Rishi Manchanda has worked as a doctor in South Central Los Angeles for a decade, where heโs come to realize: His job isnโt just about treating a patientโs symptoms, but about getting to the root cause of what is making them illโthe โupstream” factors like a poor diet, a stressful job, a lack of fresh air. Itโs a powerful call for doctors to pay attention to a patient’s life outside the exam room.