Dr. Michael Steinman is an Assistant Professor of Medicine in the Division of Geriatrics.

Dr. Steinman received his medical school training at Harvard Medical School and completed a residency in primary care internal medicine at UCSF. He then joined the UCSF Division of Geriatrics for fellowships in the VA National Quality Scholars Program and the UCSF Clinical Geriatrics Fellowship. Dr. Steinman has been a member of the faculty at UCSF since 2004.

Dr. Steinman devotes most of his time to research, while also maintaining an active clinical practice in the geriatrics clinic and inpatient general medicine service at the San Francisco VA Medical Center. Dr. Steinman's research program focuses on improving how doctors prescribe medications for older adults, and is supported by grants from the VA Health Services Research & Development Service, the National Institute of Aging, and the American Federation for Aging Research. Dr. Steinman also has an active research and educational program to improve understanding of how marketing by the pharmaceutical industry impacts physician attitudes and behavior.

Dr. Steinman's clinical work is principally focused in two areas. He is a primary care physician in the geriatrics clinic at the San Francisco VA Medical Center, where he sees elderly patients 1/2 day per week. He also serves as an attending physician on the inpatient general medicine service at the San Francisco VAMC.

 

 

 

Dr. Steinman's research program focuses on evaluating and improving the quality of care that older adults receive, with a particular focus on use and misuse of medications. His work in this area includes several active lines of research. Dr. Steinman is principal investigator on a VA-funded grant to investigate why some patients with heart failure are not prescribed guideline-recommended medications. This study involves multiple methods including analysis of national VA databases, convening focus groups, conducting chart review, and interviewing clinicians. Dr. Steinman is also principal investigator on a Paul Beeson K23 award to evaluate risk factors for adverse drug reactions in elders. Other active projects include work evaluating ways to better measure quality of care for patients with hypertension, and studies evaluating measures of medication prescribing quality, done in collaboration with researchers at Stanford and the University of Iowa.

Dr. Steinman also has a strong research and educational interest in how the pharmaceutical industry markets its products, and the impact of these marketing efforts on physicians. He has published a number of research and perspective pieces in this area, and lectures frequently on the topic. He is also a founding member of the Drug Industry Document Archive (http://dida.library.ucsf.edu), a searchable online archive of thousands of drug industry documents that relate to marketing strategies and tactics.

1. Landefeld CS, Steinman MA. The Neurontin legacy: discovery of how marketing can manufacture misinformation and manipulate physicians. N Engl J Med 2009; 360: 103-6.


2. Steinman MA, Rosenthal GE, Landefeld CS, Bertenthal D, Sen S, Kaboli PJ. Conflicts and concordance between measures of medication prescribing quality. Med Care 2007; 45: 95-99.


3. Steinman MA, Landefeld CS, Rosenthal GE, Bertenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quailty in elders. J Amer Geriatr Soc 2006; 54: 1516-1523.


4. Steinman MA, Bero LA, Chren MM, Landefeld CS. The promotion of gabapentin: an analysis of internal industry documents. Ann Intern Med 2006; 145: 284-293.


5. Steinman MA, Ranji SR, Shojania KG, Gonzales R. Improving antibiotic selection: a systematic review and quantitative analysis of quality improvement strategies. Med Care 2006; 44: 617-628.


6. Steinman MA, Fischer MA, Shlipak MG, Bosworth HB, Oddone EZ, Hoffman BB, Goldstein MK. Clinician awareness of adherence to hypertension guidelines. Am J Med 2004; 117: 747-54.


7. Steinman MA, Gonzales R, Linder JA, Landefeld CS. Changing use of antibiotics in community-based outpatient practice: 1991-1999. Ann Intern Med 2003; 138: 525-533.


8. Steinman MA, Landefeld CS, Gonzales R. Predictors of broad-spectrum antibiotic prescribing for acute respiratory tract infections in adult primary care. JAMA 2003; 289: 719-725.


9. Steinman MA, Sands LP, Covinsky KE. Medication restriction due to cost in seniors without prescription coverage: a national survey. J Gen Intern Med 2001; 16: 793-99.


10. Steinman MA, Shlipak MG, McPhee SJ. Of principles and pens: attitudes and practices of medicine housestaff toward pharmaceutical industry promotions. Am J Med 2001; 110: 551-57.