Medical Students: Career Profiles
Dr. Linda Francisco - Interventional Nephrologist
I was originally attracted to nephrology while in medical school and then again, as a resident, when I was impressed with the diagnostic skills of the nephrologists that I observed. The nephrologists were able to diagnose and manage patients that most other physicians would prefer to refer to other subspecialties. Their breadth and depth of knowledge were beyond other physicians that I had contact with during training and I was awed by their skills. After subsequent training in a fellowship in nephrology and working in private practice, I began to understand the importance of the vascular access for a dialysis patient, not only for the quality of the dialysis they would receive but also in the quality of life for the dialysis patient. Frequent trips to the hospital with thrombosed or malfunctioning accesses, sometimes requiring many days of hospitalization and multiple surgeries, resulted in the conclusion in my own mind that there must be a better way to manage these problems. I then was exposed to other nephrologists in the country with similar concerns and became aware of the emphasis of training in vascular access available to the nephrologists. So began my quest in interventional nephrology.
I have been practicing interventional nephrology for 10 years in addition to my private practice of nephrology. I spend two weeks in my office seeing renal, transplant, and hypertensive patients, doing hospital rounds with consultative nephrology, and then rounds on the chronic dialysis patients in the chronic dialysis units. This is then followed by one week in the Interventional Unit concentrating on vascular access work, which involves angiograms, angioplasties, and thrombectomies. I share the interventional responsibilities with two other partners in my group (thus the three-week rotation). This rotational schedule allows me the freedom to continue to practice nephrology as well as my personal interest in vascular access. There are generally 7-12 cases per day in the Interventional Unit, with each case taking about 30-60 minutes. There is immediate gratification with the procedures, as there is improvement in the function of the access and the appreciation of the patient to return to their dialysis within 1-2 hours after the original referral to the Intervention Unit.
In addition to practicing nephrology and interventional nephrology, I have been fortunate to be married to a wonderful person who supports my goals in life. We have 3 adult children, 2 of whom are married and we are blessed with a granddaughter who is the "love of our life." We are also very active in the community in a variety of activities in the Art Museum, Symphony, Opera, and on a variety of boards in the community. We also work in active roles in the medical staffs in the hospitals and in the county medical society.