Pioneering Models of Better Care

reprinted from Issue 18, Spring 2014 of Frontiers of Medicine (PDF)

Talmadge E. King, Jr., MD, Chair, Department of Medicine

We are on the cusp of huge changes in health care in the United States: implementation of the Affordable Care Act is underway, the fragmented, crisis-based approach to medical care is financially unsustainable, and our country’s population is rapidly aging.

Our current health care delivery system is woefully underprepared to address the complex needs of our elders. Yet the UCSF Department of Medicine is developing many creative models to successfully care for this growing population. As the cover story describes, our exceptional faculty in the Division of Geriatrics are developing programs, discovering knowledge and educating the next generation to provide seamless care for frail older adults. We also profile one of our outstanding alumni, Erwin Tan, MD, who is applying his geriatrics expertise to promote volunteerism among seniors on a national level.

UCSF is also at the forefront of palliative care – promoting the highest quality of life for all patients facing serious illness. As articles in this newsletter illustrate, we are bringing these invaluable services to a wider group of patients, and are teaching the communication skills that enable trainees to compassionately and effectively discuss a patient’s symptoms, fears and hopes.

Both palliative care and geriatrics employ a team approach and focus on the whole patient – a powerful contrast to much of today’s medical care, which too often treats each organ and disease in isolation. By talking with patients about what is most important to them and providing the right help at the right time, these teams can align care with each patient’s goals and values. This tailored approach optimizes patient health, can prevent unnecessary hospitalizations, and delivers better care at lower cost – a vital combination that addresses some of the key challenges we face today.

This newsletter also highlights innovations in quality and safety, as well as nephrologist Stephen Tomlanovich, MD, who has greatly improved outcomes and access to kidney transplantation at UCSF over the past three decades.

As several stories in this issue demonstrate, philanthropy is essential to all our endeavors. It provides the seed money that allows us to test out, evaluate and refine new ideas. It also allows us to move the national conversation forward by disseminating successful approaches and bringing them to scale. Private gifts catalyze sustainable change by providing startup funds that go on to leverage funds from the National Institutes of Health and many other sources. We are tremendously grateful for your support, and look forward to continuing our partnership with you.


Talmadge E. King, Jr., MD
Chair, Department of Medicine
Julius R. Krevans Distinguished Professorship in Internal Medicine

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