Q & A With SFGH Chief of Staff
San Francisco General Hospital is the trauma center for the entire city of San Francisco. What that means is that we are available 24/7 in order to care for all the patients, no matter what happens to them. During any given day, we are the receiving hospital for the injured for a total population of 1.5 million people. Any citizen who has a major injury in San Francisco is brought to SFGH for care, regardless of their financial status. In addition to the trauma cases that come in, we also take care of approximately 105,000 patients who receive care. That includes pregnant mothers, children and working poor people without health insurance. In addition, there is a world-class primary care division, pediatrics and many other essential services. We are also well known for our state-of-the-art health care for HIV-infected patients. In short, San Francisco General Hospital is important to all the people of San Francisco.
State regulations have mandated that we rebuild the hospital to strengthen it to withstand a major earthquake. This is a huge endeavor, since rebuilding is quite expensive. The cost of the hospital has been estimated up to $1 billion by Mayor Newsom and other city planners. It will be extremely important to pass a bond measure in order to make sure the hospital is built in the safest fashion. If the hospital is not rebuilt, a significant proportion of the population of San Francisco will have less access to medical care. San Francisco will not be the type of city it is today without what we believe is the best public hospital in the United States. Other than the seismic safety issue, what is the greatest challenge facing SFGH today?
We continue to face on a daily basis the problems with providing care for patients who are underserved and who are sick. It could be as simple as taking out or removing a cancer that has progressed to advanced stages because the patient has not received adequate health care, or treating some with the flu or pneumonia and diabetes. As part of the Health Commission's approval of the citywide trauma plan in 2001, a helipad was planned to be constructed at SFGH. In light of what happened in New Orleans following Hurricane Katrina, the medical staff believes it is essential that we build the helipad and upgrade the trauma center. In the case of a major disaster and the bridges are not passable, we will need to move patients rapidly. Air medical access would help ensure that our citizens are cared for promptly and moved swiftly in and out of the facility. This is a citywide issue for all the people in the San Francisco. Rapid treatment saves lives on a daily basis. We speak of the "golden hour" in trauma. This means that the first 60 minutes are essential to ensuring an excellent outcome after severe injury. San Francisco General Hospital is the only trauma hospital in a major city in the United States that does not have air medical access. How does the UCSF-SFGH partnership affect patient care?
Many of the physicians who work at San Francisco General Hospital are faculty members at the University of California, San Francisco's School of Medicine. This means that in addition to having the highest quality of care, there are large numbers of world-class researchers who work at our hospital. Their discoveries and innovations help ensure the best care for all the people of San Francisco. All the citizens are beneficiaries of the state-of-the-art care they receive at SFGH each day. How is the medical education and training experience unique at SFGH?
The medical education is an important part of what happens here. At any given time, we have a large percentage of residents and medical students who work at this hospital providing care to an ethnically diverse patient population. Typically, 30 percent of the residents at UCSF are at San Francisco General Hospital at any given time. In addition, there are a large number of medical students at UCSF who are receiving clinical training at the hospital. Medical students and residents work closely with the attending faculty, who are there all the time, and many cite their experience at the General as extremely valuable to their training. What is your typical day like as chief of staff?
The role of chief of staff is quite busy. There are many tasks which I have to attend to on a daily basis which involve credentialing for the medical staff in the hospital. In addition, I am involved with helping the administration deal with outside regulatory bodies that come and survey the hospital, like JCAHO [Joint Commission on Accreditation of Healthcare Organizations] and the Department of Health Services in California. I am involved a number of important operational issues that involve the medical staff. I do all this, and I work as a general and trauma surgeon at San Francisco General Hospital caring for the citizens of San Francisco. Why did you decide to become a doctor?
I decided to become a doctor when I was in junior high school because I enjoyed science and biology a great deal. I felt at the time that medicine would give me a chance to connect my love of science and my interest in helping people. I did not have many role models in my family, but I thought it was important that I made a difference with my life. Every day when I go home, I can say that I have had a positive impact on people's lives. It is an honor and a privilege to work as a physician each day and affect people's lives. How has the practice of medicine changed during your career?
Medicine is continually changing on several levels. The first is that academically, every day there are new things that are discovered in medicine. Many of these new discoveries are integrated into the medical practice. Although medicine is challenging, it is overall a wonderful experience and it is a truly exciting career. Photo by Elisabeth Fall Source: Lisa Cisneros