Bio

Clinical Focus


  • Internal Medicine
  • Preventive Medicine
  • Women's Health

Academic Appointments


Administrative Appointments


  • Clinical Assistant Professor of Medicine, Stanford University School of Medicine (2012 - Present)
  • Medical Director, Stanford Hospital and Clinics Clinical Advice Service (2015 - Present)
  • Faculty Physician, Stanford Hospital and Clinics (2009 - Present)
  • Chair, Abstract Committee, American College of Physicians Northern California Chapter (2013 - Present)
  • Educational Mentor, Stanford University School of Medicine Clinical Teaching Seminar Series Honors Certificate Program (2016 - 2017)
  • Associate, Educators for CARE, Stanford University School of Medicine (2010 - Present)
  • Elected Member, Stanford Committee on Professional Satisfaction and Support (2014 - Present)
  • Elected Member, Stanford Wellbeing Committee (2013 - 2015)
  • Lecturer on Primary Care Medicine, Stanford University School of Medicine, Course 313 (2009 - Present)
  • Preceptor for Stanford Medical Students in Primary Care Clinic, Stanford University School of Medicine, Outpatient Rotation (2009 - Present)
  • Preceptor for Stanford Residents, Stanford Internal Medicine Resident Clinic (2009 - Present)
  • Clinical Instructor, Stanford University School of Medicine (2009 - 2012)
  • Elected Representative, Stanford Committee On Residency Training and Clinical Services, Stanford University (2006 - 2009)
  • Medical Student Clinical Preceptor, Harvard Medical School (2004 - 2006)

Honors & Awards


  • Fellow, American College of Physicians (2016)
  • Chair, Abstract Committee, American College of Physicians Northern California (2013-present)
  • Pasteur Clinical Research Scholarship, Harvard Medical School (2003-2004)
  • Senior Thesis Award, Princeton University, Woodrow Wilson School of Public and International Affairs (2001)
  • Tuberculosis Initiative Research Associate Scholarship, Princeton University Project 55 (1999)

Professional Education


  • Residency:Stanford University Hospital -Clinical Excellence Research Center (2009) CA
  • Medical Education:Harvard Medical School (2006) MA
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2009)
  • Board Certification, American Board of Internal Medicine (2009)
  • BA, Princeton University (2001)

Community and International Work


  • Physician, Leyte, Philippines

    Topic

    Medical Mission

    Partnering Organization(s)

    ABC's for Global Health

    Populations Served

    Indigent Filipinos

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Community Lectures, Avenidas Community Center, Palo Alto; Stanford Health Library Palo Alto, CA

    Topic

    Osteoporosis and Hypertension

    Location

    Bay Area

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Community Health Screening Fairs

    Topic

    Volunteer

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Publications

All Publications


  • Effect of opioid prescribing guidelines in primary care. Medicine Chen, J. H., Hom, J., Richman, I., Asch, S. M., Podchiyska, T., Johansen, N. A. 2016; 95 (35)

    Abstract

    Long-term opioid use for noncancer pain is increasingly prevalent yet controversial given the risks of addiction, diversion, and overdose. Prior literature has identified the problem and proposed management guidelines, but limited evidence exists on the actual effectiveness of implementing such guidelines in a primary care setting.A multidisciplinary working group of institutional experts assembled comprehensive guidelines for chronic opioid prescribing, including monitoring and referral recommendations. The guidelines were disseminated in September 2013 to our medical center's primary care clinics via in person and electronic education.We extracted electronic medical records for patients with noncancer pain receiving opioid prescriptions (Rxs) in seasonally matched preintervention (11/1/2012-6/1/2013) and postintervention (11/1/2013-6/1/2014) periods. For patients receiving chronic (3 or more) opioid Rxs, we assessed the rates of drug screening, specialty referrals, clinic visits, emergency room visits, and quantity of opioids prescribed.After disseminating guidelines, the percentage of noncancer clinic patients receiving any opioid Rxs dropped from 3.9% to 3.4% (P = 0.02). The percentage of noncancer patients receiving chronic opioid Rxs decreased from 2.0% to 1.6% (P = 0.03). The rate of urine drug screening increased from 9.2% to 17.3% (P = 0.005) amongst noncancer chronic opioid patients. No significant differences were detected for other metrics or demographics assessed.An educational intervention for primary care opioid prescribing is feasible and was temporally associated with a modest reduction in overall opioid Rx rates. Provider use of routine drug screening increased, but overall rates of screening and specialty referral remained low despite the intervention. Despite national pressures to introduce opioid prescribing guidelines for chronic pain, doing so alone does not necessarily yield substantial changes in clinical practice.

    View details for DOI 10.1097/MD.0000000000004760

    View details for PubMedID 27583928

  • Screening for Osteoporosis American College of Physicians Smart Medicine Pier Review Papaioannou, MD, A., Ferko, MSc, N., Adachi, MD, J., Watts, MD, N. B., Koehler, MD, E., Atwan, MD, N. 2013; January
  • Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. journal of bone and joint surgery. American volume Marx, R. G., Jones, E. C., Atwan, N. C., Closkey, R. F., Salvati, E. A., Sculco, T. P. 2005; 87 (9): 1999-2005

    Abstract

    Patient-derived outcome scales have become increasingly important to physicians and clinical researchers for measuring improvement in function after surgery. The goal of the present study was to evaluate the ability of health-status instruments to measure early functional recovery after total hip and total knee arthroplasty.Four hundred and six patients undergoing total hip arthroplasty and 266 patients undergoing total knee arthroplasty completed health-status questionnaires preoperatively and six months postoperatively to determine the standardized response mean. In the second phase of the study, a group of patients undergoing knee and hip arthroplasty were evaluated with several instruments before and after surgery to test for postoperative ceiling effects.The standardized response mean at six months was 1.7 for the MODEMS Hip Core, 1.2 for the MODEMS Knee Core, and 1.5 and 1.1 for the Physical Component Summary of the SF-36 for patients managed with hip and knee replacement, respectively. A standardized response mean of 1.0 is generally satisfactory for measuring improvement in orthopaedic surgery. In Phase 2 of the study, the vast majority of patients who had a score of 95 to 100 (that is, a maximum or near-maximum score) on the joint-specific scales generally believed that the hip or knee was normal and could not be better.The MODEMS, Oxford, and WOMAC scales all demonstrated a ceiling effect following total knee and total hip arthroplasty. These scores likely reflected the patients' perception of the status of the knee or hip rather than an inability to measure their improvement beyond the highest possible score. The Physical Component Summary score of the SF-36 had similar standardized response means when compared with hip and knee-specific instruments, and, therefore, consideration should be given to using this scale without a joint-specific scale for the measurement of improvement following total knee and total hip replacement, as a way to decrease responder burden (that is, the time required to complete the questionnaires).

    View details for PubMedID 16140815