Press Releases

Two PAMF Doctors, One Nurse Named Silicon Valley Health Care Heroes

May 10, 2012

On Thursday, May 10, the Silicon Valley/San Jose Business Journal held its annual Health Care Heroes Awards. The ceremony and awards highlight the individuals in the Silicon Valley health care industry: doctors, nurses, CEOs and others who have improved the way the health system works in the valley’s hospitals, labs, start-ups, nonprofits and universities. The 2012 winners were announced at the awards breakfast held at the Computer History Museum in Mountain View, and this year, there were three finalists from Palo Alto Medical Foundation (PAMF).

Dr. David Quincy, Frank delaRama, RN, and Dr. Albert Chan

 PAMF 2012 Health Care Hero Award Finalist and Winners

David R. Quincy, M.D., M.P.H., “Administrator” Health Care Hero Award

In addition to being Regional Medical Director for the Palo Alto Medical Foundation since 2008, and a board certified Family Medicine physician, David Quincy, M.D., is the medical director of the Mountain View RotaCare Clinic.

Dr. David Quincy and Dr. Jane Varner

During his tenure at the Palo Alto Medical Foundation, Dr. Quincy has served on the board of directors, as department chair of Family Medicine, as After-Hours Primary Care program director, and as site leader at the Santa Clara Center for five years. Dr. Quincy has also been involved in numerous committees, and has been department chief and vice-chief at El Camino Hospital.

Dr. Quincy has maintained a concurrent commitment to people in need. For 15 years (since 1997) Dr. Quincy has served as medical director of the RotaCare Free Clinic inMountain View.   This clinic provides care to the growing population of working and unemployed residents who are unable to pay for primary health care. All RotaCare health care services are free to the patient including medical exams, diagnostic testing, lab testing, and pharmaceuticals. The organization is volunteer driven, and “employs” more than 1,000 medical and non-medical volunteers.

Albert Chan, M.D., M.S., “Future Leader” Health Care Hero Award

Dr. Chan goes to the stage to receive his award.

Albert Chan, M.D. has combined his talent in medicine and his dedication to patient care with his exceptional knowledge of information technology. As a board certified Family Medicine doctor,  he regularly sees patients, and combines his personalized care with technology to improve medical care and empower patients – promoting patient-centered decision support, online disease management, and leads the optimization of clinician use of electronic health records at PAMF and throughout the Sutter Health network of care.

A pioneering advocate of the value of electronic health records, Dr. Chan is physician champion of the electronic health record and e-health for the Palo Alto Medical Foundation.  He currently serves as Chief Medical Information Officer of the Palo Alto Foundation Medical Group, Medical Director of the David Druker Center for Health Systems Innovation, and Medical Director of My Health Online (formerly known as PAMFOnline) for Sutter Physician Services. Dr. Chan also headed up the creation and implementation of the My Health Online mobile formats via the MyChart app on both Android and Apple devices. More than 70 percent of PAMF’s patients are using My Health Online.

Frank delaRama, RN, “Nursing” Health Care Hero Award Finalist

A nurse navigator in the Cancer Care Department of the Palo Alto Medical Foundation, Frank delaRama, RN, is wholly dedicated in his daily work to helping people through their cancer journey.

Frank delaRama with PAMF CEO Dr. Richard Slavin

Frank likens himself to a GPS system, helping prostate and breast cancer patients find the best route to take for their journey. He deeply and genuinely cares about his patients, their families, and their futures.

He is founder and chair of PAMF’s Cancer Patient Advisory Board, which is comprised and lead by cancer patients and survivors. He also helped create PAMF’s Prostate Cancer Buddy Program – which puts men in touch with each other as they navigate the prostate cancer decisionmaking and journey. Frank is also a member of Sutter Health’s Cancer Service Line Prostate Committee, with an NIH-funded study underway exploring shared-decision making in prostate cancer treatment, as facilitated by a nurse navigator.

As an Oncology/Genomics Clinical Nurse Specialist (Navigator), Frank provides all cancer genetics counseling services for the multi-specialty group practice; he has done more than 500 genetic counseling sessions to date. He also provides all prostate cancer navigator services for about 125 new patients every year, with continuing services aimed toward survivorship care. He is also an active blogger on Sutter Health’s My Life Stages with his “Prostate Cancer: A Family Affair” blog.

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Patients’ Fear of Being Labeled “Difficult” an Important Barrier to Shared Decision-Making

May 7, 2012

Shared decision-making is an approach to patient centered care that was featured prominently in the Affordable Care Act as a way to give patients a greater voice in making decisions about their health care. A new study finds that some patients are concerned about being labeled “difficult” if they ask too many questions or disagree with a recommendation from their physician and worry that this could result in receiving lower quality care in the future.

The study, conducted by researchers at the Palo Alto Medical Foundation Research Institute and the Dartmouth Center for Health Care Delivery Science, was published in the May issue of Health Affairs. It identifies important barriers to shared decision-making that have received little attention to date. 




“We found that patients want to participate in making decisions with their physicians, but feel vulnerable and worried that they might be perceived as too assertive, resulting in lower quality care in the future,” said Dominick Frosch, Ph.D., lead author of the study.

Many health problems have multiple options for how they can be treated, but often no single best choice can be identified from the medical evidence. Ideally, patients should play a key role in making these preference-sensitive decisions to ensure that the therapeutic approach chosen is one that fits with an individual’s preferences for risks and benefits. Shared decision-making is a collaborative process that allows patients and their healthcare providers to make health care treatment decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences.

With a grant from the Informed Medical Decisions Foundation, Frosch and colleagues conducted six focus group interviews with patients to learn more about how they perceived communicating with physicians about medical decisions. Study participants were recruited inPalo Alto, an affluent city in the San Francisco Bay Area. Most were Caucasian, highly educated and had above average incomes.

“Although our study doesn’t allow us to draw conclusions about how common these concerns are, it is difficult to imagine that people who are less well-off would not share these concerns,” said Frosch.

Questioning a physician’s advice or recommendations was perceived by participants as a challenge to authority that most wanted to avoid, for fear of “displeasing” or “disappointing” their physician. Many participants also felt that their physicians perpetuated this authoritarian stereotype. To cope with this, participants described doing their own research about treatment options and bringing social support to medical consultations to make the best use of the limited time available. According to Frosch “participants wanted their physician to be an equal partner in making decisions, but did not feel they could rely on them to help them understand treatment options.”

Previous studies have found that lack of physician reimbursement for shared decision-making is a significant barrier, but findings from this study suggest that more needs to be done to increase patient-centered care.

“Most physicians are probably not aware that patients are concerned about asserting their preferences in a medical consultation,” Frosch said. “Our study suggests that health care providers need to be explicit with patients that their opinion matters and that it’s okay to disagree, otherwise the treatment that is prescribed may not be one the patient is willing to adhere to.”

Frosch’s team, including Glyn Elwyn now at the Dartmouth Center for Health  Care Delivery Science, advocates for new measures of health care quality that capture the degree to which decisions made reflect patients’ informed preferences. 

His team has also received a new grant from the Patient-Centered Outcomes Research Institute (PCORI) to develop an intervention that will help health care providers explicitly indicate to patients that their opinions are important and welcome in the process of making decisions about their care. 

“Medical consultations should be a place where patients can feel safe about being open with their concerns and opinions. Otherwise, we really can’t call it patient centered care,” noted Frosch.

The Palo Alto Medical Foundation’s Chief Operating Officer James Hereford strongly endorses Frosch’s field of research.

“Since 2009, we have enthusiastically supported Dr. Frosch’s research in shared medical decision making at PAMF, and now we are implementing simple but effective ways to promote this patient centered care model.”Hereford reported that the medical foundation has already embarked on a comprehensive redesign of primary care workflows with the dual goals of improving efficiency and increasing patient centeredness. Interventions to increase shared decision-making fit well with this vision for health care delivery.

Read more about Shared Decision Making at PAMF in the PAMF Newsroom:

 About the Palo Alto Medical Foundation and Sutter Health

The Palo Alto Medical Foundation (PAMF) for Health Care, Research and Education is a not-for-profit health care organization that is a pioneer in the multispecialty group practice of medicine. Founded in 1930, PAMF is part of the Peninsula Coastal Region of Sutter Health, one of the nation’s leading not-for-profit networks of community-based health care providers. Sutter Health’s Peninsula Coastal Region also includes Mills-Peninsula Health Services. PAMF’s 1,000 affiliated physicians and 4,900 employees serve nearly 730,000 patients at its medical centers and clinics inAlameda, San Mateo, Santa Clara and Santa Cruz counties.

For more information: www.pamf.org

Twitter: http://twitter.com/paloaltomedical

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Dr. Sharon Tapper Selected for New Innovation Advisors Program

January 3, 2012

Sharon Tapper, M.D., has been selected to the Centers for Medicare and Medicaid Services’ (CMS) Innovation Advisors Program. The initiative, launched by the CMS Innovation Center in October 2011, will help health professionals deepen skills that will drive improvements to patient care and reduce costs. 

Dr. Tapper is one of 73 individuals from 27 states and the District of Columbia participating in the Innovation Advisors Program.  After an initial orientation phase, Innovation Advisors will work with the CMS Innovation Center to test new models of care delivery in their own organizations and communities.  They will also create partnerships to find new ideas that work and share them regionally and across the United States.

Funding for this initiative was made possible by the Affordable Care Act. 

Dr. Tapper brings considerable expertise to the advisory board. She has served as medical director of Hospice of Santa Cruz County (2003-2010), medical director and creator of the Palliative Care Program at Dominican CHW Hospital (2004-present), and vice chief of staff at Dominican CHW Hospital in Santa Cruz (2009-2011). She is currently the chief of staff for Dominican CHW Hospital. Additionally, Dr. Tapper is the regional director of Inpatient Palliative Care for Sutter Health’s Peninsula Coastal Region, and the medical director and creator of outpatient Palliative Care and Support Services for the Palo Alto Medical Foundation. She earned her medical degree from the University of Maryland, and completed her internship and residency in Internal Medicine at the University of California, Davis.  Dr. Tapper is board certified in both Internal Medicine and Hospice and Palliative Medicine.

 “There has been an incredible groundswell of interest in becoming an Innovation Advisor.  It’s clear that doctors, hospitals and health care providers are enthusiastic about implementing the Affordable Care Act and strengthening our health care system,” said CMS Acting Administrator Marilyn Tavenner. 

The 73 individuals were selected from 920 applications through a competitive process, and include clinicians, allied health professionals, health administrators and others.  By attending in-person meetings as well as remote sessions to expand their skills and applying what they learn, the Advisors will be able to deepen their knowledge in health care economics and finance, population health, systems analysis, and operations research.  

“We’re looking to these Innovation Advisors to be our partners—we want them to discover and generate new ideas that will work and help us bring them to every corner of the United States,” said CMS Innovation Center Director Rick Gilfillan, M.D. 

Among other duties, the advisors will be expected to support the Innovation Center in testing new models of care delivery, to form partnerships with local organizations to drive delivery system reform, and to improve their own health systems so their communities will have better health and better care at a lower cost.

The Palo Alto Medical Foundation will receive a stipend of up to $20,000, which will be used to support Dr. Tapper’s activities while serving as an Innovation Advisor. 

More information about the Innovation Advisors Program, including a fact sheet and a list of participants and their affiliated organizations.

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