UCSF Dept of Family and Community Medicine Grand Rounds 

Held every first Friday of the month from 12-1pm.

 

How do I participate in the upcoming Grand Rounds?

To be added to the invitation list and receive the link please email: F[email protected]

To view past presentations please visit our playlist: FCM Grand Rounds playlist 

Upcoming Presentation

No FCM Grand Rounds in July 2024. Next presentation August 2, 2024. - Details TBA

     

Past Presentations

June 7, 2024 - Person-centered approaches to sexual and reproductive healthcare delivery through the lenses of health equity and racial justice

May 3, 2024 - Family Medicine Physician Researchers: A critical component of an equitable and effective primary care infrastructure

April 5, 2024 - The Changing Landscape of Primary Care: a Canadian perspective

March 1, 2024 - Community Grand Rounds: Equitable Relationships for Equitable Health Outcomes

February 2, 2024 - Preparing the Next Generation of Leaders and Change Agents

December 1, 2023 - Expanding Self-Injectable Contraceptives in the US from a Person-Centered Perspective

November 3, 2023 - Health Services and Outcomes Research to Support Quintuple Aim in Primary Care

October 6, 2023 - Expanding on Alcohol Harm Reduction: The San Francisco Department of Public Health Managed Alcohol Program

September 1, 2023 - Aging and End of Life Care in an Incarcerated Setting

July 7, 2023 - Caring for Trans and Gender Diverse People - Evidence Based Medicine Across the Lifespan

June 2, 2023 - Why Defining Health Is Radical: Implications for Health Equity, Value, and National Health

May 5, 2023 - Dr. Martin Shapiro - The Present Illness: American Health Care and Its Intractable Afflictions

April 7, 2023 - Dr. Megan Mahoney - Demoralization in Medicine with a focus on Strategies and Solutions

March 3, 2023 - Dr. Michael Fine - What is Medicine For? - Reflections from On Medicine as Colonialism

February 3, 2023 - Dr. Hillary Kunins - San Francisco's Approach to Improving Behavioral Health Services

December 2, 2022 - An Equity First Paradigm for Health Care: Hard Earned Lessons from the UCSF Health Response to COVID

November 4, 2022 - Safety for All and Care without Criminalization: A DPH Must Divest Intro to Patient Rights

October 7, 2022 - Dr. Meghan O'Brien - From Eggshells to Action: Preparing to Address Microaggressions Targeting Learners

September 2, 2022 - Dr. Ayanna Bennett - Moving from Intention to Action on Health Equity

June 3, 2022 - Daniel Dawes, JD - The Political Determinants of Health: Advocating for Equitable Health Outcomes

May 6, 2022 – Dr. Maura Jones, Dr. Deb Borne, & Dr. Jack Chase – “ Anti-coercion Ethics and the Avoidance of Medical Harm: A Case-based Discussion”

April 1, 2022 - Dr. Ron Goldschmidt, Brenda Goldhammer, Dr. Betty Dong, Dr. Christine Pecci, Dr. Carolyn Chu – “The National Clinician Consultation Center: 30 years (and counting) of tele-consultation for provider capacity-building and public health service”

March 4, 2022 - Nazineen Kandahari & Nilufar Kayhani – “Afghan Clinic: Barriers to Health for Afghan Refugees & How We Can Address Them”

February 4, 2022 – Dr. Christine Dehlendorf, Dr. Lealah Pollock, & Dr. Montida Fleming – “Family Medicine and Abortion: Responding to the Evolving Crisis in Access to Reproductive Health Care”

January 7, 2022 – Dr. Garen Wintemute – “Firearm Violence: Where We Stand, What We Can Do”

December 3, 2021 – Dr. Shira Shavit & Joe Calderon, CHW – “Who We Hire Matters: How Health Systems Address Structural Racism Through Hiring People with Histories of Incarceration”

November 5, 2021 – Dr. Saul Weiner – “Contextualizing Care: An Essential and Measurable Clinical Competency”

October 1, 2021 – Dr. Emilia De Marchis, Dr. Matt Pantell, & Dr. Caroline Fichtenberg – “Should we screen for and document social risk in health care settings?”

September 3, 2021 – Dr. Sundeep Gupta & Professor Address Mauakowa Malata, PhD – “Redefining Global Health through Structural Competency and Allyship”

August 6, 2021 – Dr. Tricia Elliott – “Addressing Racism and Advancing Health Equity In and Beyond the Exam Room”

June 4, 2021 – Dr. Ina Park – “Strange Bedfellows:  Adventures in the Science, History, and Surprising Secrets of STDs.” 

May 7, 2021 – Dr. Rita Hamad - “Social Policies to Address Health Inequities: Harder Than It Looks”

April 2, 2021 -  UCSF faculty, staff, and community partners - STOP COVID-19 CA Project - "Achieving Racial and Ethnic Equity in COVID-19 Vaccination: Learnings from Community Based Participatory Research." 

March 5, 2021 - Dr. Kevin Grumbach and Dr. Juliana Morris - “The Lancet Commission: Health and Health Policy in the Trump Administration"

 

June 7, 2024 - Person-centered approaches to sexual and reproductive healthcare delivery through the lenses of health equity and racial justice

                                 

Diana Carvajal, MD, MPH           Rachel Logan, PhD, MPH, CPH

This presentation delves into the critical issues of health equity and racial justice within sexual and reproductive healthcare. In this session, we examine the historical and structural roots of injustices in sexual and reproductive health, shedding light on longstanding inequities in care delivery. Through patient narratives and contemporary examples, we'll discuss how individuals with socially marginalized identities navigate the complexities of sexual and reproductive healthcare. With insights from a family physician and a public health researcher – drawing from data and lived experiences, we'll underscore the pressing need for systemic change, beginning with strategies for the clinical community.

Diana N. Carvajal, MD, MPH (she/her/ella) is an Associate Professor, a practicing family physician and a health services researcher in the Department of Family and Community Medicine at the University of Maryland School of Medicine (UMSOM).  She is Director of Reproductive Health Education within the department’s residency program and also co-leads the department’s research division. She completed her residency at Columbia University Medical Center in NY, NY, her MPH at the Johns Hopkins Bloomberg School of Public Health, and her Primary Care Health Services Research fellowship at the University of Maryland School of Medicine. In her research, Dr. Carvajal focuses on addressing reproductive health inequities for the most disadvantaged communities and employs lenses of Reproductive Justice and Intersectionality to understand how clinicians can best support and communicate with their patients about important reproductive health decisions. In addition to her academic and clinical roles within the University of Maryland SOM, she is also the Director of Diversity, Equity, Inclusion and Strategic Planning for RHEDI based at the Montefiore Medical Center/Albert Einstein College of Medicine in the Bronx, NY. In this role, she leads the development and implementation of programs to diversify the reproductive health workforce in Family Medicine.

Rachel Logan, PhD, MPH, CPH, is a Research Specialist who completed a postdoctoral fellowship in the department and has a background in public health. Her work centers Black and other socially marginalized communities in strategies to improve sexual and reproductive health care experiences. She lives in Florida and is committed to realizing health equity and racial justice throughout the U.S., particularly in the Southeast.

 

May 3, 2024 - Family Medicine Physician Researchers: A critical component of an equitable and effective primary care infrastructure

Christine Dehlendorf, MD, MAS

Michael Potter, MD 

Kevin Grumbach, MD 

Anjana Sharma, MD, MAS 

Hunter Holt, MD, MAS

Family medicine physicians are uniquely placed to understand what research should be done to improve the ability of our health care system to provide equitable, patient-centered primary care. However, the culture of family medicine does not always recognize or embrace this potential, at least in part due to the perception that research is inherently disconnected from the immediate needs of the communities we serve. In this session, five family medicine physicians who conduct research on a range of topics and using a range of methodologies will discuss their paths to becoming clinician researchers, and how their identity as a family physician interrelates with and informs their identity as a researcher. They will further reflect on the relationship of their research, and of research in general, to our departmental mission to advance health equity. 

Christine Dehlendorf, MD, MAS, is a Professor and Vice Chair for Research in the Department of Family and Community Medicine at the University of California, San Francisco, with additional appointments in the Departments of Obstetrics, Gynecology and Reproductive Sciences and Epidemiology and Biostatistics. She founded and directs the Person-Centered Reproductive Health Program, which aims to advance reproductive autonomy and well-being by conducting research and designing programs that center people’s experiences and preferences for sexual and reproductive health and health care, guided by an attention to the intersecting oppressions and structural injustices that impact people’s lives and health. She also provides primary care and reproductive health care at the Family Health Center at San Francisco General Hospital and Planned Parenthood.  

Michael Potter, MD is a graduate of the family medicine residency program at UCSF’s San Francisco General Hospital, where he also served as chief resident.  He has been a professor in UCSF’s department of family and community medicine for nearly 30 years. During the course of his career he has split his time in variable proportions between clinical care, teaching, and practice-based research.  His research has always been informed by the experiences and insights of practicing family physicians caring for diverse communities and patient needs with limited resources.  Findings from several of his research studies have been disseminated and incorporated into common clinical practice nationally.  He currently directs several programs within UCSF’s Clinical and Translational Science Institute, including its Research Infrastructure Network, Collaborative Research Network, and Team Science Program.

Kevin Grumbach, MD is Professor of Family and Community Medicine at the University of California, San Francisco. He served as Chair of the UCSF Department of Family and Community Medicine from 2003-2022. He is a Founding Director of the UCSF Center for Excellence in Primary Care and Director of the Community Engagement Program for the UCSF Clinical and Translational Science Institute. Throughout his career he has wrestled with translating his research and scholarship on the primary care workforce, innovations in primary care, racial and ethnic diversity in the health professions, and community health improvement and health equity into changes in policy and practice. Dr. Grumbach has been an advisor to Congressional Committees and government agencies on primary care and health reform and a member of the National Advisory Council for the Agency for Healthcare Research and Quality, and currently serves on the California Health Workforce Education and Training Council.

Anjana Sharma, MD, MAS, is Associate Professor of Family & Community Medicine. She practices at the Family Health Center at San Francisco General Hospital. Her research focus is patient and community engagement in primary care. This includes implementing and assessing patient advisory councils, community-engaged research on telehealth, and involving patients and community in the FCM residency. 

Hunter Holt, MD, MAS is a board-certified family medicine physician and assistant professor in the University of Illinois, Chicago Department of Family and Community Medicine. Dr. Holt is focused on researching and implementing solutions that improve patient experiences and health outcomes related to reproductive health and cervical cancer prevention. In medical school, at Rush University, Dr. Holt traveled to China as a NIH Fogarty Global Health Fellow to research cervical cancer prevention in China. Working with the Cancer Institute of China, Dr. Holt investigated cervical cancer screening in Chinese migrant workers and post-menopausal Chinese women. As a family medicine resident at the University of Illinois, Chicago, Dr. Holt was a part of the Global Health Track working in Senegal to implement sustainable solutions for cervical cancer prevention in rural Senegal. As a Primary Care Research Fellow at UCSF, Dr. Holt completed his master’s degree in Clinical and Epidemiological Research and worked to understand the reasons behind disparities in cervical cancer incidence and mortality. Currently Dr. Holt is working to finding solutions to reduce these cervical cancer disparities and promote health equity.

 

April 5, 2024 - The Changing Landscape of Primary Care: a Canadian perspective

Danyaal Raza, MD

In this presentation, Dr. Raza will (1) Provide a brief overview of the Canadian health care system, (2) outline how primary care and family medicine fit in, and (3) explore the contemporary crisis and opportunities for reform.

Danyaal Raza is a family physician with Unity Health Toronto’s St. Michael’s Hospital, and Assistant Professor with the University of Toronto’s Department of Family & Community Medicine. He is the founding physician lead of the Sumac Creek Health Centre in Toronto’s Regent Park, the largest social/public housing community in Canada, and a member of the Decent Work & Health Network. Dr. Raza has also served as Chair of Canadian Doctors for Medicare, is a Fellow of the Broadbent Institute, and in 2021 was named to The Medical Post’s ‘Power List’ as an influential physician voice in Canadian health policy.

 

March 1, 2024 - Community Grand Rounds: Equitable Relationships for Equitable Health Outcomes

Shavonne Allen               Sam Dennison                  Freddy Martin               Monica Hahn, MD

In this Grand Rounds presentation, we are putting community voices front and center. Residents of the Tenderloin (San Francisco’s most diverse neighborhood) and Dr. Monica Hahn (FCM) will be in dialogue with each other and with you, discussing strategies for creating effective, supportive collaborations for institutional and structural change at UCSF. We began this work in 2021, amid the chaos of COVID and discovered in the process what it looks like to mutually honor the experiences of those struggling to access care and those juggling inequitable resources and burnout as they provided care. We will tell you the history of this project, how it supports our work as community and healthcare advocates, and how you can find your place in similar communities of change agents. 

Shavonne Allen, Skywatchers Ensemble, San Francisco Artist and Resident, is a community leader whose creative talents bring light to the needs of the community and uplifts the talents of all.  

Sam Dennison, Faithful Fools, Tenderloin Resident, is a community advocate who challenges UCSF to deepen community partnerships with unlikely allies for deep institutional change.

Freddy Martin, Congregational Life & Community Engagement Manager Glide Memorial Church, Skywatcher, whose depth of commitment brings people together and knits community threads into vibrant patterns.

Monica Hahn, MD, MPH, MA, AAHIVS, Associate Clinical Professor at UCSF in the Department of Family & Community Medicine and OBGYN, is a valued community collaborator and liaison between UCSF and community residents who opens UCSF doors to otherwise unheard community voices.

 

February 2, 2024 - Preparing the Next Generation of Leaders and Change Agents

Katherine Mathews, MD, MPH, MBA

In this Grand Rounds presentation, Dr. Mathews will discuss strategies for training medical students to be leaders and change agents in medicine and society at large.  Many medical students bring passion to our profession and are often distressed to learn about the entrenched structural inequities within the US health care system.  This combination of passion and distress can lead students to jump to solutions that have the potential to do more harm than good.  By focusing on self-awareness, moral humility, perspective taking, teamwork, and cultivating a "lifelong learner" mindset, Dr. Mathews prepares students for leadership as a long-term endeavor that is best done in partnership with others.  She will review both opportunities and challenges with this approach.

Katherine Mathews, MD, MPH, MBA, is an Ob/gyn physician with a background in international work, healthcare administration, and public health.  She has lived and worked in St. Louis, Missouri, for over 25 years and has been engaged in many regional initiatives to improve access to quality care for low-income communities.  She currently serves as the Associate Dean of Health Systems Science at Saint Louis University School of Medicine where she teaches leadership and oversees many community focused initiatives.

 

December 1, 2023 - Expanding Self-Injectable Contraceptives in the US from a Person-Centered Perspective

Jennifer Karlin, MD, PhD

In this Grand Rounds presentation, Dr. Karlin will focus on her research in expanding injectable contraceptives in the US for self-injection. She will trace three steps of a research program thus far—starting with an implementation project at the Family Health Center during the COVID-19 pandemic, to qualitative interviews with patients in San Francisco and Washington State, to a nation-wide survey and interviews of interprofessional health care providers about barriers and facilitators to expansion of the contraceptive. Tracing these three arms of this research program so far and discussing next steps, Dr. Karlin will use this example of expanding self-injectable contraceptives to illustrate how research can remain centered on equity, sustain a person-centered lens, and develop more formal research plans from an emergent need.

Dr. Karlin, MD, PhD, is a board-certified family physician and fellowship-trained family planning specialist who completed her residency and fellowship in this department and currently is on faculty at UC Davis. She focuses on expanding and supporting reproductive and sexual health through primary care. Trained as an anthropologist and historian of medicine, her research addresses how we can alter health care relationships and systems to encourage patient empowerment, autonomy, and equity. Additionally, Dr. Karlin is committed to medical and resident education that encourages physicians-in-training to approach their practices from an historical, trauma-informed, and self-reflexive perspective to improve quality of care and decrease additional trauma caused by the medical system.

 

November 3, 2023 - Health Services and Outcomes Research to Support Quintuple Aim in Primary Care

Tapan Mehta, PhD, MSEE

This presentation will describe use of pragmatic study designs and artificial intelligence/machine learning to develop sustainable and scalable programs to improve population health outcomes and address health equity. Studies illustrating use of these designs will be presented. The relevance of these techniques to support a learning health system approach for primary care will be shared.

Tapan Mehta, PhD, MSEE, is a health services researcher with training in biostatistics and engineering. He currently serves as a tenured Professor and Vice Chair for Research at University of Alabama at Birmingham’s Department of Family and Community Medicine with a secondary appointment in the Department of Health Services Administration. His independent research interests are in health services and outcomes research related to disabilities and cardiometabolic conditions with a focus on knowledge generation in pragmatic settings, and strategies in translating knowledge that can influence practice and policy. He is an MPI of two NIH-funded optimization studies focused on developing sustainable diabetes management programs to support health equity. He also leads the data coordinating center for the CDC-funded National Center on Health, Physical Activity and Disability with an objective of health equity for people with disabilities and co-directs the NIH-funded Nutrition Obesity Research Center’s Behavioral Science and Analytics. He has published over eighty peer-reviewed articles, and authored/co-authored in journals such as JAMA, New England Journal of Medicine, Obesity, Nature Genetics, and American Journal of Physical Medicine and Rehabilitation.

 

October 6, 2023 - Expanding on Alcohol Harm Reduction: The San Francisco Department of Public Health Managed Alcohol Program

Alice Moughamian, RN and CNS      Bryce Bridge, LMFT            Tanya Majumder, MD MS

The San Francisco Department of Public Health's Managed Alcohol Program (MAP) started in 2020 as a COVID I&Q response for people who drink alcohol but has become a permanent part of the city's harm reduction services.  During our presentation, we will discuss how our MAP began, define the scope and purpose of MAPs, describe the different MAP care models in the literature, and identify key ethical issues at play in alcohol harm reduction work. 

Alice Moughamian, RN serves as Nurse Manager of the Managed Alcohol Program and the San Francisco Sobering Center for the San Francisco Department of Public Health.  In addition to this role, she was Nurse Manager and Program Director of the Medical Respite Program as well as nursing services in permanent supportive housing before devoting full time to Managed Alcohol and Sobering.  She completed the CHCF Healthcare Leadership Fellowship in 2020.  Alice has also served as Chair of the National Healthcare for the Homeless Council’s Respite Care Providers Network and helped develop national standards for Medical Respite care. She worked as a floor nurse at UCSF Medical Center for 4 years and did her clinical studies for her Masters degree at Zuckerberg San Francisco General Hospital’s Positive Health Program. Alice served as a Peace Corps volunteer in the Dominican Republic for 3 years between college and nursing school. When not working, Alice’s greatest joy is going on new adventures and spending time with her husband and two children.

Bryce Bridge, LMFT is a clinical supervisor for Sobering Center Case Management, a low-barrier, intensive-case management program for people who use alcohol. Bryce obtained his master's degree in clinical psychology from San Francisco State University and is a Licensed Marriage and Family Therapist. Bryce has worked in community mental health and substance treatment with marginalized populations throughout the past decade and has been employed at UCSF Citywide Sobering Center Case Management since 2019.

Tanya Majumder, MD is the Lead Physician of the Managed Alcohol Program and the Sobering Center and is also a primary care physician with Street Medicine, Shelter Health, and Urgent Care. She completed medical school and her master's in health and medical sciences at the Joint Medical Program between Berkeley and UCSF before attending residency in Internal Medicine-Primary Care at the Yale Primary Care program.  She has greatly enjoyed being part of the Whole Person Integrated Care team for the past 4 years.  

 

September 1, 2023 - Aging and End of Life Care in an Incarcerated Setting

Michele DiTomas, MD, MS

Decades of harsh sentencing laws have resulted in over 200,000 people in the Unites States currently serving life sentences with a disproportionate impact on people of color. In California, despite an overall decline in the numbers behind bars in the last decade, the number of people age 55 and older has nearly doubled. Studies have shown that the chronic disease burden and degree of functional impairment of incarcerated people is similar to those 10-15 years older in the community as more and more older adults are facing the prospect of aging, coping with serious illness and dying in prison. How do we, as a society and as clinician advocates better meet the needs of this aging population pre-sentencing, during incarceration and upon reentry?

Michele DiTomas, MD, MS is currently the Chief Medical Executive over the Palliative Care Initiative with the California Correctional Healthcare Services, which strives to improve whole person care for those struggling with the challenges of serious illness and aging behind bars. Since 2007, she has served as Chief Physician and Hospice Medical Director at the California Medical Facility, which provides end of life care to men incarcerated in the California Department of Corrections. She earned her MD from the UCSF/UC Berkeley Joint Medical Program and completed her residency at the UCSF Department of Family and Community Medicine. 

As Hospice Medical Director she works with the hospice team to create an environment where patients can live their final days with dignity, respect and comfort despite their incarceration. The hospice team supports the patients and their families in achieving compassionate release and, when this is not possible, provides a setting where they are able to have meaningful visits and often find reconciliation and closure at the end of life. 

 

July 7, 2023 - Caring for Trans and Gender Diverse People - Evidence Based Medicine Across the Lifespan

Maddie Deutsch, MD, MPH

Trans and Gender Diverse People need access to quality healthcare. This "Gender Affirming Care" can include medical or surgical care to align one's body with their identified gender, as well as access to a full scope of medical care that is respectful and culturally grounded, and acknowledges gender identities as valid.  Recent political developments have added an additional layer of complexity to the barriers to care and disparities faced by this vulnerable population. In this talk, Dr. Deutsch will review current evidence in selected areas of gender affirming care for children, adolescents, and adults of all ages.

Maddie Deutsch, MD, MPH is a Professor of Clinical Family & Community Medicine at UCSF, and the founding Medical Director for the UCSF Gender Affirming Health Program, a multidisciplinary group of medicine, surgical, and behavioral health providers for trans and gender expansive adults at UCSF Health.  She is a Co-Director for the UCSF School of Medicine Differences Matter Initiative, and a DEIB Co-Lead for UCSF Health.  Dr. Deutsch has authored or co-authored more than 50 peer reviewed journal articles in the field of sexual and gender minority health, and was a co-author, and Primary Care Chapter Lead, for the recently released WPATH Standards of Care, 8th Version.  She is the current President of the US Professional Association for Transgender Health.

 

June 2, 2023 - Why Defining Health Is Radical: Implications for Health Equity, Value, and National Health

Kevin Fiscella, MD, MPH

Concepts matter. There is a current political struggle in the US over the meanings of "race," "racism," and "wokeness." In this presentation," I argue that defining "health" is a radical idea. The meaning of health has profound implications for how we organize research, healthcare, and ultimately society. For this reason, our nation has avoided defining health. This definitional void yields a default disease-based biomedical definition of health. The consequences of this default definition are profound: 1) enabling research and healthcare funding that supports the biomedical-industrial-healthcare complex; 2) obscuring deeper meanings of health equity; 3) trivialization of social determinants of health 4) marginalization of primary care; 5) contributing to unprecedented declines in national health, wellbeing; and 6) perpetuation of gross inequities in health. The concept of health has profound implications for what it means to be human, to care for self and others, and for the social conditions that enable people to optimize their full health potential. We need a national dialogue on the meaning of health and critically how to enable it through research, healthcare, and societal change.

Kevin is a tenured professor in the Department of Family Medicine at the University of Rochester School of Medicine. He is co-director of the department research division and co-director of the equity-focused dissemination and implementation core within the University of Rochester Clinical and Transnational Science Institute. He is worked as a family physician in FQHCs caring for multigenerational families, including people living with HIV and substance use disorder, for 40 years. He is a health services researcher whose research career has addressed health and healthcare equity. His current research and mentoring involve the application of implementation science to promote health equity within health care and the community. Kevin is currently leading a scoping review for AcademyHealth on equity and value in US healthcare and a NASEM-commissioned review of trends in racial and ethnic inequities in healthcare access and quality in the US.

 

May 5, 2023 - The Present Illness: American Health Care and Its Intractable Afflictions

Martin Shapiro, MD, PhD, MPH

Drawing on the analyses in his recent book, The Present Illness: American Health Care and Its Afflictions, Dr. Shapiro will explore the reasons why it has been so difficult to solve the many problems in American health care. He identifies three underlying phenomena that shape the behavior of physicians and their organizations, medical schools and their faculty, hospitals and health systems, other corporations in the health sector, scientists and their sponsors, and also patients and the public. These are the commodification of health care and health by all the groups of participants; the consciousness of the actors—their attitudes, values, expectations, interests, and perceived needs; and the communication and the structure of the relationships across these groups, which tend to reinforce the worst tendencies in all groups. He will discuss a range of steps that can be taken to address these many problems, but that meaningful reform will need to be broad and deep.

Dr. Martin Shapiro obtained his medical degree from McGill University and a PhD in history and Master’s in Public Health from UCLA. He is Professor of Medicine at Weill Cornell and Distinguished Professor Emeritus of Medicine and Public Health at UCLA. Prior to coming to Cornell, he spent many years at UCLA, where he was chief of the Division of General Internal Medicine and Health Services Research for 25 years. He is a general internist who has practiced both inpatient and outpatient GIM. He also is a health services researcher who has studied accessibility of care and health disparities, scientific misconduct, pharmaceutical advertising, and scientific authorship, among other topics. He led a major national study of care for HIV disease. He is also interested in such conditions as hypertension and hepatitis C, in empowering communities in relation to the research enterprise, and in trying to improve health and health care for those most in need. He is an elected member of the American Society of Clinical Investigation and of the Association of American Physicians and is a past president of the Society of General Internal Medicine. He enjoys mentoring students, residents, fellows and junior faculty members. His new book, The Present Illness: American Health Care and Its Afflictions, has just been published by Johns Hopkins University Press.

 

April 7, 2023 - Demoralization in Medicine with a focus on Strategies and Solutions

Megan Mahoney, MD

Changes in the health care system have altered the nature of primary care clinician’s interactions with patients and our sense of empowerment to improve the practice environment. Profound health disparities have caused disillusionment and dwindling faith in the systems for which we work. Strategies and solutions lie in the fact that we are internally motivated when we believe in what we are doing and feel part of a community. The objective of this presentation is to review the evolution of demoralization in medicine and discuss evidence for coalition-building to drive change and restore wellbeing.

Dr. Megan Mahoney is the Hellman Endowed Professor and Chair in the UCSF Department of Family and Community Medicine. Throughout her career, Dr. Mahoney has built and led sustainable initiatives in provider engagement, quality improvement, and DEI for health care organizations. Her research has focused on the impact of primary care team cohesion on burnout, and the influence of diversity and inclusion on individual and team wellbeing. She has presented on team wellness as a keynote speaker at national and international meetings, and served as long-term faculty for the national Chief Wellness Officer Course – an executive program for physician well-being leaders. Dr. Mahoney earned her B.A in Molecular and Cellular Biology at the University of California Berkeley and her M.D. at the University of California San Francisco. She completed the UCSF Family Medicine Residency Program at San Francisco General Hospital.

 

March 3, 2023 - What is Medicine For? - Reflections from On Medicine as Colonialism

Michael Fine, MD

What is Medicine For? - Reflections from On Medicine as Colonialism uses On Medicine As Colonialism as a point of departure to discuss evidence-based ways in which medicine and healthcare can be effective at improving population health, as we strengthen and bring resilience to communities. Dr. Fine encourages residents to keep their eyes on the prizes of population health and community resilience and to listen to patients and communities, so that physicians in training aren't overwhelmed by the demands of healthcare bureaucrats and profiteers.

Michael Fine, MD is an award-winning author, community organizer, public health expert/leader, and family physician. Dr. Fine is the author of On Medicine As Colonialism (PM Press, 2023), which explores the way medicine and health care have been used by health care profiteers to co-opt the state’s regulatory power, Medicare, and Medicaid and extract resources from communities and upend democracy in the U.S.; Health Care Revolt, an expose, manifesto and playbook that exposes the failures of the healthcare market to deliver health and plans a movement to build the healthcare system the US needs (PM Press, 2018); Abundance, a novel about two young Americans caught up in the Liberian civil wars of 1998-2003 (PM Press, April 2019);  The Bull and Other Stories (Stillwater River Press, 2020) ; and Rhode Island Stories (Stillwater River Press, 2021).  He is the coauthor, with James W. Peters, of The Nature of Health (Radcliffe, 2007), a study of healthcare services, human rights, society, technology, and industry; and The Zero Calorie Diet (Red House Press, 2010), a look at the culture of excess through the lens of fasting.  The Bull and Other Stories was the 2021 IPNE Literary Fiction Book of the Year.

Dr. Fine serves as Chief Health Strategist for the City of Central Falls Rhode Island.  Dr. Fine served in the Cabinet of Governor Lincoln Chafee as Director of the Rhode Island Department of Health 2011-2015, overseeing a broad range of public health programs and services, 450 public health professionals and managing a budget of $110 million a year. 

February 3, 2023 - San Francisco's Approach to Improving Behavioral Health Services

Hillary Kunins, MD, MPH, MS

As we navigate multiple, intersecting public health crises, including the COVID-19 pandemic, systemic racism, homelessness, and the opioid/fentanyl overdose epidemic, there is unprecedented need for mental health and substance use care in the City. Dr. Kunins will share how the San Francisco Department of Public Health is growing and transforming behavioral health services to expand access to timely, equitable, and well-coordinated care. 

Dr. Hillary Kunins is the Director of Behavioral Health Services and Mental Health San Francisco at the San Francisco Department of Public Health (SFDPH). In 2021, she joined SFDPH from the New York City Department of Health and Mental Hygiene (DOHMH) where she served as the Executive Deputy Commissioner of Mental Hygiene from 2019 to 2021 and as the Assistant Commissioner for the Bureau of Alcohol and Drug Use from 2012 to 2019.  

At DOHMH, Dr. Kunins led the reimagining of New York City's public health approach to substance use and served as the DOHMH lead for Mayor Bill de Blasio’s $60 million HealingNYC initiative to address the overdose epidemic. She has dedicated her career to creating health equity through science-based public health and healthcare programs and policy for people with behavioral health concerns, including substance use disorders and serious mental illness.  

Dr. Kunins received her MD and MPH from Columbia University and her MS in Clinical Research from Einstein College of Medicine. She completed her primary care-internal medicine residency and chief residency at Montefiore/Einstein. Dr. Kunins is a Fellow of the American College of Physicians and of the American Society of Addiction Medicine. 

 

December 2, 2022 - An Equity First Paradigm for Health Care: Hard Earned Lessons from the UCSF Health Response to COVID

Pilar Collins, MPH, MSW, PMP     Tasha Toliver, MSHE       Kevin Grumbach, MD

The UCSF Health COVID Equity Work Group was formed in November 2020 to address racial-ethnic inequities in COVID-19 among UCSF Health patients, UCSF employees, and the San Francisco community. Members of the COVID Equity Work Group will describe the multifaceted interventions implemented to promote equity in COVID vaccination. An evaluation of these efforts informed development of a new framework—an Equity First paradigm—that shaped ensuing UCSF Health equity interventions for COVID test-to-treat strategies and MPX vaccination. The presentation will highlight both the progress achieved and the ongoing challenges in moving a large health care institution to make Equity First a standard operating procedure. 

Pilar Collins is a Senior Organizational Consultant in the Health Equity Division, Department of Quality and Patient Safety, at UCSF Health, and co-chair of the COVID Equity Work Group. The Health Equity division serves as the health system’s strategic and operational engine to advance health care equity. Pilar has a keen focus on leading UCSF Health to define and operationalize an Equity First strategic vision and framework. Prior to her current position, Pilar worked in Information Technology at UCSF Health, where she was the Manager leading UCSF Clinical Systems Customer Engagement applications team supporting the new technologies at Mission Bay Hospital and prior to that was the Information Technology Program Manager on the Mission Bay Hospitals project construction team, leading multiple infrastructure and applications teams. She has both a Master’s Degree in Public Health and Master’s Degree in Social Work from UC Berkeley and is a certified Project Management Professional. 

Tasha Toliver is the manager for UCSF Health’s Population Health Outreach team which focuses on closing care gaps. Prior to this position she was the operations manager for UCSF’s COVID hotline which was created at the beginning of 2020 in response to the pandemic, and won a UCSF Health Team PRIDE award in 2021. She originally joined the Office of Population Health in 2014 as a Health Care Navigator with the Care Support Program. This team was awarded a Team PRIDE award in 2018. She holds a Master’s Degree in Health Education from Kaplan University. Tasha has a passion for Diversity, Equity, and Inclusion work and has presented at UCSF’s Town Hall on Health Equity interventions.

Kevin Grumbach is Professor of Family and Community Medicine at UCSF. He served as Chair of the UCSF Department of Family and Community Medicine from 2003-2022, and as Vice President for Population Health for UCSF Health from 2015-2018. He is co-chair of the Health Equity Work Group at UCSF Health. He is a Founding Director of the UCSF Center for Excellence in Primary Care and Director of the Community Engagement Program for the UCSF Clinical and Translational Science Institute. He cares for patients at the Family Health Center at San Francisco General Hospital and the Lakeshore Family Medicine Center at UCSF Health.

 

November 4, 2022 - Safety for All and Care without Criminalization: A DPH Must Divest Intro to Patient Rights

Ana Delgado, Ji Seon Song, Nida Bajwa, Norman Archer, Jake Sonnenberg, Kelley Butler

Over the last two years DPH Must Divest has organized at SFDPH to abolish contacts with the San Francisco Sheriff’s Department, build-up non-policing crisis responses, and transform the culture of our hospitals and clinics. SFDPH is in the violent minority as one of the <1% of systems nationwide dependent on law enforcement alone to provide security. We know that policing in the hospital is a racial justice issue, with 70% of use of force incidents being against Black patients and visitors in the ED in 2019, despite representing only 24% of the patient population. In this Grand Rounds presentation, we will give a framework for thinking about abolition and the history of our campaign to get the Sheriffs out of our hospitals and clinics. We will then introduce Know Your Rights materials regarding policing in the hospital, presented by a law professor and law school graduate, and ground these protections in a conversation between two FCM Residents. Finally, we will offer further resources to interrupt criminalization and get involved with our campaign. 

Ana Delgado, MS, RN, CNM is a Clinical Professor in the Department of OBGYN, SFGH Division. Ana splits her time between clinical practice and administration, teaching, and community-based advocacy. Ana is active both regionally and nationally in efforts to diversify the midwifery workforce, support physiologic birth, and participates in community-based efforts to support and care for people throughout the reproductive life cycle. Ana sees abolition as a key part of ensuring that families can thrive.

Ji Seon Song is a professor of law whose teaching and research focuses on criminal law, criminal procedure, and policing. Prof. Song’s scholarship examines the deployment of policing authority and corresponding effects on racial minority and other marginalized groups. Her research informs interventions that address race- and class-based disparities in policing practices. Prof. Song’s scholarship draws on her years of practice experience. Previously, Prof. Song represented youth and adults as a Deputy Public Defender at the Contra Costa County Office of the Public Defender and as a Prettyman Fellow at the Georgetown University Law Center. She also worked as a senior policy advocate for the National Juvenile Defender Center. Prof. Song joins UCI Law from Stanford Law School, where she was a Thomas C. Grey Fellow and Lecturer in Law while developing an extensive research project on policing in hospitals. 

As part of her research on policing in hospitals, Prof. Song regularly conducts trainings and provides consultation for medical providers on the intersection of medical care and policing. Prof. Song is also a well-known advocate for local, regional, and national juvenile justice reform. She currently serves on the Executive Board of the Pacific Juvenile Defender. Prof. Song clerked for the late Honorable Deborah A. Batts of the Southern District of New York.

Prof. Song earned a B.A in East Asian Languages and Cultures with a minor in Music from Columbia College, Columbia University, a J.D. from Columbia University School of Law, and an LL.M. from Georgetown University Law Center.

Nida Bajwa is a second-year UCSF resident in family medicine. She graduated from Northwestern University with a degree in journalism and global health studies. In medical school she was involved in anti-deportation and anti-racist work.

Norman Archer is a third-year medical student at UCSF. He completed his undergraduate degree at the University of North Carolina, Chapel Hill, where he studied public health, nutrition, and medical anthropology. He previously worked in advocacy, policy, and research at Housing Works in New York City.

Jake Sonnenberg is a third-year medical student at the University of California, San Francisco. He completed his undergraduate degree at Stanford University, where he studied Human Biology and History, and he holds a J.D. from Stanford Law School. He previously worked in health and social policy and remains involved in advocacy and research to repair the policy failures that drive healthcare injustice.

Kelley Butler is a resident physician in family medicine at the Zuckerberg San Francisco General Hospital in partnership with the University of California San Francisco. She graduated from the University of California, Irvine School of Medicine. Hailing from Los Angeles, Kelley has committed herself to serving marginalized communities. She is an active member in various causes dedicated to students and professionals of color, people suffering from substance use disorder and addiction, and those without access to basic needs. On her medical campus and now in residency, Kelley is known for her work in social justice, health advocacy, health policy and initiatives targeted for minoritized trainees. She currently holds leadership positions within the Council of Interns and Residents, a union for residents and fellows, and Doctors for America, a national organization committed to progressive causes and physician advocacy.

Kelley completed her Masters of Public Health in Health Policy at the Harvard TH Chan School of Public Health. There, she lead organizing efforts in juvenile justice reform and prison divestment, presented research on substance use and addiction treatment, completed a fellowship in Equity, Diversity and Inclusion, increased civic engagement on campus through the Harvard Votes Campaign and oversaw a workshop series on Imposter Syndrome. Following her masters studies, she went on to serve rural and frontier communities in Oregon as an Opioid Response Program Associate for Greater Oregon Behavioral Health Inc.

Kelley  graduated from Howard University in 2015 with a passion for serving communities without access to health insurance, quality healthcare or education. As such, she’s dedicated herself to educating and serving both local and international communities in need. She’s traveled to Panama, Kenya and Angola on medical missions thus far and looks forward to continuing to be of service to all mankind.

 

October 7, 2022 - From Eggshells to Action: Preparing to Address Microaggressions Targeting Learners

Meghan O'Brien, MD, MBE

Microaggressions, or dignity violations, occur frequently in the clinical learning environment. When patient microaggressions target learners and supervisors fail to respond, the harm caused is compounded by faculty inaction. Informed by her team's research on student and supervisor experience with patient microaggressions targeting medical students, Dr. O'Brien will discuss a framework for microaggression response and highlight key attributes of skilled responders to help support supervisor bystander action when patients microaggress learners.  

Meghan O'Brien, MD, MBE, is an Assistant Professor at UCSF, and a hospital-based general internist at San Francisco General Hospital where she leverages her training in primary care, humanities, and bioethics to provide dignity-driven, whole-person care. She completed her undergraduate degree in American Studies at Brown University, her medical degree and Masters of Bioethics at the University of Pennsylvania, and her Internal Medicine residency at UCSF’s Primary Care track before joining the ZSFG’s Division of Hospital Medicine. Dr. O'Brien is a member of UCSFs Academy of Medical Educators, and a Bridges Coach for the SJV-PRIME program. She splits her non-clinical time between medical education, advancing diversity, equity, and inclusion in medical education, and addiction medicine. 

 

September 2, 2022 - Moving from Intention to Action on Health Equity

Ayanna Bennett, MD, MS, FAAP

In our post-George Floyd world, many organizations and individuals have committed to eliminate health inequity. However, many seem to focus on generating understanding and goodwill rather than concrete change. Dr. Bennett will discuss a framework for health equity implementation that the Office of Health Equity is developing at San Francisco Department of Public Health.  This is an evolving framework, but the best practices around health equity are all evolving and this framework is offered as one potential approach.

Dr. Ayanna Bennett is the Chief Health Equity Officer and Director of the Office of Health Equity at the San Francisco Department of Public Health. Dr. Bennett is a pediatrician, trained for her MD at UCSF and in the UCB-UCSF Joint Medical Program for a Master’s degree. In 2004, Dr. Bennett co-founded a non-profit in the San Francisco Bayview Hunters Point neighborhood called the 3rd Street Youth Center and Clinic, which is thriving today. Dr. Bennett led 3rd St as its Medical Director and then Executive Director for 12 years, while also working as a practicing  pediatrician in the East Bay. Dr. Bennett transitioned fully to the Health Department in 2015, taking several leadership positions before establishing the Office of Health Equity in 2019. OHE focuses 4 areas, creating a diverse staff with health equity competency, reducing health disparities, supporting a culture of accountability and authentic community engagement.

 

June 3, 2022 - The Political Determinants of Health: Advocating for Equitable Health Outcomes

Daniel Dawes, J.D. 

Today, it is commonly understood that health outcomes are influenced by more than genetics and behavior. In fact, many health problems can be firmly linked to a political action or inaction (Dawes, 2020). Our political system has not always valued each group equally much less realized the long-term implications of policies on the health of its citizenry. Conditions in the places where people live, learn, work, and play, can have a wide range effect of health risks and outcomes (CDC, 2021).

However, the real instigators or drivers of these unjust and inequitable outcomes, are the Political Determinants of Health (PDoH) which involve the systematic process of structuring relationships, distributing resources and administering power, operating simultaneously in ways that mutually reinforce or influence one another to shape opportunities that either advance health equity or exacerbate health inequities (Dawes, 2020). These determinants and drivers are what have given way to racism and health inequity in America which remain to be addressed. Before we can begin to look beyond to a more equitable America, we must first understand the foundational nature of the political determinants of health’s and their systemic influence and structural concretization i.e. the “isms” plaguing the United States. Equally paramount, is to offer novel solutions including policies, that will forge a path towards recovery and ultimately, advancing health equity for all.

Daniel E. Dawes, J.D., is a widely respected healthcare and public health leader, health policy expert, educator, and researcher who serves as executive director of the Satcher Health Leadership Institute at Morehouse School of Medicine and a professor of health law, policy and management. A trailblazer and nationally respected voice in the health equity movement, his scholarship and leadership, particularly the innovative political determinants of health framework that he pioneered, have resulted in increased policies and laws prioritizing health equity. By tackling upstream determinants of health, he has ventured into such uncharted territory as the intersection between equity and the social and political determinants of health to change the course of domestic and global policies for the better.

His groundbreaking works, 150 Years of ObamaCare, which document the health equity movement in America and elevates the health equity-focused provisions of the Affordable Care Act that he led in negotiations and formulation, and The Political Determinants of Health, which provides an in-depth lens on the root causes of inequities, both published by Johns Hopkins Press are now nationally and internationally recognized and used as top health policy books. His passion for addressing health inequities is exemplified in his unyielding commitment to building collaboratives, including the HHS grant-funded National COVID-19 Resiliency Network and the Health Equity Leadership & Exchange Network, both exist to leverage evidence-based research and develop actionable solutions to advance health equity.

Professor Dawes’ work focuses on health reform, health equity, mental/behavioral health inequities, social and political determinants of health, poverty, and health system transformation. His work bridges research, technology, healthcare, population health and public health – the translation of research discoveries into all communities, including under-resourced, vulnerable, and marginalized communities. Professor Dawes brings a forward-thinking, inclusive, and multidisciplinary approach to address issues impacting diverse populations in urban and rural communities in our progressively complex health system, including a national study examining the health and economic impact of mental health inequities in the United States and a major research project which created the nation’s first health equity tracker. Among his many achievements, he was an instrumental figure in developing and negotiating the Mental Health Parity Act, the Genetic Information Nondiscrimination Act, the Americans with Disabilities Act Amendments Act, and an architect of the Affordable Care Act’s health equity-focused provisions, among other landmark federal policies.

Professor Dawes is an elected member of the National Academy of Medicine and an elected fellow of the New York Academy of Medicine. He serves as an advisor to The White House COVID-19 Health Equity Task Force and an appointed member of the CDC’s Advisory Committee to the Director.

 

May 6, 2022 - "Anti-coercion Ethics and the Avoidance of Medical Harm: A Case-based Discussion​" 

A discussion about the impact of race, social identity, intersectionality and positionality on the behavior of interdisciplinary care teams in hospital-based intrapartum care.  We will consider generalizable principles and practice to center patients in their care from perspectives of racial equity, healing-centered engagement and trauma reduction, and medical ethics.  

Maura Jones, MD is Chief Resident, UCSF Dept of OBGYN and Reproductive Sciences in the UCSF Obstetrics & Gynecology Residency Program. She is a native of Monroe, Louisiana. She received her undergraduate degree (B.S. in Biology) from Xavier University of Louisiana and went on to receive her Medical Degree from Louisiana State University School of Medicine, in New Orleans. She is a proud first-generation college student, and the first physician in her family. On completion of residency, she will matriculate into the Maternal-Fetal Medicine Training program at the University of North Carolina- Chapel Hill. Her research and clinical interests are Health Equity, Mentorship/Support within undergraduate and graduate medical education with a focus on historically and contemporaneously excluded groups, and Quality Improvement.

Deb Borne, MD, MSW is with the San Francisco Department of Public Health. Her focus is on Health Policy, Vulnerable Populations and People Experiencing Homelessness. Deb obtained her master’s degree in social work at Columbia University, attended medical school at Brown University and completed residency training in Family and Community Medicine at UCSF. Over the past two decades, Deb has served highly marginalized communities in San Francisco as a social worker and physician. She cares for people living with complex medical, social and behavioral needs including HIV and hepatitis, substance use disorders and serious mental illness, homelessness, trauma, incarceration and community re-entry. Deb leads and teaches across SFDPH and UCSF on a range of topics including HIV prevention and risk reduction, healing-centered engagement, reducing medical trauma, and best practices in the care of people experiencing homelessness. 

Jack Chase, MD, FAAHP FHM is Associate Professor, UCSF Department of Family and Community Medicine & Co-Chair, SFGH Ethics Committee. Jack is a faculty member at the UCSF Family and Community Medicine Residency Program based at SFGH, where he provides clinical care on the Social Medicine team, Family Medicine Inpatient Service, Supportive and Palliative Care Service, and Minor Procedure Clinic. As Co-Chair of the SFGH Ethics Committee, Jack supports ethics consultation, education and policy recommendations at SFGH and in SFDPH. He also serves on the leadership team for SFGH Social Medicine which provides interdisciplinary care to people experiencing substance use disorders, mental illness, homelessness, food insecurity, trauma, medical-legal and financial needs in partnership with SF Department of Public Health, SF City and County agencies and community-based organizations.

 

April 1, 2022 - "The National Clinician Consultation Center: 30 years (and counting) of tele-consultation for provider capacity-building and public health service" 

The National Clinician Consultation Center (NCCC) is a unique, federally-supported educational resource of the Ryan White HIV/AIDS Program which has continually adapted since the early 1990s to address evolving health care needs of HIV-affected communities.  Its team has provided over 313,000 consultations to clinicians across the U.S., and it has contributed to the growth and development of several notable initiatives including an international community dedicated to the intersection of reproductive health and infectious diseases as well as multi-disciplinary educational collaborations across medicine, nursing, and pharmacy.  This presentation will include a brief history of the NCCC, recent and future expansion highlights, and perspectives from several team members.  

Dr. Ron Goldschmidt, DFCM Professor and Vice Chair, is a seasoned family physician who founded the National Clinician Consultation Center (NCCC).  Dr. Goldschmidt has served as member of multiple national advisory and review committees for HRSA, AMA, and AAFP in addition to publishing several manuscripts on HIV care.  In 2005, Dr. Goldschmidt received the 2005 Kaiser Award for Excellence in teaching from UCSF.

Brenda Goldhammer, Program Director, has worked in the HIV, viral hepatitis, and substance use fields for over 30 years.  As NCCC Program Director, she provides operational and strategic leadership and also serves as a principal liaison in the development of collaborative partnerships and public relations at the local, regional, and national levels.  Ms. Goldhammer received her MPH from the University of California at Los Angeles, where she received the Improving Public Health in Southern California Fellowship and University Fellowship for academic excellence.

Dr. Betty Dong, Professor of Clinical Pharmacy and Family and Community Medicine, is a senior HIV and viral hepatitis consultant with the NCCC.  She is a prolific clinical educator, and has also published numerous manuscripts and book chapters on HIV and hepatitis C pharmacotherapy.  She is the distinguished recipient of the 2019 Daniel B. Smith Practice Excellence Award from the American Pharmacists Association.

Dr. Christine Pecci, Professor of Family and Community Medicine and NCCC Women and Children’s Health Consultant, is a family physician and clinician educator with maternal health expertise who provides consultation on perinatal HIV for the NCCC.

Dr. Carolyn Chu is a family physician and HIV specialist.  Prior to joining the NCCC, she served as medical director for a network of federally-qualified health centers in New York City.  She is an experienced clinician educator and has investigated the integration and effectiveness of HIV medical services in community-based and primary care settings. 

 

March 4, 2022 - "Afghan Clinic: Barriers to Health for Afghan Refugees & How We Can Address Them" 

The last four decades of turmoil in Afghanistan are responsible for one of the worst episodes of forced displacement in world history. Nearly six million Afghans have been forcibly displaced from their homes, leaving them at risk of poor health. Afghan Clinic is a public health initiative by and for Afghan refugees. In this talk, we discuss findings from interviews with Afghan refugee women and community organizers who serve them. We conclude with recommendations on serving Afghan refugee patients and mitigating their barriers to health and healthcare. 

Nazineen Kandahari, MS is a student in the UCSF Program in Medical Education for the Urban Underserved. As an Afghan refugee, Nazineen intimately experienced how the healthcare institution in the United States was not built to serve certain people. Thus from a young age, she committed herself to promoting people’s agency. Through community service, research, and public health intervention work, Nazineen has established herself as a trusted leader within the refugee community. She is passionate about health equity and community engagement. Nazineen is currently the Principal Investigator of a community-based health intervention for forcibly displaced Afghan immigrant women. She completed her Master of Science at the UC Berkeley School of Public Health on a study exploring the sexual health needs of Arab immigrant youth. Nazineen was named a “Student Who Rocked Public Health in 2021” by the Journal of Public Health Management & Practice and is a UC Berkeley School of Law Human Rights Center Fellow and Albert Schweitzer Fellow.

Nilufar Kayhani is an undergraduate student studying Public Health at the University of California, Berkeley. Nilufar is the child of Afghan refugees and is committed to resolving health inequities, particularly those experienced by refugees. She has initiated multiple community-based participatory research projects with historically marginalized populations while at UC Berkeley. She is currently a research intern at the Srivastava Lab at the Gladstone Institutes at the University of California, San Francisco. Nilufar is a pre-medicine student passionate about public health.

 

February 4, 2022 - "Family Medicine and Abortion: Responding to the Evolving Crisis in Access to Reproductive Health Care" 

Family medicine’s core values include continuity of care, meeting patients’ and communities’ needs, care across the life course, and social justice. Abortion care is clearly aligned with these values, particularly in the current political and legislative climate, where access to abortion is increasingly limited and abortion care increasingly stigmatized. In this presentation, we will discuss the current state of abortion access, in California and the US as a whole, and will then review research done with new career family physicians about how they understand the values of our specialty and how this understanding relates to their decision making about abortion care. We will then discuss current initiatives to train and support family physicians to provide abortions. We will conclude with a panel discussion about how family physicians and the specialty of family medicine can act on our values through abortion care provision and advocacy and take questions from the audience.

Christine Dehlendorf, MD, MAS is a family physician with fellowship training in Family Planning and a Master’s degree in clinical research. She is the director of the Person-Centered Reproductive Health Program in the Department of Family & Community Medicine at UCSF, which aims to advance reproductive autonomy and well-being by conducting research and designing programs that center people’s experiences and preferences for sexual and reproductive health and health care, guided by an attention to the intersecting oppressions and structural injustices that impact people’s lives and health. Her research includes the development, evaluation and dissemination of interventions to better meet people’s reproductive needs, and formative research to better understand people’s reproductive health care experiences and preferences. In addition to her research, she provides primary care and abortion services within the San Francisco Bay Area.

Lealah Pollock, MD is a family doctor who specializes in care for women living with HIV throughout their lives, including during pregnancy and the postpartum period. She is the Director of Women and Children's Consultation Services and the Perinatal HIV Hotline at the National Clinician Consultation Center, where she leads a team dedicated to helping providers around the country provide patient-centered and guideline-driven care to pregnant people with HIV and their families. She also provides primary and specialty care to female-identified and gender diverse people with HIV at UCSF and teaches and provides abortion services in the Bay Area. Dr. Pollock earned a master's degree in health and medical sciences at University of California, Berkeley and her medical degree from UCSF's joint medical program with UC Berkeley.

Montida Fleming, MD is a full spectrum family and community medicine doctor who has focused on comprehensive reproductive health care, addiction medicine, and gender affirming care. She is an Assistant Clinical Professor in the UCSF Family and Community Medicine Residency Program where she trains family physicians in hospital medicine, early pregnancy and prenatal care, addiction medicine, and abortion care. In addition to providing and teaching abortion care in the Bay Area, she previously traveled to low-resource and restricted abortion access areas to provide care. Dr. Fleming currently practices gender affirming care and medication abortion care across multiple states via telehealth. Outside of clinical care, she participates in media, legislative, and AAFP advocacy efforts to improve and expand access to comprehensive reproductive health care, reduce barriers, and promote reproductive justice. She received her MD from Sydney Kimmel Medical College at Thomas Jefferson University, and completed her residency at San Francisco General Hospital with the University of California, San Francisco.

 

January 7, 2022 - "Firearm Violence: Where We Stand, What We Can Do"

This presentation will review the basic epidemiology of firearm violence, assess current trends and their implications, and review options for preventive action by health professionals. It will focus on recent research and emphasize findings for California.

Dr. Wintemute is Distinguished Professor of Emergency Medicine and Baker–Teret Chair in Violence Prevention at the University of California, Davis. He is the 2022 UCSF Robert Crede Primary Care Lecturer, named in honor of one of UCSF’s first leaders of academic primary care.  Dr. Wintemute is the founding director of the Violence Prevention Research Program at UC Davis and of the California Firearm Violence Research Center, the nation’s first publicly-funded center for research in this field, overcoming formidable political obstacles to developing and sustaining a major research program on gun violence as a public health emergency and effective approaches to firearm safety. He practices and teaches emergency medicine at UC Davis Medical Center. Trained initially as a biologist at Yale University, Dr. Wintemute attended medical school and family medicine residency at UC Davis and studied epidemiology and injury prevention at The Johns Hopkins University.

 

December 3, 2021 - “Who We Hire Matters: How Health Systems Address Structural Racism Through Hiring People With Histories of Incarceration

Decades long policies of mass incarceration and criminalization of mental illness and substance use disorder have resulted in significant health disparities for individuals and communities impacted by the criminal legal system. While primary care health systems can play an important role in addressing these disparities, studies show that people face stigma and discrimination in health systems because of their incarceration history.

The Transitions Clinic Network (TCN) works with primary care clinics to transform their systems to improve health equity for communities impacted by the criminal legal system. Clinics participating in the TCN hire community health workers with lived experience of incarceration dismantling systems that have historically prevented people with criminal records from accessing employment in the health field. 

Shira Shavit, MD is a Clinical Professor of Family and Community Medicine at the University of California in San Francisco and the Executive Director and co-founder of the Transitions Clinic Network (TCN). For over a decade through research and community engagement, Dr. Shavit has been redefining national best practices to address the health inequities experienced by communities impacted by mass incarceration. In addition to providing clinical care to communities impacted by incarceration, Dr. Shavit has led health system transformation in over 48 primary care systems in 14 states and Puerto Rico resulting in healthcare career opportunities for hundreds of people with criminal legal involvement as community health workers. Her work in the TCN has also been shown to cut health care and criminal legal costs, and support healthy, sustained integration of individuals returning home from incarceration. In 2012, she led a Center for Medicare and Medicaid Innovation funded project across 11 sites in collaboration with City College of California. She also worked as a consultant to reform healthcare systems in the California State prisons in collaboration with the Federal Receivership (2006-2011). She is a recipient of the Robert Wood Johnson Community Health Leader Award (2010). Dr. Shavit graduated from Washington University in St. Louis, completed her MD at Rush University in Chicago, and completed her residency training at the University of California, San Francisco. She is currently a California Health Care Foundation Health Care Leadership Fellow.

Joseph Calderon, CHW, Senior Community Health Worker at the Transitions Clinic Network.  Joe is a native of San Francisco and at the age of 23 he started serving a life sentence. After nearly 20 years incarcerated, he began to explore ways to give back to society upon his release. He currently works as a the Senior CHW and trainer at the Transitions Clinic Network (TCN), a national organization dedicated to improving health and reentry outcomes for those returning to the community from incarceration. Joe trains and mentors CHWs with histories of incarceration who are employed by TCN programs nationwide. Joe was an appointee to the San Francisco Reentry Council from 2013-2016 and now serves on the Policy and Procedure Sub-Committee. He also served on the Equity Advisory Committee with the San Francisco Human Rights Commission. In 2017 the San Francisco Department of Health appointed Joe to the SF LEAD (Law Enforcement Assisted Diversion) Policy Committee.  He has a passion for working with diverse and disenfranchised populations, leveraging his personal experience with incarceration to advocate for social justice and community investment. Mr. Calderon has a Post-Prison Community Health Worker certificate from San Francisco City College and plans on continuing his education in public health. Joe completed a JustLeadershipUSA fellowship in 2018.

 

November 5, 2021 - Contextualizing Care: An Essential and Measurable Clinical Competency

Evidence-based care plans can fail when clinicians do not consider a patient’s relevant life circumstances -- such as an inability to afford a medication, a competing responsibility, or a loss of social support -- when planning their care. The capacity to systematically identify and incorporate patient life context into medical decision making has been described as the process of contextualizing care.  Based on an analysis of over 500 unannounced standardized patient simulations and 7000 audio recorded clinical encounters over the course of more than a decade, Dr. Weiner’s team has characterized the skills required to contextualize care, measured their effect on patient outcomes and health care costs, tested various strategies for teaching the skills and measuring performance, and established a contextualizing care QI program at several VA medical centers.  His presentation will provide an overview of this work. 

Saul Weiner, MD, is professor of medicine, pediatrics, and medical education at the University of Illinois at Chicago (UIC), and deputy director of the research Center of Innovation for Complex Chronic Health Care at the Veterans Health Administration. His research on contextualization of care has been supported by the Department of Veterans Affairs (Health Services Research & Development), the Agency for Healthcare Research and Quality, the Robert Wood Johnson Foundation, and the National Board of Medical Examiners. Dr. Weiner is the University of Illinois at Chicago 2013 Distinguished Researcher of the Year in the Clinical Sciences. He has served as medical education dean, university vice provost, and currently as senior advisor to the provost. His book, Listening for What Matters: Avoiding Contextual Errors in Health Care, published by Oxford University Press, received the 2017 American Publishers Award for Professional & Scholarly Excellence in the Life Sciences from the American Association of Publishers. His latest book is On Becoming a Healer: The Journey from Patient Care to Caring About Your Patients, published by Johns Hopkins University Press (April 2020). 

For those of you interested in this body of work and its clinical and research implications, here is a new “fireside chat” series of short videos on contextualizing care:

https://youtube.com/playlist?list=PL9-b6XZZMupzmVuuwn1Ipph0dpI1fxx2d

 

October 1, 2021 - “Should We Screen for and Document Social Risk in Health Care Settings?”

Screening for adverse social determinants of health, or social risk factors, is becoming increasingly common in health care settings. This screening is supported by multiple professional societies, including the AAFP, AAP and ACP.  There is growing evidence to support activities to identify and intervene on patient social risk factors, with the goal of improving patient health, wellness, and health equity. Researchers from UCSF SIREN will discuss 1) the acceptability of social risk screening from the perspective of patients and caregivers of pediatric patients, and 2) current screening activities at UCSF and ZSFG.

Dr. Emilia De Marchis is a family physician and health services researcher at the University of California, San Francisco. Her research is based out of the UCSF Social Intervention Research & Evaluation Network (SIREN), where she works to assess and improve how we screen for and address social risk factors within health care settings. Dr. De Marchis co-directs coursework through the UCSF Implementation Science Training program, Partnerships for Research in Implementation Science for Equity (PRISE) Center. She uses implementation science methods to focus on moving research on social risk screening, assistance and adjustment activities into real-world settings. Her clinical work is based out of the UCSF Family Medicine Center at Lakeshore. Through her research and clinical practice, she hopes to advance the health care system’s integration of patient social risk data to provide high quality, patient-centered preventative health care, to reduce health disparities. Dr. De Marchis received her MD from Stanford University, and her MAS in Clinical Research and Certificate in Implementation Science from UCSF.

Dr. Matt Pantell is an Assistant Professor at UCSF, where his research is conducted with the UCSF Center for Health and Community, the UCSF Social Interventions Research and Evaluation Network, and the UCSF Preterm Birth Initiative. His research focuses on the utility of incorporating social information into clinical decision making, addressing social needs in clinical settings, data mining and the analysis of large datasets, and biological manifestations of the social determinants of health. Clinically, Dr. Pantell works is as a pediatric hospitalist at UCSF Benioff Children's Hospital - Mission Bay and Washington Hospital in Fremont. He also works as a pediatric urgent care physician and runs the Tattoo Removal Clinic at Zuckerberg San Francisco General Hospital.

Dr. Caroline Fichtenberg is the Managing Director of the Social Interventions Research and Evaluation Network (SIREN) and Research Scientist in the Department of Family and Community Medicine at the University of California, San Francisco. In these roles, she leads efforts to conduct, catalyze, and disseminate high quality research on health sector strategies to reduce health inequities by addressing social determinants of health. She brings to these positions more than a decade of experience working to improve health and economic outcomes for America’s most vulnerable families, including seven years working on national efforts in Washington, DC. While Director of Research at the Children’s Defense Fund (CDF), she led the development of a report that identified nine federal policy changes that could reduce child poverty by 60 percent. As Director of Epidemiology and Planning at the Baltimore City Health Department, she oversaw the city’s first analysis of neighborhood health inequities that uncovered a 20-year gap in life expectancy between the richest and poorest neighborhoods of the city. Caroline also served as director of the Center for Public Health Policy at the American Public Health Association (APHA) and as Health Policy Advisor to Senator Harkin on the Senate Health, Education, Labor and Pensions committee, where she promoted health in all policies approaches to improve health outcomes and reduce health inequities. She earned her Ph.D. in Epidemiology from Johns Hopkins University, an M.S. degree in Biology from Yale University and an A.B. in Molecular Biology from Princeton University.

 

September 3, 2021 - “Redefining Global Health through Structural Competency and Allyship”

Unlike hypertension, the widely used term Global Health has very different meanings depending on where one stands: United States, Switzerland or Malawi.  This highlights long standing differences in power and privilege, and the persistence of Global Health’s colonial roots.  We however find ourselves in a time of opportunity to push for greater accountability and true partnership on the part of privileged countries and institutions.  Doing so requires continuous self-study and the willingness to take personal and professional risks.  We will discuss a structural competency framing of Global Health, and the challenges and rewards of pursuing true allyship as part of the larger struggle for dignity for all. 

Sundeep K Gupta, MD, MPH, DTMTH, is a FCM faculty member at Natividad Medical Center; he is a past CDC Country Director for Uganda, Malawi and Zambia. He is also an Assistant Clinical Professor in the Division of Infectious Diseases at UCLA.  Dr. Gupta completed his BS in Political Science, MD and MPH from Northwestern University, and went on to complete his residency in Family Medicine at Natividad Medical Center. After completing his DTMTH at Tulane University, Dr. Gupta joined CDC’s Epidemic Intelligence Service ‘disease detective’ program.  Over the subsequent 12 years, he worked for CDC in 12 countries in Africa, Asia and Central America, leading responses to HIV, Ebola and other epidemics, while working in partnership with host country colleagues to strengthen public health systems.  Dr. Gupta was subsequently seconded by UCLA to Partners in Hope, a local Malawian organization, to lead their efforts to fight the HIV epidemic.  Dr. Gupta is board certified in Family Medicine by the American Board of Family Medicine. He has published over 50 manuscripts and provided public health leadership across different cultures and types of public health systems across the globe. His professional interests include patient lived experience, HIV primary care, community medicine, equity and social accountability, applied epidemiology and public health.  His personal interests include hiking, biking and spending time with his family.

Professor Address Mauakowa Malata PhD, MSc, BSc, FAAN. is the Vice-Chancellor of Malawi University of Science and Technology, former President of Africa Honor Society of Nursing of Sigma Theta Tau International; former Vice President, International Confederation of Midwives, former Principal of Kamuzu College of Nursing and spearheaded it to become a World Health Organization Collaborating Centre for Inter Professional Education and Leadership in 2016. A renowned international speaker, author and editor of various journals in the field of health, nursing, midwifery, and health workforce, she serves on various international, regional and national boards. Dr. Malata is an advocate for girls and women empowerment through education. Her research work focuses on maternal and newborn health, quality of care, health workforce and innovation and technology. She is a Virginia Henderson Fellow of Sigma Theta Tau International (STTI), an Adjunct Professor at Michigan State University, a Fellow of the American Academy of Nursing (FAAN); a Global Health Fellow at University of California San Francisco University; an Adjunct Professor in the Department of Obstetrics and Gynecology, Baylor College of Medicine. She was awarded a Doctor Honoris Causa by University of Oslo in Norway, 2018 ECU Distinguished Alumni and ECU Honorary Award of Doctor of Nursing honoris causa, 2019 in Australia.

 

August 6, 2021 - “Addressing Racism and Advancing Health Equity In and Beyond the Exam Room”

 

 

 

 

 

 

Racism and the repeated trauma of experiencing racism has a direct impact on health and detrimental effects on our individual patients, our communities, and our society.  In primary care, we are poised to lead action and meaningful anti-racism change because we understand our patients not just in terms of their pathophysiology, but also in terms of their relationships, their experiences, their communities, and their social context.  We will discuss actions we can take in our own practices with our patients, communities, and even beyond to address racism, advance health equity, bring about change, and promote justice. 

Tricia C. Elliott, MD, FAAFP is the immediate past president of the Society of Teachers of Family Medicine and a past president and past board chair of the Texas Academy of Family Physicians. She graduated from Rice University and received her medical degree from University of Texas Medical Branch. She went on to complete her residency in Family Medicine at Albert Einstein/Montefiore Medical Center Residency Program in Social Medicine. Dr. Elliott is board certified in Family Medicine by the American Board of Family Medicine. She has over twenty years graduate medical education (GME) experience which includes nationally-recognized work with the ACGME Family Medicine Milestones group, the American Academy of Family Physicians Council on Education, and the Society of Teachers of Family Medicine. She has provided administrative and clinical leadership across various types of health systems, including academic medical centers, a multi-specialty group practice, and a community-based, university-affiliated teaching hospital, in the roles of clinical faculty, program director, Vice Chair for Clinical Affairs, and currently as Senior Vice President of Medical Staff, Academic, & Research Affairs/Chief Academic Officer/DIO at JPS Health Network in Fort Worth, Texas. 

She is Professor in Family Medicine at Texas Christian University/University of North Texas Health Sciences Center (TCU/UNTHSC) School of Medicine, Affiliate Professor at UNTHSC Texas College of Osteopathic Medicine, and Adjunct Professor at University of Texas Medical Branch School of Medicine. Dr. Elliott’s academic interests include graduate and undergraduate medical education, learner assessments, health care advocacy and policy, and leadership development and mentoring. Her clinical interests include primary prevention, chronic disease management, women’s health, migraine management, ambulatory procedural training, patient education, and community medicine. Her personal interests include singing/vocal performance, collecting art, cooking, dancing, public speaking, and travel.

 

June 4, 2021 - Strange Bedfellows:  Adventures in the Science, History, and Surprising Secrets of STDs

 

 

 

 

 

 

Sexually Transmitted Infections (STIs) have been hidden players in our lives for the whole of human history, affecting everything from World Wars to the gay rights movement. But despite their prominence, STIs have been thought of as curious – and often terrifying – taboos for centuries, which begs the question: why do we know so little about them?  

Join us for Family and Community Medicine Grand Rounds with Ina Park, MD, MS who will talk about her new book Strange Bedfellows:  Adventures in the Science, History, and Surprising Secrets of STDs.  She'll share stories of real people’s sexual escapades and historical tales, along with the latest science of STI and HIV prevention, venturing beyond the bedroom to examine the role that STIs have played in our lives and society. Hailed by The New York Times as “joyful and funny” Strange Bedfellows has been praised for its use of “compassion, science and a loving playfulness” to diffuse the stigma surrounding these common infections.  

INA PARK MD, MS, is an associate professor at the UCSF School of Medicine in the Departments of Family and Community Medicine and Obstetrics, Gynecology, and Reproductive Services, Medical Consultant at the Centers for Disease Control and Prevention, Division of STD Prevention, and Medical Director of the California Prevention Training Center. Recently, Dr. Park served as a co-author of the 2021 CDC STI Treatment Guidelines and contributor to the Department of Health and Human Services first STI National Strategic Plan. In addition to her current book, her writing has also appeared in the New York Times.  

 

May 7, 2021 “Social Policies to Address Health Inequities: Harder Than It Looks”

There is generally positive but occasionally conflicting evidence on the health benefits of social and economic policies to address social determinants of health like poverty and educational attainment. Dr. Rita Hamad will delve into research to understand the possible reasons for the conflicting results, including the possibility that well intentioned policies may have negative effects. She will highlight the importance of evaluating the effects of even the most commonsense policies, in order to inform the design of future interventions to address the social determinants of health.

Dr. Rita Hamad is an Associate Professor at UCSF. She is a social epidemiologist and family physician in the Department of Family & Community Medicine and the Philip R. Lee Institute for Health Policy Studies. She is the director of the Social Policies for Health Equity Research Program, and Associate Director of the Center for Health Equity. Her research focuses on the pathways linking poverty and education with health disparities across the life course.

Watch recording here: https://youtu.be/0sgEkJZttvE

 

April 2, 2021: "Achieving Racial and Ethnic Equity in COVID-19 Vaccination: Learnings from Community Based Participatory Research."

UCSF faculty, staff, and community partners leading the STOP COVID-19 CA Project will discuss learnings from focus groups and interviews with members of the Black/African American, Latinx, and Chinese/Chinese American communities about perspectives on COVID-19 vaccination.

 To view this presentation please see the links below.

Internal UCSF users: https://ucsf.box.com/s/a9ui8lpssjuaydmt5omh9s2yngzt28q4  

External users:  https://youtu.be/rUydOpWnCLs 

 

 

 

March 5, 2021: "Lancet Commission on Public Policy and Health in the Trump Era" 

 

 

 

 

 

 

 

 

Presentation by Dr. Kevin Grumbach and Dr. Julianna Morrison discuss the newly released report of the Lancet Commission on Public Policy and Health in the Trump Era, recommendations to put the US back on the path to health for all, and discuss the implications for the policy agenda of the Biden administration and new Congress.