Specialty Hospital Medicine Internal Medicine Facility Sacramento Medical Center Department of Medicine - Hospital Based Services Address 2025 Morse Avenue Sacramento CA 95825 Map & Directions Telephone General Hospital Information: 916-973-5000

My Profession and Why I Chose It

I am a Hospital-Based Specialist (or HBS) as you might have heard over the intercom in hospital. HBS is simply a general internal medicine doctor who strictly works in the hospital, not a clinic. An internal medicine doctor (internist, not intern) is a non-surgical adult medicine doctor. HBS oversees the care of hospitalized patients, devises a diagnostic and treatment plan of care, and facilitates with the patient care coordinator transition back to home or to a higher level of non-medical care. We usually “round” on newly admitted patients for 7 consecutive days to help better achieve continuity of care. I have rounded on a panel of patients numbering 6 to 25. We also consult on patients with chronic or acute medical problems who are admitted to the surgery services, patients from the emergency room urgent care center and clinic. We run the hospital “Code Blues” for all the services (except Pediatrics).

I chose HBS for two basic reasons. First, clinic doctors are strictly confined to a certain time period to see their patients. Most of these patients have multiple chronic medical problems, others are taking more than 10 medications and some come to clinic grieving over the loss of a loved one. I am a compassionate person and part of my responsibility as a physician is to console. I have ample time to do this as an HBS. Second, I prefer caring for sick patients. Although I am a strong advocate of primary prevention, risk factor modification, and preventative health maintenance, "well clinic" visits are not as fulfilling to me as caring for the hospitalized patient.

My Credentials

Medical school	State University of New York Health Science Center At Brooklyn, Brooklyn, NY
Residency	UC Davis Medical Center, Sacramento, CA
Board certification	Internal Medicine, American Board of Internal Medicine

My Practice Philosophy

Hospitalization: Patients should remain in the hospital only as long as necessary and only if they require constant medical attention by a physician or clinician that is not provided at a skilled nursing facility. Obviously, the longer patients are in the hospital the greater their risk of obtaining a hospital-acquired complication which can be worse than the presenting problem itself. Many patients and families want patients to stay in the hospital because the patient isn’t completely back to normal, or they want respite. I was hospitalized 4 days last December for open heart surgery for a defective aortic valve. I wanted to go home on the 3rd hospital day but I still required a surgeon’s attention. When discharged, I still had surgical chest pain and was less than 50% of baseline, but with strong family support that would take good care of me, I was elated to return home.

Honesty and Compassion: In discussing diagnosis, management and treatment with the hospitalized patient (and their families when appropriate), I try to be as open, thorough and informative as I can regarding evidence-based medical care, short term and long term prognosis, and discharge planning. I try to do this in a compassionate way and, hopefully, not rushed. I stress the importance of risk factor modification, strongly encourage patients to stop smoking (cigarette smoking is directly attributed to more than half of the top ten causes of adult death), encourage good diet along with physical activity and honest living (just kidding). Many of my patients have asked me to be their primary care physician because I’ve explained to them the disease process and how to slow or reverse it in a way that they could appreciate and understand.

The Ideal Patient:

My wish list of things that the patient could provide that would help me better serve them is:

1. A complete and up-to-date list of medications. Some patients will say, “look in the computer.” What they don’t realize is that dosages could have been changed by their PCP or ED MD; medications have been stopped, etc. Furthermore, if you present at a non Kaiser hospital, the treating physician will benefit knowing what medications you take. It also means you are taking an active role in your health care.

2. A copy of your Advanced Directive. The patient’s chart, sometimes, is not available and not there when really needed.

3. A list of when and where important procedures or surgeries were performed

4. Honesty regarding whether or not a patient is taking their medications, drinking too much alcohol, eating too much salt or other behaviors that may be making a stable chronic condition worse.

My Tenure with Kaiser Permanente

I’ve been part of KP for five years; I began here after completion of my internal medicine residency at UC Davis Medical Center. As interns and residents, we rotated through the Kaiser Hospital system approximately 3 to 4 months/year.

Why I Like Practicing Medicine at Kaiser Permanente

I was impressed with the collegiality of physicians, easy accessibility, and ease of obtaining informal consultations and a warm working atmosphere where I always felt comfortable. I also like the concept of Kaiser: sharing physicians, resources, risk; a large medical group and not for profit organization. Contrary to popular belief, I have never been told that I can’t order this or that procedure or obtain that subspecialist consultation, etc. I feel this is the ideal working environment for a physician and the model of Kaiser Permanente should reverse the negative popular impression of health maintenance organizations. Our approach at Kaiser of diagnosis, management and treatment of disease is evidence-based and our information technology is superb (and still improving).

My Professional Interests and Affiliations

American College of Physicians

My Personal History

I am the oldest, with my twin sister, of seven children and was born and raised in Terre Haute, IN. I attended high school and one year of college away from home in minor seminary studying for the Franciscan priesthood as I felt the call to devote myself to the service of others. That was a very satisfying period of my life and I developed an intense interest in the life sciences. Because of the vow of celibacy I left seminary, returned home and attended a local college, Indiana State University, where I received a bachelor’s and Ph.D. in biology. I earned my way through college as a union meat cutter (Amalgamated Meat Cutters and Butcher Workmen of the North American AFL-CIO) at a major grocery chain.

Following completion of my studies I moved to the “big city” as a post-doctoral fellow in the Department of Medical and Molecular Parasitology at the New York University School of Medicine. There, scientists were (still are) working on a vaccine against malaria. My group studied the cell biology of the parasite stage that is carried by the mosquito and transmitted to humans by bite (our animal model was rodents), where it sets up infection in the liver. I procured research grants from the National Institutes of Health and have published between fifteen and twenty research articles. Our results actually help explain why the malaria vaccine has not been successful. I also participated in teaching medical students medical parasitology and was intrigued by the pathophysiology (abnormal structure and function of organ systems caused by disease) of disease. I made a career change and obtained an M.D. degree at SUNY Health Science (Downstate) Center where I graduated with honors and elected to the Alpha Omega Alpha Honor Medical Society. My former wife obtained a research position at UC Davis Medical Center sometime before I completed medical school, which is how I came to be in California. She has since returned to the East Coast, while I have decided to stay in Sacramento. I completed my internship and residency in the Department of Internal Medicine at the UC Davis Medical Center.

My personal interests include: vegetable gardening, golf, tennis, fishing, outdoor cookouts, leisurely driving the back roads, listening to NPR radio, enjoying our pets (3 cats, a pug, 2 chihuahuas, a lizard, guinea pig, and other critters), lounging out by the pool with my significant other (a Kaiser registered nurse) and her two delightful teenagers

Be sure to visit the New Kaiser Permanente Website for additional information regarding appointments, prescriptions, health education classes and other health-related topics. You can also click on my department link above to receive additional health information.

To choose your own personal physician, click here.

Checklist for New Members

About Your Office Visit

Prevention Information on Your Registration Slip

Disclaimer
If you think you have a MEDICAL OR PSYCHIATRIC EMERGENCY, CALL 911 IMMEDIATELY or go to the nearest hospital. DO NOT attempt to access emergency care through this web site. An emergency medical condition is a medical or psychiatric condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in any of the following: serious jeopardy to your health, serious impairment to your bodily functions, or serious dysfunction of any bodily organ or part. An emergency medical condition is also "active labor," which means a labor when there is inadequate time for safe transfer to a Plan hospital (or designated hospital) before delivery or if a transfer poses a threat to the health of the member or unborn child.

This site may contain links to other web sites outside of www.permanente.net. Kaiser Permanente has no control over the content or the availability of these sites, and is not responsible for the privacy practices or the content of such Web sites. Web links are provided as an educational tool, and should not be relied upon for personal diagnosis or treatment. A link or reference to a web site should not be construed as an endorsement of the site or its contents. Any medical content that you feel may be important to your health should always be discussed with your Kaiser Permanente physician.