Locally Grown
Bumper Crop of Packard-Trained Pediatricians Keeps Local Kids Healthy

BY HEATHER ROCK WOODS

Go into any pediatric office in the Bay Area, and chances are at least one pediatrician there is Packard or Stanford trained.

Lucile Packard Children's Hospital has one of the top pediatric residency programs in the country, and the program's graduates represent one of the many ways the hospital serves and supports Bay Area and Northern California communities. The majority of the graduates stay local, devoting their outstanding experience, skills, and resources to children and families throughout the region.

"I think we've had a tremendous impact on children's health in this region, in general and specialty pediatric care," says Theodore Sectish, M.D., director of Packard's residency program since 1993. "Over a 14-year period, of the 226 graduates I could account for, 151 are in the Bay Area or Northern California. So 67 percent stay here once they train here."

Each year 20 pediatric residents come to Packard directly from medical school to complete three years of training in pediatrics. They learn primary and specialty care chiefly at Packard Children's Hospital, Santa Clara Valley Medical Center, Kaiser Santa Clara, and Stanford University Hospital and Clinics. The variety of medical settings allows residents to become familiar with bread-and-butter cases and to gain exposure to the breadth and depth of specialty care in areas such as adolescent medicine, cardiology, and neonatology, and surgical disciplines such as otolaryngology, orthopedics, pediatric surgery, and urology.

Dramatic improvements in pediatric treatments, devices, and medicines have led to more children living longer with complex chronic illnesses, notes Sectish. "These kids will more and more be under the care of general physicians who work hand-in-hand with specialists," he says. "I think our former residents are uniquely qualified to be primary care doctors for those patients."

Why do so many Packard alumni remain in the area? It's not just the weather, says Sectish. "The growing population in the Bay Area provides a need for new pediatricians, and residents see job opportunities in the Bay Area while they train," he says. "Plus, Packard has a complete array of subspecialties for residents to pursue in fellowships after residency and there are great job opportunities for their significant others in fields outside of medicine."

No matter the reason Packard-trained pediatricians stay local, children and families here are grateful.

Tina McAdoo, M.D.

Tina McAdoo, M.D.

Tina McAdoo, M.D., finished residency in 1982, then went on to a three-year fellowship at Stanford focused on patient education, before entering practice at the Palo Alto Medical Foundation. Packard residents train regularly at her clinic.

"One of the main reasons I joined the Palo Alto Medical Foundation was to be able to continue my affiliation with Stanford and the Children's Hospital," says McAdoo. "By having a resident spend a half day per week with me, I can meet as well as learn from the fabulous young doctors at Packard. We have hired several of our residents, including the last one who worked with me."

McAdoo says she also enjoys maintaining contact and collaborating with the faculty. "Just today I had a patient come in with a complicated case of severe anemia. I called Dr. Bertil Glader, a hematologist at Packard whom I worked with when I was a resident. He fit her into his schedule today, and called me three times. It's fairly common [for Packard graduates] to have access to someone so willing to work with you. We continue to work together until we solve the problem."

Dana Duncan, M.D.

Dana Duncan, M.D.

Since she finished residency in 2002, Dana Duncan, M.D., has practiced general pediatrics at Santa Clara Valley Medical Center's East Valley Clinic in San Jose. The clinic principally serves low-income, immigrant patients who have publicly funded health insurance that private practices often do not accept.

"I really think that children deserve excellent quality health care, regardless of their type of health insurance," says Duncan. "That's why I ended up at East Valley Clinic. It's great to be able to apply my Packard training to patients who otherwise wouldn’t have the opportunity to benefit from it."

For her patients and their families, a hospital stay, navigating the referral and treatment process, even getting time off work or having the bus fare to get to an appointment are not trivial tasks. "I talk with specialists and consult by phone and sometimes save the family another trip to the clinic or to Packard," says Duncan.

Jim Cisco, M.D.

Jim Cisco, M.D.

Jim Cisco, M.D., a graduate from 1977, works with four other Packard graduates at the Menlo Medical Clinic in Menlo Park.

"Stanford has a first rate training program.What my patients get is a well-trained pediatrician and also access to Packard in all its glory. When I need subspecialty care or advice, I have world-class expertise at my fingertips, and my patients do, too," says Cisco.

About seven years ago, one of his patients injured his head from an in-line skating fall, went to Packard for overnight observation, and recovered with no problems. The boy's parents, pleased with his care, asked Cisco where they could donate $50,000. He chose the residency program. A portion of the gift is used each year to fund a particular need or special project. "I felt a kinship to the residency program and I thought an ongoing gift that benefited the program over time would be of value."

Cisco has treated many patients with complicated illnesses. "There's not a specialist over there [at Packard] whom I don't have patients seeing."

Raquel Burgos, M.D., M.P.H.

Raquel Burgos, M.D., M.P.H.

Raquel Burgos, M.D., M.P.H., offers a kind of pediatric care not normally accessible in modern medicine. She is the first "concierge" pediatrician on the Peninsula, at The Village Doctor in Woodside. With fewer patients (who pay a fixed annual fee), Burgos has the time to make house calls, visit sick or injured kids at their schools, and offer longer, unhurried appointments.

"I'm like the old-fashioned doctor. I love it," she says. "This type of pediatrics I'm practicing is creative, progressive, and high-quality. You really know your doctor and your doctor really knows you."

While having Packard expertise close at hand is advantageous, having Packard training (including serving as chief resident through 2000) benefits Burgos and her patients wherever she goes. "It's a lot less daunting after Packard training to care for children with a whole host of complex medical issues or rare diseases," she says.

Dennis Unson, M.D.

Dennis Unson, M.D.

A few months into his first job as a private practice pediatrician, Dennis Unson, M.D., listened to an infant's heart and heard an unusual heart murmur. When his colleague double-checked it, the sound was gone.

"Was I imagining it?" he remembers wondering. "I had the patient see a cardiologist, who discovered a congenital heart defect. The baby (less than two weeks old) had surgery the following day and the defect was fully corrected. Otherwise, she could have gone into heart failure."

He believes his Packard training proved valuable to his tiny patient. "Coming out of residency training at Packard, you learn about the type of patients who need to be seen immediately. Because you know what they would do for someone at the Children's Hospital, you know how to get things started right away," says Unson, a Bay Area native who completed the program in 2000, and has since worked across the Dumbarton Bridge at South East Bay Pediatric Medical Group in Fremont.