Department of Surgery »  Faculty »  General Surgery »  Emily Finlayson, M.D., M.S.

Emily Finlayson, M.D., M.S.

Associate Professor in Residence
Department of Surgery, Division of General Surgery
Phillip R. Lee Institute for Health Policy Studies
Director, Center for Surgery in Older Adults

Contact Information

415-885-3606 - Clinic Office
415-885-7678 - Clinic Fax
415-885-3625 - Academic Office
415-885-3886 - Academic Fax
Emily.Finlayson@ucsfmedctr.org

Education

  • 1985-89 Yale University, New Haven, CT- B.A., Arts
  • 1990-93 Stanford University, Stanford, CA - Pre-Med
  • 1993-97 Harvard Medical School, Boston, MA - M.D.
  • 2000-02 Dartmouth Medical School, Hanover, NH - M.S.

Residencies

  • 1997-2000  University of California, San Francisco - Intern, General Surgery
  • 2002-04  University of California, San Francisco - Resident, General Surgery

Fellowships

  • 2000-02 V.A. Outcomes Group, V.A. Medical Center, White River Junction, VT - Fellow, Surgical Outcomes Research
  • 2004-05 Mayo Clinic, Rochester, MN - Fellow, Colon and Rectal Surgery

Board Certifications

  • American Board of Surgery, 2005
  • American Board of Colon and Rectal Surgery, 2006

Program Affiliations

  • Philip R. Lee Institute for Health Policy Studies, UCSF

Clinical Expertise

Research Interests

  • Surgical outcomes in frail elderly patients

Biography

Dr. Emily Finlayson is a colorectal surgeon whose clinical areas of expertise include colon and rectal cancer, ulcerative colitis and Crohn's disease, with a focus on minimally invasive surgical techniques.

After completing her medical degree at Harvard Medical School, she trained in general surgery at UCSF and in colon and rectal surgery at the Mayo Clinic in Rochester, Minnesota. In her post-doctorate training, she received a Master of Science from the Center for Evaluative Clinical Sciences at Dartmouth Medical School and completed a research fellowship with the VA Outcomes Group in White River Junction, Vermont.  She was on faculty at the University of Michigan Department of Surgery and the Michigan Surgical Collaborative for Outcomes Research and Evaluation until she returned to UCSF in 2009. Her current research is in population-based surgical outcomes with a focus on functional outcomes in the frail elderly.

Research Overview

Dr. Finlayson's research focuses on using administrative data to examine ‘real world' surgical outcomes in the elderly. For example, in an analysis of operative mortality in 1.2 million Medicare beneficiaries age 65 and older undergoing elective diagnostic high-risk surgery, she found that the risk of death increased dramatically with age. Her work examining the impact of age and comorbidity on operative mortality and survival among octogenarians undergoing cancer surgery demonstrated population-based mortality rates in octogenarians that were considerably higher than those reported in published reports from case series or trials. To better understand surgical risks in elders, she has explored the role of institutional factors in surgical outcomes. As is now widely recognized, her work demonstrated that provider procedure volume is inversely related to operative mortality for many high-risk operations and that this association was greatest in elder surgical patients.

In Dr. Finlayson's most recent work, she uses a national nursing home registry to evaluate outcomes after surgery in long stay nursing home residents. She found that nursing home residents experienced high operative mortality for ‘low risk' procedures. After operations to remove the gallbladder or appendix, more that 1 out of 10 nursing home residents died after surgery. She has also used this data to evaluate survival and functional status after colon cancer surgery and found that nursing home residents experience substantial and sustained functional decline after surgery. One-year survival was less than 50%.

The findings in her epidemiology research inspired the creation of the UCSF Center for Surgery in Older Adults. Under her leadership, the interdisciplinary team of stakeholders from surgery, anesthesia, rehabilitation services, geriatrics, palliative care, nursing, education, and health policy with expertise in quantitative research, qualitative research, and implementation science are working together to develop, implement, evaluate best practices in geriatric surgery through the development of a geriatric surgery registry. Our overarching goal is to discover best practices in geriatric surgery through patient-centered outcomes assessment, comparative effectiveness analyses, and interventional trials. In addition, we identify and explore barriers to delivery of optimal care with the aim to improve implementation of interdisciplinary patient-centered surgical care for older adults at UCSF and beyond.

Mentored Research Residents

ResidentYearsGrant or Funding Source
Jennifer Kaplan, M.D. 7/1/2014-
Jessica Cohan, M.D.
Lawrence Oresanya, M.D.
 

Publications

Most recent publications from a total of 31
  1. Wang ED, Conkling N, Xu X, Chern H, Finlayson E, Varma MG, Hansen SL, Foster RD, Hoffman WY, Sbitany H. Perineal reconstruction following anorectal tumor resection: an 18-year single-center experience. Plast Reconstr Surg. 2014 Oct; 134(4 Suppl 1):136-7. View in PubMed
  2. Robinson TN, Finlayson E. How to best forecast adverse outcomes following geriatric trauma: an ageless question? JAMA Surg. 2014 Aug 1; 149(8):773. View in PubMed
  3. Oresanya LB, Lyons WL, Finlayson E. Preoperative assessment of the older patient: a narrative review. JAMA. 2014 May 28; 311(20):2110-20. View in PubMed
  4. Gajdos C, Kile D, Hawn MT, Finlayson E, Henderson WG, Robinson TN. Advancing age and 30-day adverse outcomes after nonemergent general surgeries. J Am Geriatr Soc. 2013 Sep; 61(9):1608-14. View in PubMed
  5. Oresanya LB, Finlayson E. Elective surgery in dialysis patients: realistic risk information from the American College of Surgeons National Surgical Quality Improvement Program Database: comment on “risk of major nonemergent inpatient general surgical procedures in patients on long-term dialysis”. JAMA Surg. 2013 Feb; 148(2):143-4. View in PubMed
  6. Finlayson E, Zhao S, Varma MG. Outcomes after rectal cancer surgery in elderly nursing home residents. Dis Colon Rectum. 2012 Dec; 55(12):1229-35. View in PubMed
  7. Oresanya LB, Finlayson E. Elective Surgery in Dialysis Patients: Comment on "Risk of Major Nonemergent Inpatient General Surgical Procedures in Patients on Long-term Dialysis" Arch Surg. 2012 Oct 15; 1. View in PubMed
  8. Finlayson E, Zhao S, Boscardin WJ, Fries BE, Landefeld CS, Dudley RA. Functional status after colon cancer surgery in elderly nursing home residents. J Am Geriatr Soc. 2012 May; 60(5):967-73. View in PubMed
  9. Finlayson E, Wang L, Landefeld CS, Dudley RA. Major abdominal surgery in nursing home residents: a national study. Ann Surg. 2011 Dec; 254(6):921-6. View in PubMed
  10. Finlayson E, Maselli J, Steinman MA, Rothberg MB, Lindenauer PK, Auerbach AD. Inappropriate medication use in older adults undergoing surgery: a national study. J Am Geriatr Soc. 2011 Nov; 59(11):2139-44. View in PubMed
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