|
Dear Trainees and Medical Students,
We are delighted that you are part of the UCSF community and proud to offer you an unparalleled education with faculty and staff who have committed their lives to improving the health of California’s diverse communities and patients through clinical care, research, and education.
During your training at UCSF, you have the opportunity to work at many clinical locations and experience broad training and exposure to diverse patient populations. Some experiences will take place in UCSF Health hospitals and ambulatory sites, Zuckerberg San Francisco General Hospital, as well as other affiliated organizations. Some of these other health systems have restrictions on what care can be provided. We want you to understand why these affiliations are important for you and for patients, as well as your rights.
Affiliations
UC’s academic health centers and health professional schools have affiliations with other health care organizations to improve quality and access for the people of the state of California, particularly those in medically underserved communities, and to support UC’s research and public service mission.
Some of these organizations have policies that are different from those of UCSF. For example, some restrict certain evidence-based health care services, such as abortion, contraception, assisted reproductive technologies, gender-affirming care, and end-of-life care, that otherwise would be offered at a UC or other health care location. We affiliate with health systems that may restrict care only after we consider the implications for our patients, providers, and the diverse educational experiences for our students, residents and other trainees.
UC Regents Policy 4405
These organizations are “covered affiliates” under Regents Policy 4405 Policy on Affiliations with Healthcare Organizations that Have Adopted Policy-Based Restrictions on Care and systemwide policy.
UC and UCSF are committed to delivering patient-centered, evidence-based, comprehensive medical care that addresses the needs of patients, advances health equity, and is free from discrimination. Accordingly, when UC providers are working or training at any UC or non-UC facility, they are expected to:
- Make clinical decisions consistent with the standard of care and their independent professional judgment, respecting each individual patient’s needs and wishes. Trainees are expected to make decisions under the appropriate level of supervision by a licensed clinician as outlined in the local UC school and program supervision policies.
- Inform patients of all health care options, regardless of whether those options are available through the covered affiliate, prescribe any interventions that are medically necessary and appropriate, and transfer or refer patients to other facilities when it is in the patient’s interest.
- Provide any item or service deemed necessary and appropriate in the event of an emergency, without restriction, and without seeking approval from any non-licensed health care provider.
Covered affiliates may ask for confirmation of adherence to their policies while working or training at their facilities. However, the major private, non-profit health systems in California with policy-based restrictions have acknowledged in their agreements with UC that their policies permit all of the above activities; and all covered affiliates will have done so no later than December 31, 2023, or UC will exit the agreement.
In addition to these organizations, many government-operated facilities are prohibited by law from performing certain services and have adopted policies implementing those laws. They also have confirmed that they expect their medical staff and personnel providing services at their clinical sites to make clinical decisions consistent with the standard of care and their independent professional judgment, considering the needs and wishes of each individual patient. These government-operated organizations have verified that they comply with federal anti-discrimination laws and that they do not bar advising, prescribing, or referring patients, nor do they bar performing emergency services.
Expectations
UC and UCSF expect that UC employees and trainees will deliver evidence-based health care services and, in those locations where a required service cannot be delivered, appropriate referrals or transfers must be made. If at any time a UC employee or trainee is asked to do otherwise, or a patient has a complaint, the University should be immediately informed as described below.
-
If patients have any concerns or complaints about care received at a covered affiliate’s location, they may contact UCSF Health Patient Relations, patient.relations@ucsf.edu, (415) 353-1936. Online feedback form: https://www.ucsfhealth.org/patient-and-visitor-feedback
-
If you, as a UC trainee, believe your professional judgment or freedom to counsel, prescribe, refer, transfer, or provide emergency care has in any way been impeded at a covered affiliate’s facility, you should immediately contact: Katherine Julian, MD, Associate Dean for Graduate Medical Education, Interim Vice Dean for Education: Graduate Medical Education, Continuing Medical Education and Clinical Affiliations, kathy.julian@ucsf.edu, (415) 514-8663
-
If you, as a UC medical student, believe your professional judgment or freedom to counsel, prescribe, refer, transfer, or provide emergency care has in any way been impeded at a covered affiliate’s facility, you should immediately contact: John A. Davis, PhD, MD, Associate Dean for Curriculum, Interim Vice Dean for Education: Undergraduate Medical Education, john.davis2@ucsf.edu, (415) 770-8792
A summary of all complaints will be provided to senior leadership, including the UCSF Health President and CEO. Concerns may also be reported through the University’s Whistleblower Hotline at universityofcalifornia.edu/hotline or (800) 403-4744.
We hope that you will follow generations of UCSF providers who have been superbly trained through these longstanding relationships and who continue to contribute to improving the health of all patients, regardless of where they access care. Please contact your deans or program directors for any questions.
Sincerely,
John A. Davis, PhD, MD
Associate Dean for Curriculum
Interim Vice Dean for Education: Undergraduate Medical Education
Katherine Julian, MD
Associate Dean for Graduate Medical Education
Interim Vice Dean for Education: Graduate Medical Education, Continuing Medical Education and Clinical Affiliations
|
