I am a hospital medicine physician, health services researcher, and Division Chief of Hospital Medicine at Zuckerberg San Francisco General Hospital. Throughout my career, I have been interested in one fundamental question:

How can we build healthcare organizations where every patient receives excellent care, not by chance, but by design?

Every patient deserves excellent care, but delivering it consistently depends on more than excellent clinicians. It also depends on the organizations in which they work. The systems, teams, culture, and learning environments surrounding clinicians profoundly shape the care they are able to deliver. Understanding how healthcare organizations create those conditions has become the central focus of my work.

Public institutions and academic safety-net hospitals have shaped that perspective throughout my career. From my residency and early faculty years at UT Southwestern and Parkland Hospital in Dallas to my faculty career at UCSF and Zuckerberg San Francisco General Hospital, I have seen both the extraordinary possibilities and the persistent shortcomings of the systems we rely on to care for our communities. Those experiences convinced me that improving healthcare requires more than generating new evidence. It requires understanding how organizations create the conditions that make excellent care possible.

Research alone cannot fully inform this understanding. To answer these questions, I draw on both research and leadership, which gives me an internal perspective of organizational culture, incentives, relationships, and daily decisions. Serving as Division Chief gives me the opportunity to observe organizational change from within, while research provides the tools to study those observations systematically and share lessons beyond a single institution. Together, these perspectives allow me to better understand how healthcare organizations learn, adapt, and create the conditions for clinical excellence.

My research examines how healthcare organizations translate evidence into routine practice, redesign care for medically and socially complex populations, and develop learning health systems capable of continuous improvement. Across clinical care, healthcare delivery, and health policy, my work is united by a common goal: understanding how healthcare organizations create the conditions that allow clinical excellence to flourish for every patient.

I believe safety-net hospitals are uniquely positioned to advance this work. Caring for patients with the greatest complexity while operating under the greatest constraints forces these organizations to continually innovate and adapt. The lessons learned in these settings have the potential to strengthen healthcare systems far beyond the safety net.

My research has been supported by the National Institutes of Health, the Agency for Healthcare Research and Quality, the California Health Care Foundation, and the Chan Zuckerberg Biohub.