Please provide a brief background of your training and practice setting and years in practice.
I have had a practice in Internal Medicine, Geriatrics and Hospice, and Palliative Care for over 25 years. For over 20 years my clinical practice encompassed hospital work, clinic, nursing home and home settings. In addition to clinical training, I completed an MPH in quality improvement, a fellowship in ethics, a fellowship in healthcare leadership and I completed my Certified Medical Director (CMD) training. For the past 5 years I have worked with United Healthcare and Optum as a regional medical director for Medicare programs and national medical director for Hospice and Palliative Care.

What are you passionate about in long term care? How are you pursuing your passion?
I believe a skilled physician can make a huge impact with a long term care team.  The patients have complex medical needs, and it is so rewarding to see how we improve their care working together. I am passionate about the need for strong interdisciplinary teams to provide really effective care. I am also passionate about the need for systems to consistently discuss and communicate about intensity of care preferences (as with POLST) and to improve quality with continuous quality improvement.

What advice would you give to a new graduate contemplating a career in long-term care?
In addition to a clinical setting which is rewarding, I would suggest getting involved in CALTCM and AMDA to find support for some kind of project that is meaningful for you.  Find a mentor and establish a work/life balance.

What additional training do you wish you had that may help with your current practice?
I went from my internal medicine training to become a clinic medical director.  In retrospect, more formal training earlier, with a mentor, would have been helpful.  Try to get involved with an exciting mentor as early as possible. CALTCM and AMDA can help you find a leader who is a good fit for you.

How has CALTCM impacted your practice?
CALTCM has provided a network of colleagues with a passion for quality in long term care. It is a bulwark against the sense of isolation that can develop in LTC and home care practice. It provides the best source of information about issues in LTC practice in CA, especially at the annual meeting. CALTCM also provides stunning exposure to the leaders and trends in LTC in California and nationwide.