I started my career in private practice in San Francisco in 1985 in the midst of the AIDS epidemic. We had little to offer these unfortunate patients and I did what I could to make sure they were at home with their friends and family. For financial reasons, I left private practice and joined The Permanente Medical Group in 1990. It turned out to be one of the best decisions I’ve ever made.
I started in primary care at the Fremont facility and became a hospitalist in 1997, the first in the Hayward Medical Center and their first Chief of Hospital Medicine. Practicing fulltime in the hospital setting means a lot of exposure to death and dying, to pain and suffering as well as to the joy of healing. I learned how to help patients make decisions about their goals of care, something no one had ever done with them before. In 2004, seeing the need, I created a Palliative Medicine program, both inpatient and outpatient. Similar fledgling programs sprang up across the Region until it was officially embraced by Kaiser Permanente. In 2006, I transferred to the South San Francisco Hospital and after a year moved into nursing home care. I received my boards in Hospice and Palliative Medicine and slowly shifted into primarily Palliative Medicine. I became Chief of Community Based Medicine (skilled nursing facility (SNF), home health and hospice) as well as Chief of Palliative Medicine. A few years ago, I also took on some regional responsibilities as the Physician Lead for SNF and Home Health for Kaiser Permanente Northern California. Despite my administrative responsibilities, the most professional pleasure comes from sitting down with patients and family and talking heart to heart about what truly matters. I live in Lafayette, CA with my beautiful wife, in a nice a quiet empty nest, except for our two cute Maltipoos.