1. < Message from the Chair

Central to our department’s strategic plan is to be LEADERS in all missions that exemplify our status as a premier academic department of medicine. In the past three years, I have been fortunate to recruit five outstanding new division chiefs and some new clinical chiefs, to continue this important journey. I devote this week’s post to feature conversations with some recently announced leaders.

In Conversation with...Patricia F. Harris, MD

On December 30, the department announced that Patricia F. Harris, MD was appointed clinical chief of the division of geriatrics. Dr. Harris is an outstanding geriatrician who has made an enormous impact on the UCLA Department of Medicine (DoM) community and our patients. She serves as the director of the Geriatric Medical Home Visit Program, a home-based primary care program for elderly patients that she started not long after joining our faculty in 2013. She is also physician lead for the UCLA Medical Group Primary Care at Home. Learn more about her career and vision for the geriatrics division in this Q&A. 

What inspired you to pursue a career in medicine?

I can't recall a time when I wasn't interested in all things pertaining to life sciences. However, it was not until I had nearly completed my graduate studies in the History of Science that I decided to attend medical school. I had been working as a medical transcriptionist to earn a little extra money when I realized that I would prefer a career in medicine. It was the correct decision for me; I am constantly intellectually challenged, enjoy working with my colleagues, and feel the gratitude from my patients regularly.

How have you seen your field evolve over the course of your career?

I think that medicine has become more and more specialized, compartmentalized and a bit isolated. It feels to me like we engage with others outside our specialties much less so than when I started. For example, before imaging studies could pop up on the computer, I recall visiting the radiology suite every day that I was on an inpatient service. Now I don't even know where the radiologists are located! As another example, the availability of virtual conferencing has given us even more excuses not to assemble.

On the positive side, virtual conferencing has opened up our ability to learn and experience from venues previously unobtainable. For example, I watched a Dale Abel lecture on YouTube before he visited UCLA — a preview of what was to come! Additionally, the EMR has greatly enabled us to access patient records, reduce redundancies in tests and evaluations, and access professionals worldwide for advice if a patient has a rare disease or an unusual presentation.

What challenges is your field currently facing?

Although surveys of geriatricians show high professional satisfaction, it is difficult to recruit residents to join the specialty. Many trainees receive very little exposure to the field, and the main lesson is that reimbursements are relatively low and administrative demands are high. We need to think more broadly as a society and we need to do it now. When I started my career, there were about 30 million people over age 65. Now there are almost 60 million. Additionally, those geriatricians who were "grandfathered" into the field are now retiring, so the numbers of geriatricians are shrinking. Currently in the United States, there are approximately 7300 geriatricians (approximately one for every 8200 elders). The American Geriatrics Society projects that we need 30,000 geriatricians to fill the gap. I don't think we are going to make it.

And of course, at the moment the state of research and funding is in complete flux. Even more concerning, the ability of the most vulnerable in our community to receive continued medical care is in question.

What is your vision for addressing a few of these challenges in your new leadership role?

UCLA is a leader in geriatrics. I want to use that leverage to continue to recruit excellent clinicians and researchers as we expand beyond our Westwood campus.

Many already are aware that I started a Home-Based Primary Care program (HBPC), the Medical Home Visit Program (MVP) when I arrived at UCLA in 2013. The program has grown to include three physicians, a nurse practitioner, and a social worker (plus our fantastic office staff). However, due to geographic and personnel constraints, we can serve only a small area of the West Side. 

But, HBPC is growing at UCLA. In February 2024, the Office of Population Health and Accountable Care (OPHAC) at UCLA launched Primary Care at Home (PCAH) for our Medicare Advantage enrollees. With this program, UCLA nurse practitioners (NPs) provide medical care to homebound enrollees throughout all of LA County. I have had the pleasure of supervising these NPs, and look forward to the program’s continued expansion. As more Medicare enrollees choose to be part of a MA program, we will have more opportunities to develop alternative models, since the cost constraints of fee-for-service will shift to more inclusive services, or as they say, “value-based care.”

Programs like these can serve as inspiration for future physicians as they carve out their careers. Many of the fellows that I have helped to train have continued in HBPC, both at UCLA and in other institutions. I believe that we need to model the joy that this kind of work brings us, allowing others to decide to make similar career choices.

What inspires you to do the work that you do?

My inspiration comes from three areas: patients, learners, and colleagues.

I receive the most inspiration first from the gratitude that patients and their caregivers show me. Most of the MVP patients do not go to the hospital at the end of life, because we have given them and their caregivers significant education about what to expect, and they know they will get the medical care they need as they transition through the dying process. Almost no MVP patients have transferred into a custodial nursing home, for the same reasons. These stories keep me going. 

Colleagues provide inspiration at all times. Their advice, questions, and stories remind me that I am part of a larger community with the same vision. And when a learner decides to pursue the same career that I have, especially when I am told that it was our rotation that formed that decision, there is no greater inspiration.

What advice do you have for physicians and physician-scientists who wish to follow your path?

I often think of the advice I received when I first had children and was already worried about how to get them through college. The larger goal may seem out of reach, but we need to focus on smaller, daily tasks that add up to achieving that larger vision. And everyone is allowed to fall flat once in awhile! In fact, failure is the best teacher. Finally, a bit of humor and optimism will only help and can’t hurt.

That having been said, this is a difficult time to start a career. Those of us who are a little more seasoned need to be mindful of that.

Anything else you’d like to share?

I deeply appreciate this opportunity. I take very seriously the trust my colleagues have placed in me. I want to see us form more connections and to find innovations in those connections. Different perspectives can help us to look at a challenge from different angles, and a solution may be in sight!

In Conversation with...Raphael J. Landovitz, MD, MSc

This past Friday we announced that Raphael J. Landovitz, MD, MSc was appointed chief of the UCLA Division of Infectious Diseases and associate chair for clinical research, a new role that will help build the infrastructure for expanded clinical trials in the department of medicine. Dr. Landovitz is an infectious diseases physician and HIV/AIDS researcher who has demonstrated tremendous leadership here in at UCLA, where in addition to serving as interim chief of infectious diseases he is the director of the UCLA CARE Center and co-director of the UCLA Center for HIV Identification, Prevention and Treatment Services. Read on to learn about his career.

What inspired you to pursue a career in medicine? 

From a young age, I was hypothesis-driven, fascinated by the concept of surface tension inspired by bubble baths. My father, a physicist, was hoping that my curiosity would stay at the sub-atomic level of magnification, but organic chemistry became my college passion. I almost pursued a graduate career in chemistry but felt that the humanity of medicine was inexorably compelling. Infectious diseases allowed me to never ignore an organ system and forced a focus on the social and structural barriers to health.

What are you most excited for in your new role? 

One of the great privileges of being division chief is redefining my personal success as the success of all faculty and trainees in the division. To have the opportunity to mentor, learn, and build collaborations with and for our faculty is the best thing about this opportunity.

How have you seen your field evolve over the course of your career?

Diagnostics, therapeutics, and preventive interventions have exponentially grown; the compendium of knowledge is unfathomably large. Learning to collaborate, leveraging shared knowledge and expertise has made medicine an obligatorily collaborative science and practice. We have all had to become chameleons, shifting and adapting to the needs of patients, systems, and pandemics.

What challenges is your field currently facing?

We must stay true to the principles, beliefs, and scientific processes that we hold near and dear; re-committing to equitable, outstanding clinical care for all, diversifying and being efficient in our research endeavors, and supporting each other in our self-care through all manner of successes and challenges.

What are you most excited about for the future of your field? 

Artificial Intelligence and previously unthinkable computational powers have accelerated the science of therapeutic agent development beyond our imaginations. Having the power to be nimble and thoughtful in response to emerging threats, and the opportunities to fight against forces that conspire to prevent equitable benefit from these advances on the global stage are all tremendously exciting and challenging. The power of prevention and preventive interventions gaining more balanced attention compared to therapeutics to avoid disease states is also a particular passion that I hope to share with others.

What advice do you have for physicians and physician-scientists who hope to follow your path? 

We all have a part to play in the great theatrical production that is medical care; all are vital and incredibly valuable. Find the part that feeds your soul, and you will never be bored, aimless, or astray. And do not give in to despair – the work is too important to allow it to falter. Watching our junior faculty and trainees, I know that the future is extremely bright, and we must support their success and perseverance with all available resources.

In Conversation with...John Belperio, MD

Last Wednesday, the DoM announced that John Belperio, MD has been appointed chief of the division of pulmonary, critical care and sleep medicine, allergy and immunology. Dr. Belperio is world renowned for his clinical work with patients presenting with severe complex lung diseases and for his research on lung transplant rejection. In December he was awarded UCLA Health’s Younes Nazarian Humanitarian Prize, an honor that recognizes clinicians whose research, clinical care or technological innovation is advancing humanity.

What inspired you to pursue a career in medicine? 

While working as a chemical engineer at United Engineering in Philadelphia, I would volunteer at a local community hospital emergency room in South Philadelphia. There I encountered many experiences and saw firsthand how a physician could make an incredible impact on patient lives through the power of medicine. Fortunately, multiple physicians encouraged me to consider changing my career to medicine, which lead to a few biology courses in the evening, then the MCAT, and medical school.

What are you most excited for in your new role? 

Helping pulmonary, critical care, sleep medicine, clinical immunology and allergy fellows and junior faculty discover the joys of becoming a clinician, clinician educator or physician-scientist. 

What are some challenges your field is currently facing?

Faculty are discovering it is difficult to find a great work-life balance that allows them to continue their joy, while healing complex patients, educating medical students to fellows, or creating novel science that leads to cures in diseases that take away our patients’ lives far too soon.

What are some ways you hope to address these challenges in your new leadership role? 

Ensure everyone within the division is treated equally and fairly, as well as make sure we lean on each other for support and guidance. To remind our fellows and faculty to pace ourselves as if this is a marathon and not a sprint. We want all faculty to stay here for decades (the marathon) and not years (the sprint). Physicians (clinicians, educators, scientists) need to find the correct pace at work that will allow them to enjoy the journey as well as finish strong.

What are you most excited about for the future of your field? 

Seeing our young physicians come up with novel ways to change outcomes in pulmonary, critical care, sleep medicine, allergy and clinical immunology. 

What advice do you have for physicians and physician-scientists who hope to follow your path? 

At the start of one’s career it is fine to be broad regarding clinical, educational and scientific interests. This allows the individual to determine what their passion is. Once an area of interest is found, focusing will allow for expertise and over time will lead to a national to international reputation and a high chance of making an impact on patient care and clinical outcomes.

Pulmonary Division Receives $20 Million Donation from the Saul and Joyce Brandman Foundation

What an exciting week for the pulmonary division. In addition to celebrating the appointment of Dr. Belperio, the division celebrated receipt of a transformative gift! On March 6 it was announced that the Saul and Joyce Brandman Foundation has committed $20 million to establish a new lung health center, which will provide research and training to physicians and scientists who are working on new ways to fight lung disease. This gift is a culmination of years of advocacy and delivery of care to many grateful patients with advanced lung disease. Read more here!

Celebrating Our New Chief of Geriatrics 

On Feb. 26, the DoM celebrated the appointment of Arun Karlamangla, MD, PhD to his role as chief of the division of geriatrics with a special reception in the UCLA Botanical Gardens. It was a pleasure to welcome him to his new role as we honored the division’s past and its future. As we honor the contributions of prior leaders, we are excited about the future under of geriatrics in the DoM under Arun’s leadership.

Relive this lovely evening in the video below!

Thank A Resident Day Celebrations

Thank a Resident Day may have taken place on Friday, February 28^th but our celebration continued into last week when we hosted an ice cream social for our talented and dedicated residents! We captured a few messages of the celebration and express our sincere gratitude to all residents who are caring for our patients in hospitals and clinics across the health system. Enjoy video of the event below!

Our residents are the backbone of care delivery to thousands of patients in our health system. We are grateful for your service and your commitment to innovate, transform care and advance health for all

Dale

P.S.

For my mom’s 90^th Birthday, I promised to have her attend a VIP event. It turns out she was the VIP!

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