Summary.
When Laura Esserman, MD, MBA, became the director of the Carol Franc Buck Breast Care Center at the University of California at San Francisco, in 1997, she had big plans—for both the center and medicine more generally. She hoped to boost the institution’s prominence and patient throughput by delivering integrated care in one attractive setting. Women would not have to go from place to place for the various diagnostic procedures and treatments they needed, enduring anxious, multiday delays as they waited for test results. A woman could arrive in the morning with a suspicious lump and leave at the end of the day with a treatment plan. To accelerate overall progress in treating breast cancer, Esserman wanted to increase the ease and speed of enrolling patients in clinical trials and to build an informatics system that would capture data about treatment outcomes from many sites. All of this represented a sensible strategy, and it has worked out well: The center now sees many times more patients than when Esserman took over; a new website has led to increased and easier enrollment in clinical trials; and the Athena project, which collects data from multiple UC medical centers, is under way.