A gift to the Department of Surgery helps our physicians and scientists find new treatments and cures for serious diseases.
John Maa, M.D. is an Assistant Professor of Surgery at UCSF and a surgeon dedicated to improving the quality and access of emergency surgical care. He earned his medical degree at Harvard Medical School, and served as a captain in the medical corps of the U.S. Army for nine years. During medical school, he was awarded the New York City Mayor's Prize for his research thesis entitled "Concomitant Mycobacterium tuberculosis and human immunodeficiency virus infection in New York City, 1986-1991". During his general surgical residency at UCSF, Dr. Maa was awarded an NIH Gastrointestinal Research training grant. He as also published numerous scientific articles on pancreatic and gastrointestinal inflammation.
After his residency, Dr. Maa completed a Fellowship in Health Policy at the UCSF Institute of Health Policy Studies, exploring mechanisms to improve the delivery of general surgical care nationally. During the fellowship, he conceived of the UCSF Surgical Hospitalist Program to enhance the quality and timeliness of hospital based emergency surgical care. This model was implemented at UCSF Medical Center in 2005 to improve the timeliness and quality of emergency surgical care.
In 2009, Dr. Maa was named as one of country's leading advocates for health care reform by HealthLeaders Magazine. In an eloquent and moving essay in the New England Journal of Medicine "Hospital Overcrowding Becomes Personal", Maa addressed a critical issue that had dire consequences for his own family.
John Maa is a member of numerous public health organizations and holds numerous leadership roles including:
Dr. Maa's clinical research focuses on the applying the surgical hospitalist model to improve hospital based emergency care, specifically through new processes and strategies that address the challenges of emergency department overcrowding, boarding and ambulance diversion. Dr. Maa helped create the UCSF Surgical Hospitalist program, which serves as the foundation for quality improvement research programs and collaborations with the UCSF Department of Medicine.high quality and timely hospital based emergency surgical care.
In addition to providing inpatient care more efficiently and addressing the national challenges in emergency call coverage, surgical hospitalists are also more readily available to teach surgical residents and medical students, and thereby promote the overall educational goals for the Department of Surgery
A recent Viewpoint article in JAMA, co-authored by John Maa, M.D., Assistant Professor of Surgery at UCSF, highlighted the importance of smoking cessation before surgery, a conversation that both improves surgical outcomes and creates a teachable moment in the life of the patient:
"Elective surgery offers a powerful opportunity for physicians to help smokers quit, yet 25% to 30% of patients smoke perioperatively, and approximately 10 million patients who smoke undergo surgical procedures annually. Approximately 42% of all surgeons and 70% of anesthesiologists do not routinely counsel patients to stop smoking before an operation or do not refer them to appropriate cessation services........Perioperative smoking is linked to surgical complications including wound infection, respiratory failure, cardiac arrest, myocardial infarction, prolonged hospital stay, stroke, sepsis, shock, and anastomotic leak."
"Two doctors who have learned the art of telling stories are convinced that it has become indispensable to top-notch medical care. "A slow cultural shift over the past 20 years led by television - from "St. Elsewhere" to "ER" - has been humanizing society's view of the practice of medicine," said John Maa, M.D., an assistant professor in the UCSF Department of Surgery. "... As physicians, we must now harness the power of storytelling to enlighten Capitol Hill to enact new laws" to support emergency health care personnel. Maa spoke at Grand Rounds on "The Future of Emergency Care in America: Doctors as Storytellers." He was joined in Cole Hall by Neal Baer, M.D., executive producer and writer for television's "ER" and "Law & Order: Special Victims Unit." His current show is "A Gifted Man."
"The far-reaching implications were made painfully
clear" in an eloquent and moving
essay in the New England Journal of Medicine by
John Maa, M.D., Assistant Professor of Surgery
and Director of the UCSF Surgical Hospitalist
Program. A national leader in improving emergency care, "Dr.
Maa describes the all-too-familiar story of a 69-year-old woman who
is admitted to the E.R. for a procedure to correct an irregular
heartbeat. Her operation is delayed because she has to board for a
full day while waiting for a real bed. During the delay, she
suffers a major stroke and dies............The woman, we learn, was
the author's mother."
Click photo collage or here to enlarge
"It is hardly news that the existing Medicare scheme already includes an element of rationing by limiting the number of Medicare inpatient and long-term care days a person can receive. Our nation has yet to meaningfully discuss end of life care and the potential solutions by setting a budget to overall spending, but starting this discussion will inevitably become necessary."
Note:This is a follow-up to John Maa, M.D.'s blog post Ultimate Sacrifice that appeared several months ago.The most recent issue of the New England Journal of Medicine has a related healthcare policy story, The Waits that Matter, about Dr. Maa's mother.
"An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle's tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured. The 2008 recession claimed my uncle's job, health benefits, and assets, except for a small inheritance. By 2009 he found work (but not health coverage) as a consultant."
Siddhartha Mukherjee, M.D. (pictured left), Assistant Clinical Professor at Columbia University Medical Center, is author of "The Emperor of All Maladies, A Biography of Cancer", dubbed by the N.Y. Times dubbed as one of the "10 Best Books of 2010". The book was reviewed in the SF Chronicle by John Maa, M.D., Assistant Professor of Surgery and Director of the UCSF Surgical Hospitalist Program at UCSF (pictured right) who praised it as "magisterial". Maa recently appeared on C-SPAN's "Booknotes" at Kepler's Books in Menlo Park, CA following the author's book presentation. Maa, a leading advocate for health care reform, took questions with Dr.Mukherjee about the state of healthcare in America.
"Our emphasis in the United States is on the elective patient," UCSF general surgeon John Maa, M.D. asserts. "I think that we have to weigh where society's needs are the greatest. And actually, the needs of these patients are greatest in the emergency population-the patient who is critically injured in trauma who has been shot or who has suffered a penetrating stab injury, patients who have active bleeding-those patients whose traumatic injuries have the highest need," Maa continued.
"Patients who have cancer, I strongly feel, should be prioritized to get to the operating room sooner than patients who merely have cosmetic conditions or relatively elective conditions," he said."
"Given the enormous societal cost of tobacco, the fields of anesthesia and surgery are presented with a special opportunity to deliver a unified message about smoking cessation that will make a real difference in the lives of patients. The first step is to make surgeons around the world fully aware of the risks of smoking so that they can educate their patients who smoke about the increased risks of surgery. Surgeons should include a discussion of active smoking and its risks during the preoperative informed consent discussion when weighing the overall risks and benefits of an operation."
"Hospitalist medicine is the fastest growing medical specialty in the U.S., and surgical hospitalists are especially poised for rapid growth. Many hospital systems see surgical hospitalists as the most valuable response to the growing crisis of general call coverage and as a critical strategy in their effort to comply with quality measures." Acclaimed as a book that "represents the combined wisdom of many of the early physician and non-physician leaders of the surgical hospitalist field, the guide, coauthored by John Maa, M.D., FACS and John Nelson, MD, FACP, provides tools and strategies for executives and physicians.
San Francisco, CA
John Maa, M.D., an Assistant Professor of Surgery, Director of the Surgical Hospitalist Program at UCSF, and a Board Member of the American Heart Association in San Francisco, moderated a panel discussion, "Smoking Cessation Summit: The Solutions" at the Commonwealth Club of California. The panel included health leaders of business, state government and the CDC and addressed the barriers to overcoming nicotine addiction and smoking reduction among Californians.
"The University of California, San Francisco (UCSF) Medical Center realigned its surgical team in order to provide increased coverage and consultations in the emergency department (ED) and general acute care units through use of rotating surgical "hospitalists" who take call for a week at a time (rather than the traditional 24-hour on-call shift). This program, which is believed to be the first large-scale implementation of a surgical hospitalist model in the United States, resulted in quicker response time for consultations and, according to physician surveys, shorter ED length of stay (LOS), better patient satisfaction, improved professionalism and resident supervision, and better overall quality of care."
At most hospitals nationally, it takes nearly four
hours on average before the surgeon on call becomes
available, and even longer before the operation is finally begun.
At UCSF Medical Center, the goal is for the patient to be seen by a
"surgical hospitalist" in less than 30 minutes................"Over
the first year of our program, the average waiting time was 20
minutes," says Hobart Harris, MD,
Professor of Surgery at UCSF and Chief of the Division of General
Photo Provided Courtesy of Majed Photo