Pulmonary and CRITICAL CARE Medicine Expands to Emeryville

Arthur Sung, MD, a professor of pulmonary and critical care medicine, spends a bit more time getting to some of his patients than he used to, and that’s fine with him. When he commutes to the multi-specialty Stanford Health Care Clinic in Emeryville in the East Bay, a variety of patients with diseases of the lung await him in a recently renovated building. The same is true for many of Sung’s colleagues at Stanford, and Sung is proud to describe what they have done as “a village effort, with early adopters and dedicated faculty. It is truly a programmatic and division integration of the community aligned with both the School of Medicine and Stanford Health Care’s vision.”

Sung explains the motivation for many Stanford pulmonologists to commute 40 miles to the East Bay to treat patients: “There was a need gap there in terms of both the presence of disease and the difficulty patients had accessing the Stanford campus. For patients in the East Bay it may be a short distance by absolute miles to go to Stanford, but because of the traffic it’s quite a chore to cross the bridges. So this was an underserved population, and that was the main stimulus for our coming to Emeryville. We wanted to offer a comprehensive pulmonary program that manages lung diseases from the more common to the more complex.”

The new clinic’s patients are both similar to and different from those seen at Stanford, Sung says. “In Emeryville, I see a lot more patients with common lung ailments such as emphysema and asthma, some smoking-related, that we don’t see commonly at the Palo Alto campus. We also see a lot of complex lung diseases including pulmonary hypertension, lung fibrosis, and lung cancer in the East Bay. And we see general pulmonology problems that community pulmonologists would like us to consult with them about.”

A Collaborative Relationship with Community Physicians

Critical to the success of the partnership at the Emeryville Health Clinic is a cordial and cooperative relationship among all the pulmonologists who practice there. Sung believes the groundwork for their success came from significant effort on all sides. He explains, “Stanford wants to establish close relationships with communities. From the beginning there was a lot of communication between us and the community physicians. This is a partnership. It isn’t really like cutting a pie; it is like sharing and treating the patients holistically.”

“We took many trips to Emeryville to reassure that we were not there to take away business; we were there to add tertiary care. Patients often come to us for just a consultation and then go right back to their community pulmonologist. We don’t keep patients unless it’s necessary; for example, the community pulmonologists don’t really have the bandwidth to take care of diseases like lung fibrosis and pulmonary hypertension, and we can provide those resources.”

Designing the Pulmonary Clinic

In addition to enhancing the local lung disease expertise, all the pulmonologists had the common goal of being able to care for their patients in a completely renovated, state-of-the-art building. Working jointly on that project meant that, as Sung says, “both the community physicians and the Stanford physicians had a lot to say about the design. We had multiple sessions to discuss both the type of patients we wanted to serve and the way they would flow through the building. We took trips to some of the more progressive centers across the country to see how they did things so that we could emulate them.”

The building’s design ensures that patients have a smooth and logical pathway from the entrance to the building to their discharge after being treated. As Sung sees it, “The patient flow is very well thought out. We are able to deliver very simple care and handle diseases that require a lot more expert testing, such as biopsies and procedures, as well as those needing advanced CT scanners and operating rooms. We have all of that."

Exposure to Community Medicine for Trainees

Emeryville also offers a different opportunity for younger doctors than clinics at Stanford. Because of the complexity of so many patients with lung diseases who travel to Palo Alto, Sung believes that “the fellows sometimes miss the opportunity of seeing how it would be practicing in the community. Having Emeryville is a win-win situation. Not only do we provide complex care, but that exposure to community medicine is there for our fellows to experience as well.”

Chunrong Lin, MD, a clinical assistant professor of pulmonary and critical care medicine, agrees that the Emeryville population is different. “At Emeryville I see patients from Oakland, where there are a lot more African Americans than I see at Stanford. I am seeing some patients with severe asthma who have never seen an asthma specialist, and I’m able to introduce them to some new therapies.”

Sung’s own practice in Emeryville mirrors his practice at the main campus. As Sung says, “I do interventional pulmonology for patients who require minimally invasive procedures such as bronchoscopy, severe asthma, lung nodules, and emphysema.”

Sung returns to the unique characteristics of the situation in Emeryville and the advantages it offers both patients and their physicians: “It is uncommon to have such a comprehensive building as we have in Emeryville that provides a lot of the things that you would otherwise send the patient back to the main campus to be tested for.”

The Stanford Health Care Clinic, Emeryville offers every subspecialty of Stanford’s pulmonary program, and each subspecialty is led by Stanford physicians.