Michael Steinman, MD

Professor of Medicine, Director of Research Training Programs, Division of Geriatrics, Geriatrician, SFVAMC

Dr. Steinman received his medical school training at Harvard Medical School and completed 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 in the UCSF Division of Geriatrics and at the San Francisco VA Medical Center since 2004.

Dr. Steinman is a national leader in identifying and improving the quality of medication prescribing in clinically complex older adults. He 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 National Institutes of Health and other funders. His research interests also include improving evaluation and care for older adults with multiple chronic conditions, and pharmaceutical industry marketing, and he has a strong interest in mentorship and supporting career development for junior investigators.

Dr. Steinman is co-Principal Investigator of an NIH-funded national research network for research on deprescribing medications in older adults; Associate Director of the UCSF Pepper Center for Aging Research; Co-Director for Research, Director of Research Training, and Director of the T32 Aging Research Fellowship in the UCSF Division of Geriatrics; and Visiting Research Scientist at the San Francisco Campus for Jewish Living (formerly known as the Jewish Home of San Franciso). He also has leadership roles with several national organizations, including service as co-chair of the American Geriatrics Society Beers Criteria guideline panel.
Education
Clinical Fellowship, 2003 - Geriatrics, University of California, San Francisco
VA Quality Scholars Fellowship, 2002 - Research, University of California, San Francisco
Residency, 2000 - Internal Medicine, University of California, San Francisco
MD, 1997 - , Harvard Medical School
Honors and Awards
  • Elected member, American Society of Clinical Investigation, 2017
  • Mid-career Mentoring Award, Society of General Internal Medicine, 2015
  • Academic Senate Distinction in Mentoring Award, University of California San Francisco, 2014
Publications
  1. Deprescribing in Older Adults With Cardiovascular Disease.
  2. Association of Functional Impairment in Middle Age With Hospitalization, Nursing Home Admission, and Death.
  3. Association Between Secondary Prevention Medication Use and Outcomes in Frail Older Adults After Acute Myocardial Infarction.
  4. Using Wisely: A Reminder on How to Properly Use the American Geriatrics Society Beers Criteria®.
  5. A systematic review of methods for determining cross-sectional active medications using pharmacy databases.
  6. Using Wisely: A Reminder on the Proper Use of the American Geriatrics Society Beers Criteria®.
  7. Muscle Relaxant Use Among Hemodialysis Patients: Prevalence, Clinical Indications, and Adverse Outcomes.
  8. Psychoactive Medications and Adverse Outcomes among Older Adults Receiving Hemodialysis.
  9. Making Function Part of the Conversation: Clinician Perspectives on Measuring Functional Status in Primary Care.
  10. Reducing hospital admissions for adverse drug events through coordinated pharmacist care: learning from Hawai'i without a field trip.
  11. Overcoming Inertia to Improve Medication Use and Deprescribing.
  12. Authors' Reply.
  13. Deprescribing: Future directions for research.
  14. Intensification of older adults' outpatient blood pressure treatment at hospital discharge: national retrospective cohort study.
  15. Impact of a nurse-based intervention on medication outcomes in vulnerable older adults.
  16. Characteristics Associated With Physical Function Trajectories in Older Adults With Cancer During Chemotherapy.
  17. Patient-Important Adverse Events of ß-blockers in Frail Older Adults after Acute Myocardial Infarction.
  18. Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" ß-blockers in older nursing home residents with diabetes after acute myocardial infarction.
  19. Gabapentin and Pregabalin Use and Association with Adverse Outcomes among Hemodialysis Patients.
  20. Opioid Analgesics and Adverse Outcomes among Hemodialysis Patients.
  21. Developing a Core Outcome Set for Trials to Improve Medication Use: Guidelines or Guidance?
  22. Secondary Prevention Medication Use After Myocardial Infarction in U.S. Nursing Home Residents.
  23. Current approaches to measuring functional status among older adults in VA primary care clinics.
  24. Bringing functional status into a big data world: Validation of national Veterans Affairs functional status data.
  25. Epidemic Use of Benzodiazepines among Older Adults in Israel: Epidemiology and Leverage Points for Improvement.
  26. Folic Acid Supplementation Is Suboptimal in a National Cohort of Older Veterans Receiving Low Dose Oral Methotrexate.
  27. Desire for predictive testing for Alzheimer's disease and impact on advance care planning: a cross-sectional study.
  28. Beta-Blocker Use in U.S. Nursing Home Residents After Myocardial Infarction: A National Study.
  29. Perception of primary care physicians on the impact of comprehensive geriatric assessment: what is the next step?
  30. Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006-2013.
  31. Changes in Medication Use After Dementia Diagnosis in an Observational Cohort of Individuals with Diabetes Mellitus.
  32. Polypharmacy-Time to Get Beyond Numbers.
  33. Dextromethorphan-Quinidine for Agitation in Alzheimer Disease.
  34. Use of Renally Inappropriate Medications in Older Veterans: A National Study.
  35. How to Use the American Geriatrics Society 2015 Beers Criteria-A Guide for Patients, Clinicians, Health Systems, and Payors.
  36. Weight Loss Associated with Cholinesterase Inhibitors in Individuals with Dementia in a National Healthcare System.
  37. The Course of Functional Impairment in Older Homeless Adults: Disabled on the Street.
  38. Health Outcomes of Obtaining Housing Among Older Homeless Adults.
  39. Response to Einhorn and colleagues.
  40. Case 38-2014: A man with sore throat, hoarseness, fatigue, and dyspnea.
  41. Potential overtreatment of diabetes mellitus in older adults with tight glycemic control.
  42. Police on the front line of community geriatric health care: challenges and opportunities.
  43. Identification of risk factors for elevated transaminases in methotrexate users through an electronic health record.
  44. Prescribing quality in older veterans: a multifocal approach.
  45. Risk of thiazide-induced metabolic adverse events in older adults.
  46. Blood culture use in the emergency department in patients hospitalized for community-acquired pneumonia.
  47. Blood culture use in the emergency department in patients hospitalized with respiratory symptoms due to a nonpneumonia illness.
  48. Patterns of chronic co-morbid medical conditions in older residents of U.S. nursing homes: differences between the sexes and across the agespan.
  49. Polypharmacy, drug-drug interactions, and potentially inappropriate medications in older adults with human immunodeficiency virus infection.
  50. Changing chronic medications in hospitalized patients--bridging the inpatient-outpatient divide.
  51. Managing chronic disease in hospitalized patients.
  52. Polypharmacy and the management of the older cancer patient.
  53. Reasons for not prescribing guideline-recommended medications to adults with heart failure.
  54. Cumulative changes in the use of long-term medications: a measure of prescribing complexity.
  55. Characteristics of emergency department visits by older versus younger homeless adults in the United States.
  56. The 'worthy' patient: rethinking the 'hidden curriculum' in medical education.
  57. Reaching out to patients to identify adverse drug reactions and nonadherence: necessary but not sufficient.
  58. Geographic variation in outpatient antibiotic prescribing among older adults.
  59. Regional differences in prescribing quality among elder veterans and the impact of rural residence.
  60. Elder care as "frustrating" and "boring": understanding the persistence of negative attitudes toward older patients among physicians-in-training.
  61. Age and sex variation in prevalence of chronic medical conditions in older residents of U.S. nursing homes.
  62. Industry support of CME--are we at the tipping point?
  63. Beers criteria as a proxy for inappropriate prescribing of other medications among older adults.
  64. Confined to ignorance: the absence of prisoner information from nationally representative health data sets.
  65. Using patients to promote evidence-based prescribing: comment on "Communicating uncertainties about prescription drugs to the public".
  66. Inappropriate medication use in older adults undergoing surgery: a national study.
  67. Beyond the prescription: medication monitoring and adverse drug events in older adults.
  68. Age and receipt of guideline-recommended medications for heart failure: a nationwide study of veterans.
  69. Clinician attitudes about commercial support of continuing medical education: results of a detailed survey.
  70. Geriatric conditions, medication use, and risk of adverse drug events in a predominantly male, older veteran population.
  71. Do geriatric conditions increase risk of adverse drug reactions in ambulatory elders? Results from the VA GEM Drug Study.
  72. Conducting high-value secondary dataset analysis: an introductory guide and resources.
  73. A taxonomy of reasons for not prescribing guideline-recommended medications for patients with heart failure.
  74. Managing medications in clinically complex elders: "There's got to be a happy medium".
  75. Coronary risk assessment by point-based vs. equation-based Framingham models: significant implications for clinical care.
  76. When tight blood pressure control is not for everyone: a new model for performance measurement in hypertension.
  77. Choice of initial antiepileptic drug for older veterans: possible pharmacokinetic drug interactions with existing medications.
  78. Suicide-related behaviors in older patients with new anti-epileptic drug use: data from the VA hospital system.
  79. Commercial influence and learner-perceived bias in continuing medical education.
  80. Drug detailing in academic medical centers: regulating for the right reasons, with the right evidence, at the right time.
  81. Variation in outpatient antibiotic prescribing in the United States.
  82. Medication prescribing practices for older prisoners in the Texas prison system.
  83. Agreement between drugs-to-avoid criteria and expert assessments of problematic prescribing.
  84. Physician use of brand versus generic drug names in 1993-1994 and 2003-2004.
  85. The Neurontin legacy--marketing through misinformation and manipulation.
  86. Interventions to reduce unnecessary antibiotic prescribing: a systematic review and quantitative analysis.
  87. Polypharmacy and the balance of medication benefits and risks.
  88. Rebuttal: Is CME a drug-promotion tool?: YES.
  89. Is continuing medical education a drug-promotion tool?: YES.
  90. Number of medical conditions and quality of care.
  91. Age affects outcomes in chronic kidney disease.
  92. What's in a name? Use of brand versus generic drug names in United States outpatient practice.
  93. Characteristics and impact of drug detailing for gabapentin.
  94. Attitudes of preclinical and clinical medical students toward interactions with the pharmaceutical industry.
  95. Conflicts and concordance between measures of medication prescribing quality.
  96. Evolution of medication use in Jerusalem elders: Results from the Jerusalem Longitudinal Study.
  97. Polypharmacy and prescribing quality in older people.
  98. Narrative review: the promotion of gabapentin: an analysis of internal industry documents.
  99. Improving antibiotic selection: a systematic review and quantitative analysis of quality improvement strategies.
  100. Age and rising rates of cyclooxygenase-2 inhibitor use. Results from a national survey.
  101. Mortality risk stratification in chronic kidney disease: one size for all ages?
  102. Interactions between pharmaceutical representatives and doctors in training. A thematic review.
  103. Quality of ambulatory care for women and men in the Veterans Affairs Health Care System.
  104. Fluoroquinolone prescribing in the United States: 1995 to 2002.
  105. Clinician awareness of adherence to hypertension guidelines.
  106. Office evaluation and treatment of elderly patients with acute bronchitis.
  107. [Our experience with the medical rehabilitation of homeless-disabled people].
  108. Changing use of antibiotics in community-based outpatient practice, 1991-1999.
  109. Predictors of broad-spectrum antibiotic prescribing for acute respiratory tract infections in adult primary care.
  110. Donepezil for nursing home patients with dementia: a reinterpretation of the evidence.
  111. The costs of making practice more cost-effective.
  112. Finding the target: getting started with quality of care and health services research.
  113. Self-restriction of medications due to cost in seniors without prescription coverage.
  114. Of principles and pens: attitudes and practices of medicine housestaff toward pharmaceutical industry promotions.
  115. MSJAMA: gifts to physicians in the consumer marketing era.
  116. Clarithromycin-associated visual hallucinations in a patient with chronic renal failure on continuous ambulatory peritoneal dialysis.