your care here?
I served as Associate Professor of Internal and Preventive Medicine and Assistant Dean/Director of Student Wellness at the University of Texas Rio Grande Valley, where I built and directed a residency programme weaving lifestyle medicine, community engagement and health equity into everyday training, taught medical students, and helped contribute to systems change. Mentoring young physicians to think systemically about prevention and equity, while serving some of the most under-resourced communities in the United States, taught me that the best care is both scientifically rigorous while preserving the art of caring and empathy for each individual.
Outside of medicine, what keeps you grounded?
I was born in Canada and raised across multiple continents, and exploring new ideas, environments, and cultures feels like home to me. I love being outdoors - nature is my restoration - and immersing myself in local communities, whether that means trying new foods, learning new languages, or participating in a local festival or celebration. I’m naturally curious; I love learning from patients, colleagues and local culture about what health and “ageing well” actually mean in real life, not just in textbooks. On the more playful side, I love making my kids and husband laugh and spending time hiking with them; I also enjoy running and fitness (which is truly “fun” to me), and derive great joy from both creating and listening to music. I spend a fair amount of my downtime in the kitchen developing and testing “healthy” recipes that taste good. On the whole, I try to practise what I preach, but I’m always learning and empathising with patients as I struggle through my own lifestyle blocks - so I guess I can add self-development as a hobby of sorts!
Any message you’d like to share with Aucklanders considering Autonomy?
I’m honoured to be joining the Auckland community and working alongside the talented clinical and coaching team here at Autonomy. I came into medicine wanting to make a real difference, and I’ve come to believe that’s exactly what good preventive, lifestyle-oriented care can do, both for individuals and for a health system that needs more of it. If your health story is complex, or the standard workup hasn’t quite explained what’s going on, I’d love to meet you, listen carefully, and help you build a plan that’s both scientifically grounded and personalised to you.
If your story feels familiar — a pattern no one has quite connected, or results that came back "normal" but never explained the full picture — the next step is a Discovery Consultation. It's a 30-minute conversation with one of our doctors, online or in person, to talk through what's been going on and look at what a standard panel may not have covered. Together you'll decide whether a fuller investigation makes sense. $249, no obligation.
Dr. Ula Heywood, MBChB, FACEM
Co-Founder and Lead Physician, Autonomy
