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Frontliners

SGIM is honoring our members at the front lines of COVID-19 with our new member highlight series, "Frontliners". Are you or anyone you know at the front lines of COVID-19? Contact us with the subject “Frontliners” to have your story told.

Mitchell Feldman, MD, MPhil, Chief of Internal Medicine at University of California San Francisco

Q: How are you involved in the COVID response?
A: As a leader in our health care system as the Chief of the UCSF Division of General Internal Medicine for UCSF Health - and as a GIM clinician and educator. 

Q: California is now leading the nation in positive COVID-19 cases, however San Francisco county accounts for only 5500 of the 432,000 confirmed cases. What are the major factors keeping San Francisco numbers so low compared to southern California?
A: It seems that in the San Francisco Bay Area we were both smart and lucky. We instituted shelter in place earlier than most through local government edict and with the support of many of the prominent tech companies (it turns out that even one week earlier of SIP seems to have made a significant difference in cases and deaths when one compares Southern California with San Francisco), and we have a highly educated population living for the most part in lower density settings along with other factors intrinsic to San Francisco. The Bay Area experience also underscores the importance of strong, proactive, engaged, and evidence-based leadership who believe in science and rely on epidemiological data to make decisions. Who knew that would matter!!

Q: How has COVID tested your leadership as Chief of General Internal Medicine at UCSF?
A: It has been a challenging time for all of us in so many ways. I was approached by UCSF Health leadership at the very outset of the pandemic and asked if the Division of General Internal Medicine (DGIM) would take responsibility for standing up and leading the ambulatory response to the crisis: Respiratory Symptom Clinics (RSCs). At the time, like our colleagues across the country, we were expecting and preparing for a large surge of patients to overwhelm our ambulatory practices and the ED. Literally overnight, we transformed the urgent care clinic we run into an RSC and created a second one in clinic space that had recently been vacated. So operationally, we were gearing up to prepare for the surge while continuing to care for our large cohort of multimorbid primary care patients and trying to maintain our high standards for our educational and research programs. This put tremendous strain on DGIM faculty, staff, and trainees—many of whom were also confronting their own personal challenges of kids now home from school, staff with new financial challenges, and so on. Maintaining DGIM’s sense of purpose and mission, attending to the personal and professional challenges for many faculty and staff, and overseeing increasingly complex finances, all while doing our part to respond to the crisis was both challenging and exhilarating. I am beyond proud of how our entire division responded.

Q: As the Associate Vice Provost for UCSF Faculty Mentoring Program, how has COVID effected mentoring programs, and how have mentoring practices been adjusted for the current medical environment?
A: This is an interesting question. I have long spoken about the importance of distance and virtual mentoring as part of a robust mentoring program. But there is not much empirical evidence on best practices for virtual mentoring. This has allowed us to think more deeply about how to support faculty development and mentoring in an environment in which face-to-face meetings are not possible. I think we have learned that like many other aspects of this new Zoom world, that we can have satisfying mentoring relationships by Zoom, just like we can conduct other meetings and even care for patients in this way. Just not exclusively – and not forever.

Q: What advice would you like to give to SGIM members to encourage them in their efforts to contribute to the response?
A: There are so many ways that SGIM and its members can contribute, but perhaps the most important is for us to individually and collectively help lead the response to the crushing and immoral disparities that are evident in who is being most impacted by COVID. It has been said that there are two pandemics taking place in this country: structural racism and COVID-19. But of course, these crises are inextricably linked, and I am so proud of SGIM for speaking up for social justice and acting against structural racism and health care disparities.

Tom Staiger, MD, Medical Director, University of Washington Medical Center, Professor of Medicine, University of Washington School of Medicine

Robert Fogerty, MD, MPH, Director of Bed Resources at Yale-New Haven Hospital

Sunil Sahai, MD, Division Chief of General Medicine at the University of Texas Medical Branch at Galveston

Kimberly Peairs, MD, Associate Vice Chair of Ambulatory Medicine at Johns Hopkins University

Eboni Price-Haywood, MD, MPH, FACP, Director at Center for Outcomes and Health Services Research, Ochsner Health

Simranjit Singh, MD, Assistant Professor of Clinical Medicine, Indiana University School of Medicine

Nicole Lurie, MD, MSPH, Strategic Advisor to the CEO, Coalition for Epidemic Preparedness Innovations (CEPI)

Noble Maleque, MD, Assistant Professor of Medicine at Emory University

Christopher O’Donnell, MD, Associate Professor of Medicine, Emory University School of Medicine

Karen DeSalvo, MD, MPH, MSc, SGIM Past President and Chief Health Officer at Google

 

Dan Hunt, MD, Director of the Emory Division of Hospital Medicine