INSTRUCTIONS:
Cost Center 362 – Hepatology (includes GI Liver Clinic and Liver Transplant)
Dictated Work type: 9, 19 or 17
Document Type: 11 – Hospital 1, Parnassus
Letterhead autotext: CC362
There are five different letterheads to choose from. Please choose according to clinic
type (GI Liver or Transplant), dictator and/or location. Dr. Peters has two letterheads for
her clinics. Dr. Davern has two different locations.
Letterhead for Liver Clinic (CC362):
GASTROENTEROLOGY PRACTICE
350 Parnassus Avenue
Suite 410, Box 0657
San Francisco, California 94143-0657
Tel: (415) 353-2318 Fax: (415) 353-2407
Possible subheadings, bold+center+underline, if dictated:
LIVER CLINIC
or
HEPATOLOGY
And possibly a location subtitle
LAS VEGAS CLINIC
or
FRESNO CLINIC
Or
SANTA CLARA VALLEY MEDICAL CENTER
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INSTRUCTIONS (continued):
Cost Center: 362
Letterhead for Liver Transplant Clinic (CC362LT):
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
LIVER TRANSPLANT SERVICE
505 Parnassus Avenue
Room M-884, Box 0657
San Francisco, CA 94143-0657
Tel: (415) 353-1888 Toll-Free: (800) 548-3789
Pre-transplant Fax: (415) 353-8917
Post-transplant Fax: (415) 353-8917
Possible subheadings, bold+center+underline, if dictated:
LAS VEGAS CLINIC
Or
FRESNO CLINIC
Attending physicians:
NATHAN M. BASS, M.D., PH.D.
PROFESSOR OF MEDICINE
MEDICAL DIRECTOR, UCSF LIVER TRANSPLANT PROGRAM
GASTROENTEROLOGY FACULTY PRACTICE
KIRAN BAMBHA, M.D., M.Sc.
ASSISTANT PROFESSOR OF MEDICINE
HEPATOLOGY AND LIVER TRANSPLANTATION
DIVISION OF GASTROENTEROLOGY
UNIVERSITY OF CALIFORNIA SAN FRANCISCO
SCOTT W. BIGGINS, M.D., M.A.S.
ASSISTANT PROFESSOR OF MEDICINE
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INSTRUCTIONS (continued):
Cost Center: 362
TIMOTHY J. DAVERN, M.D.
ASSOCIATE PROFESSOR OF MEDICINE
UCSF DIVISION OF GASTROENTEROLOGY AND
LIVER TRANSPLANT PROGRAM
Also at Mt. Zion (see below)
ALEXANDER MONTO, M.D.
ASSISTANT CLINICAL PROFESSOR OF MEDICINE
GASTROENTEROLOGY FACULTY PRACTICE
NORAH A. TERRAULT, M.D.
ASSOCIATE PROFESSOR OF MEDICINE
GASTROENTEROLOGY FACULTY PRACTICE
(see attached memo and sample)
FRANCIS YAO, M.D.
PROFESSOR OF CLINICAL MEDICINE AND SURGERY
MEDICAL DIRECTOR OF LIVER TRANSPLANTATION
UCSF GASTROENTEROLOGY FACULTY PRACTICE
RENA FOX, M.D.
MONTGOMERY BISSELL, M.D.
OREN K. FIX, M.D., M.Sc.
ASSISTANT CLINICAL PROFESSOR OF MEDICINE
HEPATOLOGY AND LIVER TRANSPLANTATION
Reminder: Please type Dr. Fix's reports exactly as dictated.
Other dictators:
ELIANA AGUDELO, PA-C
SENIOR PHYSICIAN ASSISTANT
DIVISION OF GASTROENTEROLOGY
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INSTRUCTIONS (continued):
Cost Center: 362
Letterhead for Timothy Davern, M.D. at Mount Zion:
Document type: 12 - Hospital 2, Mount Zion
Letterhead AutoText: CC362TD
****Use WT 12 and hospital 2 for Dr. Davern's reports at Mount Zion.****
****Cost Center remains 362.****
GASTROENTEROLOGY FACULTY PRACTICE
2330 Post Street, Suite 610
Box 1623
San Francisco, CA 94143-1623
Phone: (415) 502-4444
Fax: (415) 502-2249
______________________________________________________________________
Letterhead and signature block for Marion Peters, M.D.
Dr. Peters has a separate letterhead for her regular liver patients and for her liver
transplant patients.
THIS IS ONLY FOR DR. PETERS’ REGULAR LIVER PATIENTS, THAT IS, NOT LIVER
TRANSPLANT PATIENTS:
Letterhead Macro: CC362MP
GASTROENTEROLOGY PRACTICE
400 Parnassus Avenue
Fourth Floor, Box 0538
San Francisco, California 94143-0538
Tel: (415) 353-2318 Fax: (415) 353-2407
MARION G. PETERS, M.D.
PROFESSOR OF MEDICINE
GASTROENTEROLOGY FACULTY PRACTICE
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INSTRUCTIONS (continued):
Cost Center: 362
THIS IS ONLY FOR DR. PETERS’ LIVER TRANSPLANT PATIENTS:
Letterhead Macro: CC362MPLT
GASTROENTEROLOGY PRACTICE
400 Parnassus Avenue
Sixth Floor, Box 0538
San Francisco, California 94143-0538
Tel: (415) 353-2318 Fax: (415) 353-8917
Possible subheadings, bold+center+underline, if dictated:
LIVER TRANSPLANT OFFICE CONSULTATION (or FOLLOW-UP or other subtitle)
MARION G. PETERS, M.D.
PROFESSOR OF MEDICINE
GASTROENTEROLOGY FACULTY PRACTICE
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Memo and sample - Norah Terrault, M.D.
-----Original Message----From: Elizabeth Bybee
Sent: Wednesday, June 23, 2004 9:56 AM (rev 4/7/08)
To: Elizabeth Bybee
Subject: REQUEST FROM UCSF
Dr. Norah Terrault (cost center 362) has requested we use the same format for all her letters. As
per the attached sample, all subheadings should be CAPITALIZED AND BOLD. Use
subheadings as dictated, but Dr. Terrault notes that for follow-up patients those are Chief
Complaint, Interval History, Medications, Examination, Laboratory Results, and Impression and
Plan. For new patient dictations, History of Present Illness is used instead of Interval History, and
there are the additional subheadings Past History, Family History, and Social History.
For all clinic letters, please use subheadings as dictated. It is not necessary to "convert"
headings into narrative text. As Dr. Terrault points out, the use of subheadings lends clarity to
particularly lengthy letters.
Thanks everyone.
NOTICE OF CONFIDENTIALITY
This Email message may contain information that is intended only for the use of the individual or entity to whom it is
addressed and may contain protected health information that is privileged, confidential and exempt from disclosure under
the Health Insurance Portability and Accountability Act of 1996 [HIPAA]. The recipient agrees to use the information only
for the purposes for which they have been engaged and agrees to maintain the integrity and confidentiality of the transmit.
UNIVERSITY OF CALIFORNIA, SAN FRANSCISCO
LIVER TRANSPLANT SERVICE
505 Parnassus Avenue
Room M-884
San Francisco, California 94143-0780
Tel: (415) 353-1888 Toll-Free: (800) 548-3789
Pre-transplant Fax: (415) 353-8917
Post-transplant Fax: (415) 353-8917
March 16, 2004
Ross Armstrong, MD
Kaiser – Walnut Creek
1425 S. Main Street
Walnut Creek, CA 94596
Steven Cheng, MD
Kaiser – Walnut Creek
1425 S. Main Street
Walnut Creek, CA 94596
RE:
U#:
99999999
DATE OF SERVICE: 3/16/2004
Dear Doctors Armstrong and Cheng:
I had the pleasure of seeing this patient in followup today in the UCSF Liver Transplant
Clinic.
CHIEF COMPLAINT:
Status post liver transplantation for fulminant hepatic failure.
Hepatitis C acquired in the peritransplant period, with grade 2, stage II disease on most
recent biopsy (January 2004).
Status post treatment with interferon and ribavirin without viral clearance.
INTERVAL HISTORY: The patient returns today to review the results of his liver biopsy.
In essence, his disease appears to be stable over the past year with no progression of
fibrosis. Given these findings, we are in a position to consider deferring treatment for
another year. As you know, he was previously treated with antiviral therapy (interferon
and ribavirin combination) but failed to achieve viral eradication. Treatment was most
problematic from the standpoint of exacerbating his headaches. As you know, he has a
longstanding history of headaches and they became extremely severe during treatment.
He currently tells me the headaches are occurring with increasing frequency. He is only
taking Extra-Strength Tylenol but uses it on a daily basis. He has not seen a neurologist
regarding this problem in many years and has not been counseled or advised about
alternative management of his headaches. I indicated to him that this might be useful
since several new therapies are now available.
Overall, he has been feeling quite well, although in the last week he has suffered from
what sounds like a viral gastroenteritis. Prior to this, his only noteworthy change was a
mild decline in energy. He admits that this may be related to his age, but he remains still
very active. I do not think his fatigue is related to his chronic hepatitis C, although this is
certainly a possibility. In terms of surveillance, he tells me cholesterol and triglyceride
levels were recently checked and were satisfactory.
CURRENT MEDICATIONS: Dapsone 100 mg a day, verapamil SR 180 mg daily,
calcium 2 g per day, Wellbutrin 150 mg a day, CellCept 1000 mg b.i.d., Aciphex 20 mg a
day, Zestril 20 mg a day, Metamucil daily and Replenex.
PHYSICAL EXAMINATION: He looks well. Weight 166.6 pounds (minus 3), blood
pressure 122/86, pulse 83, temperature 36.6°. Sclerae are anicteric. Neck supple. No
lymphadenopathy. Chest clear to auscultation and percussion. Heart sounds normal.
Cardiac rhythm regular. Abdomen soft, nontender and nondistended. A well-healed
incision. No peripheral edema. No tremor.
LABORATORY RESULTS: From 03/04/2004, white count 4.2, hemoglobin 12.9,
platelets 104, pro time 11.7, sodium 141, potassium 3.7, urea 18, creatinine 1.0, AST 75,
ALT 70, bilirubin 2.1, alkaline phosphatase 90.
IMPRESSION AND PLAN: Status post liver transplantation for fulminant hepatic failure
complicated by hepatitis C post transplantation. He is now nearly 15 years post
transplantation and is overall doing extremely well. He is not keen on re-treatment of his
hepatitis C because he had very problematic headaches with his prior course. Since his
liver histology has not shown progression, I think it is reasonable for us to defer
treatment, at least in the short term. I indicated to him that a repeat liver biopsy would be
needed in one year’s time, and if progression was seen, we would need to reconsider
therapy.
I made no changes in his medications today. He will follow up with the transplant
surgeons on his next visit, at which time his immunosuppressive therapy will be
re-reviewed. He currently remains on monotherapy with CellCept. He appears to be
tolerating this medication very well.
If you have any questions, please do not hesitate to contact me.
Sincerely,
NORAH A. TERRAULT, M.D.
ASSISTANT PROFESSOR OF MEDICINE
GASTROENTEROLOGY FACULTY PRACTICE