Dr. Michael Peterson: Coaching for Excellence

reprinted from Issue 20, Spring 2015 of Frontiers of Medicine (PDF)

Michael Peterson, MD, proudly wears the UCSF Fresno Internal Medicine jacket.

As a resident at the University of Wisconsin, Madison, Michael Peterson, MD, remembers pulmonologist Helen Dickie, MD, walking by and quizzing him about chest X-rays she pulled from nearby filing cabinets. "You dropped what you were doing, and she was going to teach you for a while," says Peterson, now the chief of medicine at UCSF Fresno, Valley Medical Foundation Professor, and vice chair of the Department of Medicine. "She was very demanding of students, but she took great pride in helping you get better."

He brings a similar approach as an educator, administrator and researcher. Inspired by Dickie and the excitement of treating life-threatening conditions, Peterson completed a pulmonary and critical care fellowship at the University of Iowa, then served on the faculty there for 16 years. Though he enjoyed his work, he came to UCSF Fresno because he thought he could make a difference. "This was an opportunity to take a program that was struggling, and see if I could help it excel," says Peterson.

In 1975, the California Legislature and the Veterans Administration created UCSF Fresno as a clinical branch of UCSF to address the severe physician shortage in the San Joaquin Valley. Today, its faculty and trainees work at the VA Central California Health Care System and Community Regional Medical Center, which includes a hospital, ambulatory clinics, Level 1 trauma center and the state's third busiest emergency department.

Since Peterson arrived in 2002, he has led an era of tremendous growth. "Dr. Peterson has transformed the Department of Medicine at UCSF Fresno, more than doubling the size of the faculty, increasing the number of residents from 45 to 96 and establishing six new fellowship programs," says Joan Voris, MD, former associate dean of the UCSF Fresno Medical Education Program. "He raised funds to establish a clinical research center and is a role model for other UCSF Fresno departments in starting and expanding their own research programs." Upon Voris's retirement in January, Peterson was named interim associate dean of UCSF Fresno.

Peterson is a highly respected educator, and compares teaching to coaching world-class athletes. "I tell [trainees], you're already very good — my job is to help you get even better," he says. "If you want to take half a second off your 100 meter time, it's going to hurt a little bit. If you know all the answers, I'll just make the questions harder, because that's where you.ll learn."

UCSF Fresno also created the LIFE (Longitudinal Integrated Fresno Experience) Program, a six-month clinical clerkship for third-year UCSF medical students — and partnered with other UC campuses to establish San Joaquin Valley PRIME (Program in Medical Education) for students who want to practice in the region.

Diversity and Discovery

UCSF Fresno serves a diverse community, including Latino, Hmong, Pakistani and Indian patients. "Fresno is one of those places you can practice global health without leaving home," says Peterson. Many patients have conditions more commonly seen in the developing world.

"When I came here, we weren.t doing much research," said Peterson. "That bothered me. If we're in a place with a disease that few others see, we should become the experts." Peterson and his colleagues began running standardized tests for lung cancer on every patient with a suspicious chest CT scan. In addition to reducing the average diagnosis time from three months to seven days, they made a startling finding: one in three patients actually had coccidioidomycosis, also known as "Valley fever" — an infection caused by breathing in soil fungus that is especially prevalent in the Central Valley. In the past, many of these patients would have endured unnecessary surgery because of misdiagnosis as cancer. The team also developed a new lab test for Valley fever, and works with other UC campuses to discover better therapies.

In addition, Peterson established the UCSF Fresno Center for Clinical Studies, which supports more than 45 research projects, and collaborates with UCSF pulmonologist Michael Matthay, MD, on improving treatment of patients with acute respiratory distress syndrome.

In his free time, Peterson enjoys going on motorcycle road trips and traveling with his wife, Barbara, to visit their sons in Southern California and Montana. Peterson appreciates the esprit de corps that has blossomed. Pointing to his gray jacket emblazoned with "UCSF Fresno Internal Medicine," he recalls, "When the chief resident initially proposed these, I said, "Do you really think people are going to be excited about this?" Well, they were ecstatic — it's 90 degrees in Fresno, and they.re walking around with their jackets on. They are proud of who they are and what they do."

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