Alex is a clinician-researcher who is at the forefront of efforts to integrate Geriatrics and Palliative Care. He received his medical school training in the UC Berkeley/UCSF Joint Medical Program. He completed a primary care internal medicine residency at the Brigham and Women’s Hospital (BWH) followed by two fellowships, a one year clinical fellowship in Palliative Medicine at BWH and Dana Farber Cancer Institute, followed by a two year General Internal Medicine Fellowship at Beth Israel Deaconess Medical Center, including an MPH from the Harvard School of Public Health. He returned to UCSF in July 2008 as an Assistant Professor in the Division of Geriatrics.
Alex’s research program focuses on improving palliative care for vulnerable and dependent elders. He has strong interests in bioethics and improving patient-physician communication. Along with Dr. Eric Widera, Alex co-founded GeriPal, a Geriatrics and Palliative Care Blog, the leading source for news and commentary related to Geriatrics or Palliative Care on the web (www.GeriPal.org).
In 2010, Alex decided to provoke a mature national conversation about the role of prognosis in medical decision making, based on science and ethics, rather than misinformation about so-called “death panels”. He argued in the New England Journal of Medicine that clinicians should routinely offer to discuss prognosis with all very elderly patients. In conjunction with a review of prognostic indices published in JAMA 2012, he and his collaborators launched ePrognosis (www.eprognosis.org), an online compendium of prognostic indices for older adults. ePrognosis generated considerable discussion about making life expectancy information available to the general public, including multiple stories in the New York Times, a story in USA Today, and online at the Hastings Center Blog and thedailybeast. ePrognosis received over half a million hits in the first week alone. As a result of this press, Alex was invited to speak to the National Academy of Sciences Committee on Science Technology and the Law.
Below are links to several of Alex’s representative publications:
- Smith AK, Williams BA, Lo B. Discussing overall prognosis with the very elderly. N Engl J Med. 2011 Dec 8; 365(23):2149-51.
- Yourman LC, Lee SJ, Schonberg MA, Widera EW, Smith AK. Prognostic indices for older adults: a systematic review. JAMA. 2012 Jan 11; 307(2):182-92.
- Smith AK, Cenzer IS, Knight SJ, Puntillo KA, Widera E, Williams BA, Boscardin WJ, Covinsky KE. The epidemiology of pain during the last 2 years of life. Ann Intern Med. 2010 Nov 2; 153(9):563-9.