Best Doctors in the East Bay
From Botox shots and bionic pancreases to eye injections and DMARDs, peer-honored physicians share their insights on medical breakthroughs in their fields.
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Yvette Fan, M.D
Kaiser Permanente Medical Center, Oakland
A mother of two, Fan attended medical school at the University of Arizona College of Medicine, before coming to Kaiser Permanente Medical Center in Oakland to finish her residency. After completing a fellowship at Stanford University’s School of Medicine, Fan returned to Kaiser Permanente’s Oakland Medical Center and has worked for the Permanente Medical Group as a pediatric endocrinologist since 1997. In her spare time, Fan, 49, enjoys hiking, scrapbooking, and kickboxing. She lives in the East Bay with her husband and two teenagers.
What types of cases do you see in your practice?
I treat children with a variety of conditions, including growth issues, type 1 and type 2 diabetes, and thyroid conditions. With childhood obesity, we work with the children and a dietitian to try and get their diet and weight under control. We also work with children who are pre-diabetic to help them lose weight and avoid having their condition progress to type 2 diabetes. It’s very rewarding to work with so many families, such as our diabetic patients, over a period of years, and to watch them live full lives and not let their medical condition define them.
How has the practice evolved over the past 16 years?
We’re seeing more children who are going through puberty at an earlier age and have also seen the rates of childhood obesity and type 2 diabetes rise rapidly among children. When I was doing my fellowship, I typically would only see one to two children with diabetes, and now that population makes up a third of my practice. Over the last couple of years, we’ve also seen a rise in the number of transgender kids that we treat. They now make up 5 percent of my practice, or about 15 to 20 children and teens, but five years ago, we had none.
Are there any cases in particular that have impacted the way you practice medicine?
One of my patients is an 11-year-old who has a rare genetic disease called Wolfram syndrome that caused him to develop diabetes at the age of 2 and will gradually rob him of his sight and hearing as a young adult. His family organizes a team every year to run in the Oakland Running Festival to raise money for research for a cure for Wolfram syndrome. Initially I started running the 5K, and each year I’ve doubled the distance that I run. This year I will be running the half marathon. For those who know me, I am incredibly uncoordinated and unathletic, so for me to run any kind of race is a huge deal. I’m not a researcher, so while I can’t find a cure for diabetes, I can care for my patients, educate others about how diabetes affects our lives, and raise money for awareness and research.
How has technology changed your practice?
Continuous glucose monitoring and insulin pumps have really evolved, and they help our diabetic patients to better manage their blood sugar levels. A bionic pancreas is already being tested—it checks a person’s blood sugar level, using a little sensor that goes just under the skin, every five minutes, and it sends this information to a Smartphone app that then “decides” whether blood sugar needs to be raised or lowered and automatically administers insulin as needed. It’s already been successfully tested on adults and teens with type 1 diabetes, and I believe it will be approved by the FDA and available to consumers within the next 10 years.
James Lahey, M.D.
Kaiser Permanente, Union City Medical Offices
Growing up in Southern California, Lahey originally set his sights on being a bass player. Although he decided to ultimately pursue a career in medicine, Lahey continues to play the bass and to write original music. A graduate of University of Texas Health Science Center School of Medicine in San Antonio, Lahey came to the Bay Area to complete his internship at St. Mary’s Hospital and Medical Center in San Francisco, and his residency at UCSF. He also completed a fellowship at UCLA Medical Center before joining Kaiser Permanente in 1993. Lahey, 54, is the father of three grown sons and lives with his girlfriend in the East Bay.
You recently went on a medical mission. Can you tell us more about that experience?
Last year, I traveled to Nepal in South Asia for four weeks to perform retinal surgery. Nepal is one of the poorest countries in the world, and their hospitals don’t have the equipment that we have here in the United States. It’s also not uncommon for the power to frequently go out in Nepal, so we were working under very different conditions. People would travel for miles and line up waiting to be seen. We treated cases of retinal detachment, eye complications caused by uncontrolled diabetes, and operations for cataracts and glaucoma. It was a phenomenal experience and I hope to return, but the mission also made me even more appreciative of my practice here at Kaiser Permanente.
What advancements have you seen in the field of ophthalmology?
The field of retinal surgery has advanced dramatically in recent years. It’s very exciting to have so many new treatments to offer to our patients. We now have eye injections that we can offer to patients to combat the wet form of macular degeneration, the most common cause of vision loss, affecting one in five people over the age of 70. Until recently there was no medication available to treat macular degeneration, and they would lose their eyesight. While these injections aren’t a cure, they do allow people with the most severe form of the disease to maintain their sight longer.
What’s the most rewarding aspect of your job?
I enjoy being able to help patients overcome any challenges they might be having with their eyesight and to get the highest-quality vision. My philosophy is to treat each patient’s problem as I would want to be treated if a family member or myself had the same problem. At Kaiser Permanente, there is no financial reward for choosing a certain treatment pathway, so I can recommend the course of treatment that I believe will offer my patients the greatest impact.
What vision advice do you have for readers?
Many vision problems such as macular degeneration and cataracts are best treated in their early stages. In order to maintain long-term eye health, we recommend that patients under 40 have their eyes examined every two to four years, after the age of 40, patients should get an eye exam every two to three years, and every year after the age of 60. By getting regular eye exams, an ophthalmologist can detect whether you have macular edema, cataracts, or diabetic retinopathy (a diabetic eye disease), and can work with you on a treatment plan to preserve your vision.