Bio

Bio


Dr. Megan Mahoney is the Chief of General Primary Care in the Division of Primary Care and Population Health at Stanford University where she leads primary care practice transformation, precision health, and population health initiatives for the network of primary care faculty practices at Stanford Health Care. She relies on a close collaboration between health care administration, researchers, and medical education which is essential for ensuring a learning health system at Stanford. Her career has focused on developing innovative and transformational approaches to integrated, team-based primary care that empowers patients, health care providers, and communities in the U.S. and globally. She is a faculty fellow in the Center for Innovations in Global Health and provides lectures on Global Primary Care.

Dr. Mahoney served as the Medical Director and Clinic Chief of Stanford Family Medicine, Stanford's academic family medicine practice at Hoover Pavilion 2014-2016. Before joining Stanford, she was a faculty member at UCSF for 10 years where she served in several leadership capacities in clinic operations, medical education and research.

Dr. Mahoney endeavors to provide patient-centered and compassionate services that enable patients to reach their health and wellness goals. Her academic focus is to develop innovative and transformative approaches to proactive and personalized team-based primary care that empowers patients, health care providers, and communities in the U.S. and internationally.

Clinical Focus


  • Family Medicine
  • Primary Care

Academic Appointments


Administrative Appointments


  • Director, Correctional Medicine Consultation Network HIV Services UCSF (2006 - 2011)
  • Lead Consultant/Mentor, Ethiopia Fitun Warmline of the National Resource Center (2009 - 2012)
  • Principal Investigator and Program Director, Health Access Program for Prevention, Empowerment, and Networking for Women (2009 - 2012)
  • Director, Family HIV Clinic Family Health Center San Francisco General Hospital (2006 - 2012)
  • Residency Program Director, Aga Khan University East Africa Medical College, Department of Family Medicine (2012 - 2014)
  • Director, UCSF East African Office, University of California San Francisco Center of AIDS Research (2013 - 2014)
  • Associate Clinical Professor, University of California San Francisco (2001 - 2014)
  • Lead Consultant, Integrated Primary Health Care Programme, Aga Khan University East Africa Medical College (2012 - Present)
  • Visiting Associate Professor, Aga Khan University East Africa Medical College, Department of Family Medicine (2012 - Present)
  • Medical Director; Clinic Chief, Stanford Family Medicine (2014 - 2016)
  • Senior Fellow, Center for Innovation in Global Health, Stanford University (2015 - Present)
  • Associate Chief, Primary Care (2015 - Present)

Honors & Awards


  • "Outstanding Family Service Network HIV Provider" for the Family HIV Clinic, Family Service Network, Ryan White Care Act Part D (2007)
  • Presidential Award of Distinction for Presentation, AASLD Annual Meeting, American Association for the Study of Liver Disease (2009)

Boards, Advisory Committees, Professional Organizations


  • Member, HHS Office on Women's Health Trauma Working Group in Washington D.C. (2011 - Present)
  • Member, Kenyan Ministry of Medical Services Family Medicine Coordinating Committee (2011 - 2014)
  • Member, California Department of Public Health STI and Viral Hepatitis Division Viral Hepatitis Task Force (2010 - 2012)
  • Reviewer, Human Resources and Services Administration HIV Clinical Review Textbook (2010 - 2011)
  • Member, California Department of Public Health Office of AIDS Rural Think Tank (2009 - 2010)
  • Lead Author, California Department of Corrections Chronic Hepatitis C Care Program Guidelines (2007 - 2011)
  • Member, California Department of Corrections Hepatitis C Program Implementation Task Force (2007 - 2011)
  • Member, California Department of Corrections HIV and Hepatitis Advisory Committee (2007 - 2011)
  • Member, California Department of Corrections Clinical Guidelines Committee (2007 - 2011)

Professional Education


  • Residency:UCSF School of Medicine SF General Hospital (2004) CA
  • Medical Education:UCSF Graduate Medical Education Ofc (2001) CA
  • Board Certification: Family Medicine, American Board of Family Medicine (2004)

Community and International Work


  • Family Medicine Global Exchange, Nairobi, San Francisco, Martinez, Palo Alto

    Topic

    Exchange of family medicine residents training opporutnities

    Partnering Organization(s)

    Stanford, Aga Khan University, UCSF, Contra Costa County Hospital

    Populations Served

    Family Medicine Residents

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • Integrated Primary Health Care Program, Kaloleni, Kenya

    Topic

    Global Health, Primary Health Care Systems Strengthening

    Partnering Organization(s)

    Aga Khan University

    Populations Served

    Medical Students, Residents, Masters Students

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

Research & Scholarship

Current Research and Scholarly Interests


Stanford Family Medicine is the academic hub for family medicine teaching at Stanford University. As Chief of GEneral Primary Care, I lead a team who are innovating primary care strategies that empower patients and health care providers which serve as a model of primary care in U.S. and abroad. Related to this work, I am a Visiting Associate Professor at the Aga Khan University East Africa and a lead consultant for the Integrated Primary Health Care Program which is a public-private partnership between AKU, government and community. At IPHC, we develop and assess strategies that lead to a better integrated primary health care system in a rural region of Kenya called Kaloleni. This setting provides educational and research experiences for medical students, residents and masters students from U.S. and AKU. Current research projects include an assessment of the health information system, enumeration of community, population based survey of district maternal child health indicators, population based research on common mental illnesses, and population based research on hypertension.

As the family medicine residency director at Aga Khan University in Nairobi, my main focus was producing well-trained family physicians who can provide high-quality and cost-effective ambulatory care in urban and rural resource-constrained settings. My role included administration, scheduling, curricular design and evaluation, faculty development, respresentation at various academic, donor, community and government bodies, and work-based, summative and formative assessments of the residents. An important aspect of previous position was relationship building among different health sciences disciplines and different stakeholders, including Ministry of Health and community health committees. Recent curricular developments include community-based primary care and interprofessional, community-based education, in partnership with AKU School of Nursing and Kenya Ministry of Health Community Health Workers.

In addition, I assist in providing placements for family medicine and emergency medicine residents who are doing their elective at the Aga Khan University Hospital in Nairobi, and have mentored Global Health Sciences students during their field experience in Kenya.

From 2004-2012, I taught nurse practitioner students and family medicine residents at the San Francisco General Hospital Family HIV Clinic at the Family Health Center.

Publications

All Publications


  • Utilization of health services in a resource-limited rural area in Kenya: prevalence and associated household-level factors PLoS One Ngugi, A., Agoi, F., Mahoney, M., Lakhani, A., Mang’ong’o, D., Nderitu, E., Macfarlane, S. 2017
  • An academic achievement calculator for clinician-educators in primary care Family Medicine Lin, S., Mahoney, M., Singh, B., Schillinger, E. 2017
  • Community-Oriented Primary Care Curricula in Kenyan Family Medicine Residencies. African Journal of Primary Health Care and Family Medicine Nelligan, I., Shabani, J., Tache, S., Mohamoud, G., Mahoney, M. 2017
  • "I have it just like you do": voices of HIV-negative partners in serodifferent relationships receiving primary care at a public clinic in San Francisco AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV Mahoney, M., Weber, S., Bien, M., Saba, G. 2015; 27 (3): 401-408

    Abstract

    HIV transmission among serodifferent couples has a significant impact on incidence of HIV worldwide. Antiretroviral interventions (i.e., preexposure prophylaxis, post-exposure prophylaxis, and treatment as prevention) are important aspects of comprehensive prevention and care for serodifferent couples. In this study, HIV-negative members of serodifferent couples were interviewed using open-ended questions to explore their health-care needs, perceptions of clinic-based prevention services, and experience of having an HIV-infected partner. Analysis of interviews with 10 HIV-negative partners revealed the following themes: (1) health needs during joint medical visits; (2) sexual risk reduction strategies; (3) relationship dynamics; and (4) strategies for coping. This study elucidated relationship, health and health care factors that might affect development and implementation of clinic-based prevention interventions for HIV serodifferent couples. The findings point to possible relationship-centered recommendations for health-care providers who serve HIV-affected couples in clinical settings.

    View details for DOI 10.1080/09540121.2014.964659

    View details for Web of Science ID 000348663000020

    View details for PubMedID 25311152

  • Reversely Innovative Journal for the San Francisco Medical Association Mahoney, M. 2014
  • Formal hepatitis C education enhances HCV care coordination, expedites HCV treatment and improves antiviral response LIVER INTERNATIONAL Lubega, S., Agbim, U., Surjadi, M., Mahoney, M., Khalili, M. 2013; 33 (7): 999-1007

    Abstract

    Formal Hepatitis C virus (HCV) education improves HCV knowledge but the impact on treatment uptake and outcome is not well described. We aimed to evaluate the impact of formal HCV patient education on primary provider-specialist HCV comanagement and treatment.Primary care providers within the San Francisco safety-net health care system were surveyed and the records of HCV-infected patients before and after institution of a formal HCV education class by liver specialty (2006-2011) were reviewed retrospectively.Characteristics of 118 patients who received anti-HCV therapy were: mean age 51, 73% males and ~50% White and uninsured. The time to initiation of HCV treatment was shorter among those who received formal education (median 136 vs 284 days, P < 0.0001). When controlling for age, gender, race and HCV viral load, non-1 genotype (OR 6.17, 95% CI 2.3-12.7, P = 0.0003) and receipt of HCV education (OR 3.0, 95% CI 1.1-7.9, P = 0.03) were associated with sustained virologic treatment response. Among 94 provider respondents (response rate = 38%), mean age was 42, 62% were White, and 63% female. Most providers agreed that the HCV education class increased patients' HCV knowledge (70%), interest in HCV treatment (52%), and provider-patient communication (56%). A positive provider attitude (Coef 1.5, 95% CI 0.1-2.9 percent, P = 0.039) was independently associated with referral rate to education class.Formal HCV education expedites HCV therapy and improves virologic response rates. As primary care provider attitude plays a significant role in referral to HCV education class, improving provider knowledge will likely enhance access to HCV specialty services in the vulnerable population.

    View details for DOI 10.1111/liv.12150

    View details for Web of Science ID 000321344000005

    View details for PubMedID 23509897

  • ADAPTATION OF AN EVIDENCE-BASED HIV PREVENTION INTERVENTION FOR WOMEN WITH INCARCERATED PARTNERS: EXPANDING TO COMMUNITY SETTINGS AIDS EDUCATION AND PREVENTION Mahoney, M., Bien, M., Comfort, M. 2013; 25 (1): 1-13

    Abstract

    High rates of incarceration in urban, low income communities may exacerbate women's risk of HIV infection by decreasing the number of available male sexual partners and disrupting long-term partnerships. The Health Access Program for Prevention, Empowerment, and Networking for Women (HAPPEN) was established to address the HIV prevention needs of women partnered with incarcerated or recently released men in community settings. HAPPEN is an adaptation of the evidence-based HIV prevention intervention Health Options Mean Empowerment (HOME) project. HOME was designed specifically for women visiting their incarcerated male partners and was delivered at a prison visiting center. Recruitment and program implementation for HAPPEN occurred at community-based organizations serving women with histories of substance abuse, intimate partner violence and incarceration, and provided health education, HIV testing, and linkage to health care and social services. This paper describes the process of adapting HOME using input from target organization stakeholders and target population members.

    View details for Web of Science ID 000315129800001

    View details for PubMedID 23387947

  • Applying HIV Testing Guidelines in Clinical Practice AMERICAN FAMILY PHYSICIAN Mahoney, M. R., Fogler, J., Weber, S., Goldschmidt, R. H. 2009; 80 (12): 1441-1444

    Abstract

    An estimated one fourth of persons with human immunodeficiency virus (HIV) are not aware they are infected. Early diagnosis of HIV has the potential to ensure optimal outcomes for infected persons and to limit the spread of the virus. Important barriers to testing among physicians include insufficient time, reimbursement issues, and lack of patient acceptance. Current HIV testing guidelines address many of these barriers by making the testing process more streamlined and less stigmatizing. The opt-out consent process has been shown to improve test acceptance. Formal pretest counseling and written consent are no longer recommended by the Centers for Disease Control and Prevention. Nevertheless, pretest discussions provide an opportunity to give information about HIV, address fears of discrimination, and identify ongoing high-risk activities. With increased HIV screening in the primary care setting, more persons with HIV could be identified earlier, receive timely and appropriate care, and get treatment to prevent clinical progression and transmission.

    View details for Web of Science ID 000273015000012

    View details for PubMedID 20000306

  • Clinicians' knowledge of 2007 Food and Drug Administration recommendation to discontinue nelfinavir use during pregnancy. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002) Fogler, J., Weber, S., Mahoney, M. R., Goldschmidt, R. H. 2009; 8 (4): 249-252

    Abstract

    In 2007, the US Food and Drug Administration (FDA) and Pfizer Inc recommended immediate discontinuation of nelfinavir (NFV) during pregnancy due to contamination with a potential teratogen. A few weeks after the announcement, we surveyed antenatal HIV care providers to determine how widely the warning was disseminated. Overall, 69 of 121 (57.0%) providers knew to discontinue NFV. Callers with more than 50 HIV-infected patients were 2.54 times as likely to be aware as callers with 1-3 HIV-infected patients (P < .01). Only 12 (33.3%) obstetricians were aware, compared to 21 (80.8%) infectious diseases specialists (P < .001). The FDA/Pfizer Inc recommendation to avoid nelfinavir mesylate (NFV) in pregnancy appears to have successfully reached HIV experts. However, not all pregnant women have access to experts and may receive most of their care from providers without extensive HIV experience. More effective dissemination of critical HIV-related information to all antenatal care providers, including general obstetricians, family physicians, and midwives, may be needed.

    View details for DOI 10.1177/1545109709337034

    View details for PubMedID 19506052

  • . In Reply to HIV Testing: Removing Barriers Can Lead to Earlier Detection and Reduced Transmission American Family Physician Goldschmidt, R., Mahoney, M., Neff, S., Weber, S. 2009
  • Minority Faculty Voices on Diversity in Academic Medicine: Perspectives From One School ACADEMIC MEDICINE Mahoney, M. R., Wilson, E., Odom, K. L., Flowers, L., Adler, S. R. 2008; 83 (8): 781-786

    Abstract

    To examine the perceptions and experiences of ethnic minority faculty at University of California-San Francisco regarding racial and ethnic diversity in academic medicine, in light of a constitutional measure outlawing race- and gender-based affirmative action programs by public universities in California.In 2005, underrepresented minority faculty in the School of Medicine at University of California-San Francisco were individually interviewed to explore three topics: participants' experiences as minorities, perspectives on diversity and discrimination in academic medicine, and recommendations for improvement. Interviews were tape-recorded, transcribed verbatim, and subsequently coded using principles of qualitative, text-based analysis in a four-stage review process.Thirty-six minority faculty (15 assistant professors, 11 associate professors, and 10 full professors) participated, representing diversity across specialties, faculty rank, gender, and race/ethnicity. Seventeen were African American, 16 were Latino, and 3 were Asian. Twenty participants were women. Investigators identified four major themes: (1) choosing to participate in diversity-related activities, driven by personal commitment and institutional pressure, (2) the gap between intention and implementation of institutional efforts to increase diversity, (3) detecting and reacting to discrimination, and (4) a need for a multifaceted approach to mentorship, given few available minority mentors.Minority faculty are an excellent resource for identifying strategies to improve diversity in academic medicine. Participants emphasized the strong association between effective mentorship and career satisfaction, and many delineated unique mentoring needs of minority faculty that persist throughout academic ranks. Findings have direct application to future institutional policies in recruitment and retention of underrepresented minority faculty.

    View details for Web of Science ID 000267654300013

    View details for PubMedID 18667896

  • Care of HIV-infected Latinos in the United States: A description of calls to the National HIV/AIDS Clinicians' Consultation Center JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE Mahoney, M. R., Khamarko, K., Goldschmidt, R. H. 2008; 19 (4): 302-310

    Abstract

    HIV disproportionately affects the Latino population in the United States. Little is known about clinicians who provide HIV care to the Latino community or the types of issues they face. This report presents descriptive analyses of calls made by clinicians who care for HIV-infected Latinos to two lines of the National HIV/AIDS Clinicians' Consultation Center, the National HIV Telephone Consultation Service (Warmline) and the National Perinatal HIV Consultation and Referral Service (Perinatal HIV Hotline). Separate analyses of data from Latino clinicians are also presented. The majority of Warmline calls about Latino patients (81.0%) concerned antiretroviral treatment strategies or HIV-related conditions. More than half (54.3%) of perinatal-specific calls concerned HIV management during pregnancy and the care of HIV-exposed infants. Latino clinicians most frequently called about minority patients. This descriptive study adds to the growing literature about the care of the Latino HIV-infected patient. The Warmline and Perinatal HIV Hotline are resources for HIV care providers in the nursing and medical care of Latinos.

    View details for DOI 10.1016/j.jana.2008.05.002

    View details for Web of Science ID 000257758100007

    View details for PubMedID 18598905

  • African-American clinicians providing HIV care: The experience of the national HIV/AIDS clinicians' consultation center JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION Mahoney, M. R., Sterkenburg, C., Thom, D. H., Goldschmidt, R. H. 2008; 100 (7): 779-782

    Abstract

    This analysis compares patient and provider characteristics of African-American clinicians and non-African-American clinicians who called the National HIV Telephone Consultation Service (Warmline). In 2004, a total of 2,077 consultations were provided for 1,020 clinicians, 70 (6.9%) of whom were African American. Compared to the non-African-American group, a higher percentage of African-American clinicians were nurses (20.0% vs. 8.8%, p=0.002). A significantly lower percentage of African-American physicians were infectious disease specialists (3.5% vs. 25.6%, p=0.007). African-American clinicians were more likely to work in a community clinic (48.5% vs. 34.1%, p=0.015). Both African-American and non-African American clinicians reported caring for a similar number of HIV-infected patients. Patient-provider racial concordance was common among African-American clinicians (76.4%), whereas non-African-American clinicians called about patients of more diverse racial and ethnic backgrounds. African-American clinicians who called Warmline exhibited differences in patient and provider characteristics when compared to all other clinicians. These findings contribute to the growing body of research on HIV providers in the United States.

    View details for Web of Science ID 000257844700001

    View details for PubMedID 18672554

  • Consultation needs in perinatal HIV care: experience of the National Perinatal HIV consultation service AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY Fogler, J. A., Weber, S., Goldschmidt, R. H., Mahoney, M. R., Cohan, D. 2007; 197 (3): S137-S141

    Abstract

    This study evaluates the consultation needs of clinicians who provide perinatal human immunodeficiency virus (HIV) care in the United States. The Perinatal Hotline (1-888-448-8765) is a telephone consultation service for providers who treat HIV-infected pregnant women and their infants. Hotline calls were analyzed for demographics about callers and their patients and information about consultation topics. There were 430 calls to the hotline from January 1, 2005, through June 30, 2006. Most calls (59.5%) were related to pregnant patients; 5.1% of the calls pertained to women currently in labor. The most common topic was HIV care in pregnancy (49.1%), particularly antiretroviral drug use (42.1%). HIV testing was discussed in 21.9%, and intrapartum treatment was discussed in 24.0%. Callers most often requested help choosing antiretroviral drug regimens; many of the discussions were about drug toxicities and viral resistance. Although the hotline received few calls about women in labor, the need for these consultations is expected to increase with the expanding use of rapid HIV testing. Access to 24-hour consultation can help ensure that state-of-the-art care is provided.

    View details for DOI 10.1016/j.ajog.2007.02.033

    View details for Web of Science ID 000249582700019

    View details for PubMedID 17825645

  • The changing role of family physicians in HIV care AMERICAN FAMILY PHYSICIAN Mahoney, M. R., Goldschmidt, R. H. 2006; 74 (10): 1683-1684

    View details for Web of Science ID 000242144600002

    View details for PubMedID 17136997

  • HIV Infection: Clues to Timely Diagnosis. Consultant Mahoney, M., Fogler, J. 2006; 46 (8): 853-860
  • Beyond Antiretrovirals Synapse Mahoney, M. 2000