Q&A Part I: Dr. Gene Kallsen, chief of emergency

Dr. Gene Kallsen started his career as a resident physician at Valley Medical Center (now University Medical Center) in 1977 and became faculty in 1979. Now the chief of emergency medicine, Dr. Kallsen never left.

“I’ve been doing it ever since,” said Dr. Kallsen during an interview in his new UCSF Fresno office, where he has relocated in preparation for the April 16-18 move of UMC’s Level 1 trauma, burn, pediatric and acute inpatient services to the downtown Community Regional Medical Center.

During his tenure, Kallsen has also served as medical director of the EMS system and assistant dean at UCSF Fresno from 1986-1991.

With the long-awaited move just days away, Dr. Kallsen took some time to reflect on what has been accomplished at UMC and to look at what’s ahead:

How do you feel about this move?
It’s great for everybody, it’s great for our community, it’s great for UCSF Fresno and its medical education program, it’s great for the downtown area and it’s great for people who need the services of the regional trauma center.

What are you most looking forward to about moving to the downtown Community Regional Medical Center?
The immediate benefit is the consolidation of our specialists. We have been in a situation where, especially, orthopedic surgeons, hand surgeons and neurosurgeons from UMC had to cover more than their own hospital and it’ll be much easier then for them to manage the combined volumes of trauma and emergency patients under one roof.

We hear a lot about UMC. Tell us, what is so special about it?
The special thing about UMC is that the people who work there are especially devoted to the management of major trauma and to the underserved, who rely on us to take care of them. There’s a certain camaraderie among the staff and physicians that I think is more than in most hospitals and it’s a camaraderie that I hope we can preserve as we move to our shiny new digs.

How will this UMC move impact what the people from UMC can do?
Well for one it’s a chance to change the way we do a lot of things. Any time you move, and especially if you’re merging with people who have different cultures and different habits, it makes you examine the way you’ve always done things. And it makes you look at the way other people are doing things. And it’s a real opportunity to find the best way to do things instead of the old way. The other thing is we’re going to have access to more modern facilities and equipment which makes our job a little bit easier, and I hope it makes the outcomes for the patients a little bit better.

The new five-story trauma critical care building will house UMC's Level 1 trauma, burn, pediatric and acute inpatient services after the April 16-18 move.

What will be the toughest part of this transition?
The toughest part is for all of the various cultures and perspectives that are being merged. We have to carefully find the best new way to do things, the best of the combined culture, and we need to help the transformation for those who are stuck in the way they’ve always done it.

If I’m a patient coming to this bigger than ever regional medical center, what can I expect?
You can expect first-rate, world-class care. You can expect specialty backup that’s about as good as you can find in America today. You will find some crowding and some waits, like you’ll find in emergency departments all over the country. I hope you find an eager and friendly staff 100% of the time, and I know you’ll find that the vast majority of the time. One thing you’ll find that isn’t present in most hospitals, but typical of major teaching hospitals, is that all hours of the day you will find at least a dozen physicians ready to respond to emergencies regardless of the time of day.

What does it truly mean to be an academic regional medical center?
To be an academic regional medical center you have to successfully deliver three products. The first is service to your patient and your community by providing care to all comers at all times of day, period.

Secondly, to be an academic medical center you need to provide education. The central San Joaquin Valley is significantly underserved in terms of its medical education being provided. We have less than half as many residents per capita as California as a whole and less than a third as many per capita as the United States as a whole. The best way to solve the ongoing shortage of medical specialists in the Central Valley is to grow as many of them as we can in our own programs. It’s well-known that people very often settle in the community where they do their specialty training for residency.

The third leg of an academic medical center is research. We have a significant research program. We expect it to be more robust in the future. We expect to be able to offer our patients treatment opportunities that they can’t find anywhere else in the region.

How important does Community Regional now become to the Valley?
It’s absolutely essential. There is no place like this for well over 100 miles in any direction and it gets close to 200 miles in most directions. Community Regional is more important to central California than any facility in Los Angeles or the Bay Area is to its respective area.

Give me your best UMC story.
I remember back when I was a resident, one night back in 1978, I was the most senior resident on duty in the department. We had no faculty in the hospital at that time, as opposed to now when there’s always faculty in the department around the clock, and at 10 p.m. on this Saturday night the chief of our department checked out to go home for the night after a long day in the ER. He signed out a number of patients to me.

At the time there were about 20 patients waiting to be seen. So I went to work and just a few minutes later we got a radio call that we had a six-victim car accident and there were some very serious casualties. As I remember, at least two of them had to go to the operating room almost immediately and a couple of others had major injuries so it was a big influx of serious casualties all at once that kept us fully occupied for at least the next couple of hours.

So the next day as I was telling him about that story he said, “well why didn’t you call me back?” And I said, “Gee, if I didn’t need you for 20 patients why would I need you for 26?” … Fortunately for us, and for the public, we staff much better than that now and we don’t spread ourselves that thinly.

This story was reported by Eddie Hughes. He can be reached at eddieh@communitymedical.org.

Monday, April 09, 2007