Critical Care Medicine; Internal Medicine - General; Pulmonary; Pulmonary & Critical Care Medicine; Sleep Medicine
I provide intensive care to patients admitted to the intensive care unit (ICU) at the Veterans Administration Medical Center (VAMC), I care for adult patients with pulmonary diseases such as chronic obstructive pulmonary disease (COPD)/emphysema, asthma, sarcoidosis, cough, lung nodules, pneumonitis and bronchitis, and patients with sleep disorders such as sleep apnea, narcolepsy, insomnia and restless legs syndrome. I have a special interest in the value of good physician-patient communication, and its effect on outcomes. Explaining disease process to patients, listening to their concerns and involving them in their medical decisions may have a positive effect on the results of treatment and interventions, and on their outcomes. I emphasize the importance of physician-patient communication with the students, residents and fellows I teach, train and mentor. I teach medical students in small group sessions in their first and second years, including courses in respiratory pathophysiology. Third- and fourth-year students rotate with me in the ICU and on the pulmonary service. I also supervise residents in the ICU and on the pulmonary consult service, and I mentor pulmonary, critical care and sleep medicine fellows in all aspects of their training. My sleep medicine research interest is focused on the pathophysiology of cardiovascular disease in patients with sleep breathing disorders, and on the interplay between PTSD and sleep disorders. My pulmonary and Critical Care Medicine research focuses on the relation between PTSD and Critical illness, and on pneumonia. Fellows are welcome to work with me on research projects.
Critical Care Medicine; Pulmonary & Critical Care Medicine; Internal Medicine; Pulmonary Disease; Pulmonary; Bioinformatics
I am engaged in clinical, teaching and research responsibilities related to the evaluation and treatment of patients with pulmonary disease or patients who are critically ill. My inpatient practice is primarily located at the medical intensive care unit (MICU) at the Buffalo General Medical Center (BGMC). The MICU provides ongoing medical care to patients who are critically ill and require significant life support therapies to sustain life or vital bodily functioning. I also evaluate patients with pulmonary disorders including shortness of breath, lung masses, abnormal chest imaging, abnormal pulmonary function tests, chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease, pulmonary hypertension and lung cancer, at the lung and heart outpatient clinic located in BGMC. The pulmonary team to which I belong also provides inpatient pulmonary consultation at both BGMC and Roswell Park Cancer Institute. I am specifically interested in asthma, COPD and lung cancer. I am investigating the pathophysiology of lung inflammation. Recently I am engaged in the study of the human airways microbiome and metagenome. The human microbiome is the the collection of all the microbial organisms in a human body, and the corresponding metagenome is the collection of the genes, and gene products of the microbes. Due the potential impact of the microbiome on human health and disease, I am interested in studying the putative effects the interaction with human hosts, specifically innate immunity interaction with the metagenome in lung disease. Additionally, I collaborate with the Division of Allergy and Immunology and the Institute of Laser, Photonics and Biophotonics to elucidate immune cell function in airway diseases such as asthma and COPD. Our research focuses on the development of therapeutics aimed at novel targets identified as important in the molecular basis of pulmonary disease; efficacious laboratory results will generate more effective treatment plans for patients. I am actively involved in teaching medical students, residents and fellows about the appropriate care of the critically ill patient, as these trainees rotate in the MICU.
Critical Care Medicine; Pulmonary & Critical Care Medicine; Internal Medicine; Pulmonary; Sleep Medicine
My clinical responsibilities include serving as an intensivist to patients requiring critical care and participating in the care of hospitalized patients with pulmonary problems at the Buffalo VA Medical Center (Buffalo VAMC). I also diagnose and manage outpatients with sleep problems at the Buffalo VAMC. My clinical research interests include asthma in the elderly and the impact of passive smoke on respiratory health. I also have been exploring novel appreciative assessment approaches to raise resilience and prevent burnout in faculty and medical trainees. In addition, I have a keen interest in working on strategies to enhance faculty mentoring skills. In addition to my clinical and research responsibility, I am passionate about educating future generations of health care professionals, and I help train and mentor medical students from the first to final year of medical school. I am one of the seminar leaders for the Clinical Practice of Medicine course. As such, I help train first-year students in clinical skills. I also play an active role in mentoring medical students, helping them to develop into compassionate and well-rounded physicians who have sound clinical skills as well as the humanistic qualities that are exhibited in the best medical care. As a member of the steering committee for the medical school’s Center for Medical Humanities, I am involved in designing a humanistic curriculum to prepare the next generation of physicians. I facilitate sessions with second- and third-year medical students, with the goal of supporting and fostering humanism. I teach students how to develop their ability to use self-awareness of knowledge, skill and emotional limitations in order to engage in appropriate help-seeking behaviors. As the associate clerkship director in internal medicine, I run “brain teasers” sessions to excite and activate my students as they embark on their clerkship journey into medicine. I conduct lectures and small group sessions in pulmonary and critical care medicine, on topics such as asthma, chest x-ray interpretation, pulmonary function testing and shock--and on topics diverse from my subspecialty such as rheumatology, infectious disease and hematology. In addition, I teach medicine residents and the pulmonary, critical care and sleep medicine fellowship trainees who rotate with me on the inpatient and outpatient services. As a preceptor and member of the Resident Clinical Competency Committee, I provide support and career advice to residents during their training. I believe the ability to think creatively is essential in the medical field, and I strive to help students and physicians-in-training overcome creative barriers. I develop methods to guide students to think “out of the box” and to be inquisitive, and I encourage them to apply these skills to help recognize problems, solve medical cases and design research and clinical treatment.