UCSF Fresno has been honored to have an affiliation with the Veterans Administration (VA) since 1975, when the graduate medical education campus of the UCSF School of Medicine was created in Fresno with support of the state Legislature and the VA to address the severe shortage of physicians in California’s San Joaquin Valley.
The Fresno VA Medical Center, the hospital at Fresno Street and Clinton Avenue, has been and continues to be a major training site for UCSF Fresno residents. Last year, residents helped provide care to more than 33,000 veterans.
For this Veterans Day, we highlight Paulette Ginier, MD, a UCSF Fresno endocrinologist and geriatrician, UCSF professor and the associate chief of staff for Geriatrics at the Fresno VA Medical Center. Dr. Ginier has long served an integral role in patient care at the Fresno VA, where her journey there began more than four decades ago.
“I was the first resident who rotated to the VA when we made the affiliation,” she says.
Upon completing her UCSF Fresno residency in Internal Medicine, Dr. Ginier remained at the Fresno VA, running the hospital’s outpatient department for four years. She left Fresno to complete a fellowship in Endocrinology at UCLA and to briefly teach there. Returning to Fresno VA, she soon developed a diabetes clinic/program, opened a women’s clinic, created and oversaw a home-based primary care program. She also has conducted research projects, including participating in a VA diabetes control and complications trial that followed 100 patients for seven years.
Dr. Ginier is also well known at the VA for her beloved yellow Labrador, V.V., whom she rescued as a six-month-old puppy from potential euthanasia. No one wanted V.V. because she had diabetes insipidus, a disease Dr. Ginier was well-equipped to treat. “She was easier to manage than some of my patients,” she says, laughing. For 11 years, until recently passing, V.V. accompanied Dr. Ginier to the hospital and made daily rounds on the Five East patient floor.
“Dr. Ginier has dedicated her life to serving the veterans and educating the next generation of physicians,” says Steven Tringali, DO, acting director for Clinical Affairs at UCSF Fresno and program director of the UCSF Fresno Internal Medicine Residency Program. “She is a role model of what it means to be a compassionate, patient-centered and competent physician. The Central California VA and UCSF Fresno are fortunate to have her as part of our team.”
Working at the Fresno VA has been fulfilling, Dr. Ginier says. “You will never get bored,” she says. Patients often have multi-system medical concerns and “you have to be pretty astute in how you are going to handle that complexity.”
She cites teamwork as pivotal to providing the best care. “I don’t do this alone. I have pharmacists who are superb. They really can tell me about medications in the VA because they work under a scope of practice so they can help us prescribe and unprescribe medications. I have a nurse practitioner and nurses who are fantastic.” The VA also has dietitians and physical therapists onsite and she can consult with a geriatric psychiatrist, Neil Smith, DO, (who was a UCSF Fresno psychiatric resident).
This year, Dr. Ginier welcomed Mandeep Kaur, DO, the first UCSF Fresno endocrine fellow at the VA. Dr. Kaur is pleased to be working alongside Dr. Ginier. “We see a wide range of patients, a lot of pathology. And I get to work one-on-one with Dr. Ginier. She has so much experience. It’s been great so far.”
Throughout her years at the VA, Dr. Ginier has combined interests in endocrinology and geriatrics. She became director of the Community Living Center, a 54-bed skilled nursing/rehabilitation center, shortly after its opening in 1985. “I thought it was a chance to do research and blend endocrinology and geriatrics. And that’s how I ended up in this role and now I am the Associate Chief of Staff for Geriatrics.”
“Dr. Ginier is a highly respected physician leader at VA Central California Health Care System and senior faculty member at UCSF Fresno,” says Wessel Meyer, MD, associate chief of staff for Education at the VA, and UCSF clinical professor. “She has made a positive impact on the lives of countless veterans and health profession trainees in pursuit of excellence as a physician, educator and researcher. We are blessed to have someone of Dr. Ginier’s caliber and passion devote her entire career to these important health care objectives in the Central Valley.”
Under Dr. Ginier’s directorship, the Community Living Center received a coveted “five-star” rating for the past seven years from the Centers for Medicare and Medicaid Services (CMS). A five-star is the highest rating for overall quality given to nursing homes nationwide, both those operated by the VA and community-based homes outside the VA. “I think there’s only one or two other skilled facilities that have attained a five-star rating for that length of time,” she says.
The Fresno VA hospital is preparing to open a new rehabilitation unit this winter that will have six private patient rooms with private bathrooms and showers. Veterans will have a community kitchen and a common living area, where families can gather. “We want to make it as much like your home as possible, so you can heal,” Dr. Ginier says.
The rehabilitation unit is the latest addition at the VA, which is continually modifying to accommodate veterans’ health needs. The Fresno VA Medical Center is an invaluable resource in the community, Dr. Ginier says. “There is something about veterans. They want to be around veterans. And when they’re here, I think that’s healing to be around people who have served.”
As for UCSF Fresno’s part in providing care for veterans, Dr. Ginier says, “I think we do really good things here. And I’m proud of what we’ve accomplished as a team – and I feel that I am making a difference.”
