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Edward Harris
President of the medical staff The merger and clinical research - meant for each other |
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The UCSF Stanford Health Care merger is a reality, and we as physicians are part of the formal structure of appointed and elected representatives that are now guiding professional programs. We are seeing some changes, and we are also seeing some familiar patterns continuing on a steady course.Service lines have been assembled fusing specialists at both UCSF and Stanford and ensuring no more than minimal organizational redundancy. At the same time, we are learning - as we probably intuitively knew - that except for an extremely complex and specialized procedure, a patient would rarely drive from San Francisco to Stanford, or vice versa, to see a physician. We sensed that the exchange of primary, secondary and even most tertiary patients between the two campuses just won't happen. Now we have evidence that this sense was correct. What about exchange of faculty, giving Stanford residents and students the benefit of UCSF faculty in Stanford clinics and sending Stanford faculty up to UCSF for clinics and rounds? That will be a rare happening, and for two good reasons: highways 101 and 280. But integration is in the air, and one crucial area that begs for closer ties is clinical research. This is particularly intriguing because it involves not only the clinical enterprises, but the academic units as well. Joint protocol development will mean that one plus one equals much more than two. Think how much faster one can sign up the required numbers of patients for a study if we combine forces with colleagues at the north campus. Just as size provides leverage in going after HMO contacts and negotiating with insurance carriers such as Blue Shield, so will it give clinical research a "leg up" in competing for, among other things, the most intriguing and likely-to-succeed Phase I trials of new biologic compounds. I'm convinced, as are many colleagues I've talked with, that the potential for growth in clinical drug trials is enormous. And the attraction does not stop with the faculties of the north and south campuses. Highly developed clinical research programs would appeal to our colleagues at Menlo Medical Clinic, Palo Alto Medical Foundation and Welch Road sites, as well. One exciting intitiative is the ACCESS program headed by pediatrics professor Charles Prober and Chris Scott, the associate director of the Beckman Center. This unit has been able to do what generations before them have not: to simplify the process of contracting for and running clinical trials at Stanford. I will talk more about this marvelous administrative/clinical group in a future column. But before we are completely up-to-speed to develop the premier clinical research program, we must make some infrastructure adjustments. For example, I am convinced that an institution needs dedicated space for outpatient studies to effect optimal clinical research. By space, I mean more than just offices to see patients. We need such seemingly mundane facilities as storage space for supplies, flexible clinical space for procedures requiring special equipment, and rooms that can be changed readily to meet the needs of ever-changing protocols. We will need offices for research nurses and their data files, as well as computer space for staff performing data analysis. Right now, most of us have little or no dedicated space for study of outpatients in various protocols at Stanford. In my own experience, I find that our clinical faculty members and their nurses/coordinators on the third floor of the Blake Wilbur clinics building are currently making do with a tiny space squeezed among piles of boxes and forms. And I know that the crowded conditions faced by those I know best are not unique. So, this is a recommendation to the leadership at UCSF Stanford Health Care. When you plan space, remember to prioritize dedicated space for ambulatory clinical research for all divisions at Stanford that need it, and I believe the need is felt by most clinical services. I firmly believe that that the investment will pay back its cost many times in increased numbers and satisfaction of patients here for research protocols or for established procedures. All these patients should arrive with the confidence that UCSF Stanford Health Care is the "gold standard." |
COLUMNS
Chief of Staff
President of the Medical Staff
Chief Medical Officer, UCSF Stanford Health Care
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