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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Lawrence Dickinson, M.D.
Pacific Brain & Spine Medical Group, Castro Valley
A native of Southern California, Dickinson received his medical degree from the University of Southern California, before completing a seven-year residency in neurological surgery at the University of Michigan, and a fellowship in cerebrovascular surgery from the University of Florida. After completing his fellowship, Dickinson returned to Michigan and served as assistant professor of neurosurgery at the University of Michigan for six years. In 1998, he moved to the East Bay to join the Pacific Brain & Spine Medical Group. A resident of San Ramon, Dickinson, 55, is a married father of two college-aged children and enjoys surfing, snowboarding, and traveling.
How did you choose neurological surgery as a medical specialty?
I originally wanted to be an astrophysicist, but in my third year of college, I changed to biophysics. When I was in college, my sister died from head injuries sustained in a car accident, and just as I was applying to medical school, my brother was hit by a drunk driver, sustained severe head injuries, and later died. The experience of losing two family members had a huge impact on my entire family. My mother became very involved with the Los Angeles chapter of Mothers Against Drunk Driving, and I decided to become a neurological surgeon, in part to help patients who had sustained brain injuries and their families.
Do you think your family’s experience has altered the way you interact with patients?
I believe that I have more empathy for patients and their families having gone through the experience of having a loved one with a head injury. The physician who treated my brother had an awful bedside manner, and I vowed to never be like that. My mentor in medical school was a saint of a man who taught us the importance of having compassion in our practice. He wouldn’t allow us to be egomaniacs. When a patient suffers a brain injury, the entire family is affected, and it’s part of our job as doctors to educate families and to help them become better caregivers. For this reason, I think it behooves physicians to become better communicators.
What types of cases do you see in your practice?
At Eden Medical Center in Castro Valley, where I practice [surgery], we provide trauma care for the southern and southeastern part of Alameda County. We treat patients with traumatic brain injuries, concussions, brain aneurysms, spinal cord injuries, strokes, and brain tumors. We also provide care to the Oakland Raiders, so if a member of the team, or an opposing NFL team, receives a head injury during a home football game, we treat them.
How has your practice changed over the years?
When cars didn’t come with airbags, we used to see a lot more cases of traumatic brain injuries. Today, we see a lot of concussions resulting from sports injuries. We use the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) program, the same program used by the NFL, as the standard for computerized concussion evaluation. We work with high school teams in Castro Valley to give athletes a baseline ImPACT test, and then after a player is injured, we evaluate their injury, repeat the ImPACT test at the clinic, and compare the results with their baseline test results. This helps us to manage their recovery from the concussion and ensures they don’t return to the game too soon.
Holly Magnano, M.D.
Sutter East Bay Medical Foundation, Berkeley
After attending medical school at Stritch School of Medicine at Loyola University Chicago, Magnano, 39, moved to California to complete her internship, residency, and fellowship at Stanford University’s School of Medicine. It was there that Magnano became interested in rheumatology, a medical subspecialty that diagnoses, manages, and treats patients with conditions including osteoarthritis and joint pain, as well as autoimmune diseases including rheumatoid arthritis, gout, and lupus. Magnano, a married mother of three children, lives in San Francisco and enjoys reading, running, and playing tennis in her spare time.
How did you choose rheumatology as a specialty area?
I first became interested in the field during my residency at Stanford. Many autoimmune diseases, including lupus and rheumatoid arthritis, are still misunderstood and misdiagnosed. Often my patients have seen several doctors and received different diagnoses since the symptoms of autoimmune diseases can mimic those of many other conditions. I enjoy diagnostic challenges and helping patients to get an accurate diagnosis and then working with them to devise a treatment plan that helps them live well.
The Centers for Disease Control and Prevention estimate that by the year 2030, 70 million Americans will be at risk for osteoarthritis. What advice do you have for readers who may be looking to ease or alleviate arthritis pain?
I recommend that people with osteoarthritis start by maintaining a healthy body weight. Several studies have shown that patients who lost weight but received no other treatments for knee osteoarthritis experienced improvements in quality of life, the ability to perform day-to-day tasks, and their capacity to participate in sports activities. I also recommend doing some kind of strength training. Even working out with light weights can help reduce soreness, stiffness, and pain. For many people, exercising with arthritis seems counterintuitive, but if I can talk someone into exercising two to three times a week, they usually see a big difference in their pain and stiffness and become believers in the benefits of exercise.
What advancements have been made in the field of rheumatoid arthritis since you first began practicing medicine?
Many medications such as disease-modifying antirheumatic drugs—referred to as DMARDs—have greatly improved outcomes for patients with rheumatoid arthritis by decreasing pain and inflammation. For most people with RA, early treatment can control joint pain and swelling, and lessen joint damage, preventing disability, and even putting RA into remission for some patients.
You also treat autoimmune diseases such as lupus. Have there been any significant advancements to help patients with this debilitating disease?
With improved understanding of lupus, we’ve seen an emergence of new medications in recent years. In 2011, the first lupus medication in 50 years was approved, and since then, drug development has been heating up, and we’ve seen a breakthrough with targeted therapies which are medicines directed at one little molecule in the immune system. In addition, we hope that innovative research in human tissue may also drive discovery of new therapies.