Facility Sacramento Medical Center Department of Neurosurgery Address 2025 Morse Avenue Sacramento CA 95825 Map & Directions Telephone Appt/Advice: (916) 973-5490 Fax: (916) 973-5826 E-mail your doctor View your preventive services

Department Hours

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Closed	8:30 am 5:00 pm	8:30 am 5:00 pm	8:30 am 5:00 pm	8:30 am 5:00 pm	8:30 am 5:00 pm	Closed
Closed during lunch, 12:30 pm to 1:30 pm

My Specialty and Why I Chose It

I am an interventional neuroradiologist. This is a specialty within radiology that deals with treatment of disease rather than simply diagnosis. The problems we deal with are often related to the vascular system (arteries and veins) and include treatment of cerebral aneurysms, arterial narrowing, acute stroke, and vascular malformations. We also treat vascular malformations of the face and neck, spine, or other parts of the body. In addition, we perform vertebroplasty or kyphoplasty, which is a method of injecting a bone cement into fractures of the spine using needles instead of open surgery. These procedures all can be termed "minimally invasive," as they often can help avoid the need for open surgery of the brain or spine. This is one of the aspects of the field that appealed to me when I was deciding on what to do within medicine and continues to appeal to me now.

My Practice Philosophy

My practice is one primarily of evidence-based medicine, meaning using the information we have in the medical literature to guide practice. This may at times lead to counter-intuitive conclusions, such as the recommendation to not treat an aneurysm in the brain which, although it may be the cause of some trepidation, often is at such a low risk of bleeding over time that the risk of treatment outweighs the risk from the aneurysm itself. Practitioners who do not use evidence-based medicine may be more prone to have a "knee-jerk" reaction and treat things that have been found by chance and may not need treatment at all. I should also comment though that in addition to this evidence-based practice, I recognize that each person comes to the doctor or hospital with his or her own background, preferences, concerns, and wishes, and these also must be taken into consideration. So the decision-making is always a balance of multiple factors and is always based upon adequate discussion of the multiple aspects of a problem.

My Tenure with Kaiser Permanente

I began working at Kaiser Permanente in 2005 after having been at an academic medical center for several years and on a daily basis I consider myself fortunate to be here. As part of the neuroscience group caring for patients with all varieties of neurologic and neurosurgical disease, I am constantly challenged and intrigued by the problems we face and buoyed by the difficulties we overcome. As interventional neuroradiology is part of the neurosurgery department, we care for members from all over the region and it is truly a pleasure to be part of a center at which people can obtain focused, high quality specialty care.

Why I Like Practicing Medicine at Kaiser Permanente

I enjoy practicing at Kaiser Permanente for multiple reasons. One is the daily interactions with a specialty team, the members of which--each with their own specific area of interest and expertise--know neurologic and neurosurgical diseases inside and out. The feedback from these colleagues and the ability to consult and draw upon their cumulative experience is invaluable to providing the best care possible. We also have the latest, most up to date equipment available, including state of the art angiography, CT, and MRI scanners. Similarly, we use one of the most advanced and comprehensive electronic medical records available, and importance of the way that this adds a cohesiveness to patient care cannot be overstated. The Kaiser Permanente medical library is an on-line resource providing access to thousands of journals and full text medical references, and Kaiser Permanente supports extensive ongoing medical education, both within the system and by allowing time for attending outside conferences in order to prevent our medical knowledge from getting "moldy." Perhaps the best aspect, however, is the autonomy that I have in my day to day practice; never has anyone asked me to reconsider ordering a test or performing a procedure because of cost or any other reason. I have freedom to practice medicine in the best way I know how and without interference from an administrator who has determined that something is "not approved" and therefore cannot be done. The corollary is that within Kaiser Permanente we are also free of the influence of any financial gain that might alter the integrity of one's decision-making.

Professional Interests & Affiliations

• Society of Neurointerventional Surgery
• World Federation of Interventional and Therapeutic Neuroradiology
• American Roentgen Ray Society
• Radiological Society of North America
• American Medical Association

On a Personal Note

The path that led to me practicing interventional neuroradiology is on one hand circuitous and on the other hand fairly straight. The straight part is that I guess I've always had some fascination with the brain; the circuitous part is the various refining of that interest into its current form. I was fortunate enough to attend medical school at a place where giants of the field worked, and this profoundly shaped my decisions regarding career choices at the time and, hence, now.

As for life outside the hospital, I relish my time with my friends and family. Part of the reason for that is I have very little life outside the hospital, so I appreciate these other things more. I'm hoping one day to get back to all the recreational activities I used to once enjoy...perhaps in retirement.

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My Credentials

Medical school	UC San Francisco Medical Center, San Francisco, CA
Internship	UC San Francisco, San Francisco, CA
Residency	Beth Israel Medical Center, New York, NY
Fellowship	Beth Israel Medical Center, New York, NY
Board certification	Diagnostic Radiology, American Board of Radiology

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