Modern Medicine

The East Bay’s Best Doctors Put Patient Care First


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     When you’re looking for a new doctor or you need to help a family member find a physician in a specific specialty area, where do you turn?
      Our list, provided annually by Best Doctors Inc. (www.bestdoctors.com), can help make the process easier. Since 1989, Best Doctors, founded by two Harvard physicians, has conducted the largest peer-to-peer survey of the medical profession asking physicians, “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” Only doctors identified by their peers as “best doctors” in previous years receive the survey. In addition, the staff of Best Doctors reviews each physician nominee for current licensure, board certification and any malpractice incidents, as well as their specific expertise including special research and published work. The doctors are chosen not just for their resumes, but for their continued clinical prowess and their ever-important interpersonal skills.
     This year, we chose five outstanding physicians, including two Oakland natives, to profile from the list of 264 doctors identified by Best Doctors Inc. Each physician is a recognized leader in his or her field. Spanning a wide variety of specialties including pediatrics, dermatology and neurology, this list of local physicians is a guide to some of the finest medical care the East Bay has to offer.
 


Jorge Gutierrez

Pediatric Intensive Care
Kaiser Permanente Oakland Medical Center


     Although Gutierrez grew up down the street from Kaiser Permanente’s Oakland
Medical Center, he was far more interested in being the next shortstop for the Oakland A’s than in being a doctor. It wasn’t until he began studying genetics at UC Berkeley that Gutierrez began contemplating a career in medicine. He attended Harvard Medical School and then completed his residency and fellowship at UC San Francisco. Gutierrez joined Kaiser Permanente in 2005 and continues to indulge his love of baseball by attending his son’s high school baseball games. The 49-year-old married father of two lives with his family in Orinda.

How did you choose your specialty area?
     I did my fellowship in pediatric critical care and found I really enjoyed the fast pace of the job and the broad spectrum of patients. I treat patients who are newborns through age 18, with a variety of conditions such as diabetes and pulmonary disorders. It’s very rewarding to care for a child who is critically ill and to be able to help them recover, or to better manage their condition so they can concentrate on just being a kid again.

What’s a typical day like in your job?
     Kaiser Permanente’s Oakland Medical Center is an academic institution that serves as the Northern California referral center for pediatric subspecialty conditions including childhood cancers, neurosurgical care and cystic fibrosis, to name a few. The pediatric intensive care unit can easily become impersonal, so we make an effort to get to know each patient and to learn something personal about them, like their favorite sport or hobby. Each morning, I conduct family-centered rounds at the hospital with a team that includes a pharmacist, a nutritionist, a respiratory therapist, a nurse and a pediatric resident and, of course, the family. This gives us the opportunity to not only check in with the patient, but to answer any questions their family might have and to ease any of their fears or concerns about their child’s condition.

What do you like best about your job?
     We’ve literally created a children’s hospital within an adult hospital, and I’m looking forward to our new medical center being completed in two years. At Kaiser Permanente, I can do many of the things I enjoyed at UCSF such as teaching and training medical residents and working on a variety of interesting cases, but I don’t have to worry about writing grants to cover salaries. I like being a part of Kaiser’s integrative and collaborative approach to medicine and not having to justify to an insurance company about why I need to refer a patient to a specialist, or be questioned by an insurer about whether the tests I ordered were really necessary.

Are there any exciting medical advancements that will change the way you practice pediatric medicine?
      Leading-edge research into potential stem cell therapies is very exciting, and many of the stem cell studies are focusing on childhood health problems. This research could ultimately lead to cellular treatments for children afflicted with a number of congenital diseases such as those that affect blood cells, the cardiovascular system and the brain. Some early research shows that embryonic stem cell research could even help cure juvenile diabetes by turning embryonic stem cells into healthy insulin-producing  cells that could be transplanted into children with the disease.

What professional accomplishments are you most proud of and why?
     I see how our programs promote good health among the children in our community, and I’m excited about some of the amenities our new hospital will offer families, such as a Family House where out-of-town families can live while their kids are receiving care at our medical center. During my tenure here, we’ve built up the department’s inpatient and subspecialty services, and we are applying  for membership to the National Association of Children’s Hospitals and Related Institutions, an organization that recognizes 221 children’s hospitals throughout the world. I believe it’s not enough for us to provide good care; we need to ensure our patients and their families receive the best care.


Pamela Simms-Mackey

Pediatrician and Associate Director of Graduate
Medical Education
Children’s Hospital & Research Center, Oakland


     Even as a young girl growing up in Oakland, Simms-Mackey, 43, knew she wanted to be a doctor. Today the mother of two young children, ages 8 and 11, maintains a medical practice where she sees children from birth to age 21. A graduate of Stanford University, Simms-Mackey attended medical school at the University of California Los Angeles, served her internship, residency and chief residency at Children’s Hospital & Research Center Oakland, and has worked as an attending physician there since 1998. She is also the associate medical education director at
Children’s where she oversees the hospital’s 83 pediatric residents, 30 interns and four chief residents, ensuring they receive exemplary training in the field of pediatric medicine. An avid cardio kickboxer, Simms-Mackey lives in Oakland with her husband and family.

When did you first decide to pursue a career in medicine?
      I’ve always wanted to be a pediatrician. When I ran for student body president at Montera Middle School, I was quoted in the school newspaper. My mom worked in child development, and my dad’s a retired urologist, so in many ways, my career is a combination of both of their jobs. My sister, Erin Simms-Edwards, is a pediatric ENT doctor in Berkeley. I chose my specialty area because I’ve always liked children. I’m the person who isn’t scared to sit next to the baby on a long airplane flight, or who can be found playing with the kids at a birthday party. When I was in high school at Skyline High, I remember driving by Children’s Hospital Oakland and thinking, “I want to work there some day!”

What is the most challenging aspect of your job?
    Right now, given the state’s current financial crisis, it’s ensuring that our patients get the quality care they deserve, even if they can’t afford it. A large majority of the patients we see in our outpatient clinic are hardworking families who have lost their medical insurance as a result of job layoffs or not being able to afford insurance premiums. A lot of people don’t realize how the recession is affecting children, too, both financially and emotionally.

How has your practice changed over the years?
    We are definitely  diagnosing asthma more and seeing more cases of childhood obesity. Many of our patients are overweight at a much younger age then when I first became a doctor. Kids aren’t exercising as much, due to the cutback in physical education requirements at the middle and high school level, and many of their parents can’t afford to pay for sports leagues or extracurricular physical activities. As a result, we’re seeing more kids diagnosed with medical conditions that we didn’t used to see until middle age, including type 2 diabetes, sleep apnea, high blood pressure and elevated cholesterol.

What advances have you seen in pediatric care?
    We don’t see nearly as many cases of chicken-pox or bacterial meningitis that I saw during my residency, thanks to the effective vaccines we now have for many of these conditions. Medicine has also made great strides in the management of childhood asthma and attention deficit hyperactivity disorder. We are now able to diagnose children with these conditions at a younger age and to offer them better treatment options. We also can treat many pediatric conditions, such as urinary tract infections in young children on an outpatient basis with antibiotics rather than admitting them to the hospital as we did years ago.

What do you like best about your job?
    I really enjoy the interaction I have with patients and their families. I’ve met many of my patients as newborns and continued to be a part of their lives until they become adults. I’ve received e-mails from some of my former patients who are now away at college, thanking me for
the care I provided, and I’m now starting to see the children and in some cases, the grandchildren, of my former patients.


Sunil Dhawan

Dermatologist
Center for Dermatology — Fremont and Milpitas


     A native of San Francisco, Dhawan graduated from San Francisco State University and the University of Southern California School of Medicine. He completed an internship and residency in internal medicine at UCSF
followed by a residency in dermatology at Mt.
Sinai Hospital in Miami. He is an assistant adjunct professor at Stanford’s Department of Dermatology, where he teaches residents and medical students. Dhawan, 52, is married and the father of two teenagers. A dermatologist for the past 21 years, he enjoys working out with his wife at the gym and lives with his family in Fremont.

What types of conditions do you treat?
    We see patients with a wide variety of skin conditions including acne, sun damage, psoriasis, and also people who are seeking anti-aging treatments. The majority of my patients are in their 20s to 30s, but I also have treated babies as young as a month old and I have one patient who just turned 101.

How have advances in technology and medications changed your practice?
    Patients with acne, psoriasis and rosacea have more treatment options than ever before. We now have medications that can treat skin cancers and injections that work to combat plaque psoriasis, which causes red, raised patches
producing dead, flaky skin cells. For patients who are seeking anti-aging solutions, we offer many treatments that are less invasive than
a traditional facelift, including lasers, fillers
and topical treatments. We have better sunscreens today than we did years ago, and some of the newer cosmetic treatments contain growth factors and peptides that stimulate collagen production and thickening of the elastic tissue.

How would you describe your approach to treating patients?
    I believe in a long-term preventative approach and in helping my patients take care of their skin to ward off future problems. I’ve had patients who have come in for one procedure and then ask about getting Botox or another cosmetic procedure. I always give them lots of info and tell them to take it home and read it and then make a follow-up appointment if they still want the procedure. I’ve seen too many people choose Botox or Restylane on the spur of the moment and then wish they had given the procedure more thought. I tell my patients that if they do choose to have an injectable that it won’t turn back the clock, but it will make them look like a more rested and relaxed version of themselves.

How has the medical profession changed over the past 21 years?
    I believe the era of the sole practitioner is a thing of the past. We’re seeing fewer younger doctors going into private practice and more doctors in general taking salaried positions. In the future, patients are going to see more large medical groups and more of a corporate-style practice, a change that is being mandated by insurers and federal health laws. The advantages of a larger group are being able to provide better, more coordinated care, but I think you will be seeing less of the intimacy of long-standing doctor-patient relationships.

What do you consider to be your biggest professional accomplishment?
   I’m very proud of the clinical trials I conduct in my practice where we test newer medications and procedures, such as how different topical treatments might be used in combination to treat tough cases of acne. I’m also proud to be an assistant adjunct professor at Stanford University teaching dermatology residents. My business partners and I also recently opened a new office in Milpitas that we hope will provide patients in the South Bay with better access to our services.


Kendrick Lee

Hand Surgeon
Webster Orthopedics, Oakland


     A  native of Southern California, Lee graduated from Pomona College and received his medical degree at Yale University and served four years as assistant professor of orthopedics there. After choosing to subspecialize in hand surgery, he completed his fellowship training at the
Curtis National Hand Center in Baltimore. In 1988, Lee returned to California to private practice and joined Webster Orthopedics in 1994. He serves as the hand consultant for the Oakland Raiders and enjoys skiing, snowboarding and hiking. Lee, 58, is married and the father of two grown children and lives in Piedmont.

How did you choose your area of specialty?
   It became clear to me in college that I preferred taking care of people more than I did working in a lab. I specialize in reconstructive surgery, microsurgery and disorders of the hand, wrist and elbow. I feel privileged that in my job I am able to treat a wide spectrum of patients who have sustained injuries and fractures from power saws, arthritis, nerve damage, tendonitis and carpal tunnel syndrome. I enjoy helping my patients to overcome their injuries and disorders and resume work and an active lifestyle.

How have your patient demographics changed over the years?
   I used to see more industrial trauma — people who had been injured on the job with machinery. As industry has changed in Oakland and the East Bay, the spectrum of injuries has also changed. While I still see people who have sustained injuries due to falls on ladders or working on construction sites, I see fewer people who have suffered trauma due to drills and power saws. I also see more people who have osteoarthritis or other degenerative hand problems. Years ago, it would have been unusual to see a patient in their 70s who wanted to remain active in order to continue playing singles tennis three times a week, but today we see many older patients who want to continue using their hands and pursuing an active lifestyle for as long as possible.

Have advances in medications and technology impacted your practice?
   In the mid 1980s, arthroscopy was introduced, a minimally invasive technique that allows doctors to diagnose and treat problems inside hand, wrist and elbow joints. Treatments for rheumatoid arthritis have also improved. Recent advances in medications have made it possible to stop, or at least slow, the progression of joint damage, and some new therapies target inflammation. Fifteen to 20 years ago, I saw many cases where RA would lead to deformities and degeneration in a patient’s hands, which would ultimately require surgery. New medications have allowed doctors to better manage RA, resulting in fewer deformities and much less need for surgery. Microsurgery techniques have also made advanced reconstruction possible.

What is the biggest challenge you face in your practice?
   I’ve seen an increase in paperwork As an example, workers’ compensation insurers are enabled by law to conduct “utilization review” of proposed medical treatment in order to determine the appropriateness of that treatment and its compliance with applicable workers’ compensation guidelines. There aren’t enough hand surgeons to complete these reviews, so often a specialist in a different field without the appropriate training or experience reviews the case.Denials of treatment are common and as a result, physicians spend countless hours writing letters to appeal these denials.

What do you consider to be your biggest professional accomplishment?
   I remember one case where my patient had lost  his thumb in a work-related accident. In addition to the injury, there were some cultural factors involved. This man came from a background where it was considered shameful to lose a body part. I was able to reconstruct his thumb using bone from his hip and nail skin and pulp from one of his toes. This is something that wasn’t possible when I was in medical school. This procedure enabled the patient to resume his job and to enjoy a better quality of life.


Barbara McQuinn

Neurology
Private Practice, Alameda


   As a young girl growing up in West Virginia, McQuinn dreamed of entering a career in science. While pursuing her undergraduate degree at Duke University in Durham, N.C., McQuinn discovered she enjoyed working with patients far more than conducting research. Intrigued by the brain and how it works, McQuinn decided to take up a career in neurology, graduating from the West Virginia University School
of Medicine in Morgantown and serving her
residency at Boston City Hospital. An avid triathlete, McQuinn moved to the Bay Area in 1986. Today, the 54-year-old married mother of two teens has medical offices in Alameda and lives in Oakland.

How has the field of neurology changed since you began your practice?
   I’ve seen a lot of changes in the way that certain conditions such as epilepsy are treated. There are much better surgical options available to epilepsy patients as well as more effective and safer medications. We’re seeing better treatments for many autoimmune conditions like multiple sclerosis and a push for the
development of better treatments for neurological disorders such as Alzheimer’s and Parkinson’s. The latter two diseases represent some of our biggest clinical challenges as the baby boomer generation ages.

Are you seeing more of a certain kind of neurological condition in your practice?
   I see a lot of patients who have suffered concussions and traumatic brain injuries, as well as people who are suffering from migraines, vertigo and cognitive problems. I treat a lot of occupational medicine patients who have sustained injuries on the job including common conditions like carpal tunnel syndrome and spinal nerve root injuries. As the population continues to age, we expect to see more cases of Alzheimer’s and other neurodegenerative dis-orders. The flip side is we will also begin to see more research and better treatments designed to delay the onset and progression of many neurological diseases.

What is the biggest challenge you face in your practice?
   One of the biggest challenges doctors face today is obtaining insurance authorization for treatments and procedures their patients need. It’s frustrating to see an insurer deny coverage for necessary diagnostic testing or medications a patient truly needs. It’s also hard to see patients who cannot afford to pay for such care out of pocket, especially when they thought they were insured, but the insurer doesn’t cover the care they need.

What advancements can we expect to see in the future?
   I think new developments in genetics and pro-teomics (the study of proteins produced by genes) will help increase our understanding of predisposition to diseases so we can develop the next wave of therapies to treat neurological disease. Continued research will help us to understand the specific connections between  genetic and environmental risk factors, and to enable us to develop preventative as well as treatment strategies for many of these conditions.

What is your biggest professional accomplishment?
   I find it very rewarding when I can treat a patient’s neurological disorder and, as a result, help them change their life, whether that means maintaining their independence, or finding a drug therapy that helps improve a patient’s cognitive or mobility issues.






 

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