Campus Messages

An archive of email messages sent to the entire UCSF community by the Chancellor and members of the Chancellor's Cabinet.

UC’s Commitment to Comprehensive Access

Dear Members of the UCSF Community:

UCSF’s mission to advance health includes a responsibility to address disparities in care, with special attention to underserved populations. Increasing access to comprehensive health care – for groups such as the economically disadvantaged, the LGBTQI community, and women – is and will remain a fundamental part of the work we do.

As you know, across UC Health and at UCSF Health, access to beds and clinic appointments are limited by capacity and geography. Because of this, UC Health entities have been forging relationships with other health systems in our geographies or in more remote locations.

Affiliations with other health systems help UC broaden access to care and leverage our high-quality research-backed care by:

  • Expanding UC health care’s geographic reach through health systems that have facilities where we don’t have a presence, including in many underserved communities
  • Providing UC patients with access to specialized services not available at our own facilities, and in turn providing patients at other systems access to UC services they could not otherwise receive—including women’s reproductive health services, LGBTQI-related care, and end-of-life care
  • Providing access to inpatient services when UC hospitals are full
  • Sharing UC’s expertise to help other organizations improve care and patient outcomes
  • Maintaining training opportunities for the next generation of UC health care professionals

Our goal is to broaden access to UC’s high-quality care services and broaden the influence of UC care standards in other health systems while guiding our work with the values of our public mission.

Recently, the University withdrew from negotiations to expand its relationship with another health system in the San Francisco Bay Area following a spirited public debate. An outgrowth of that debate was a commitment to address legitimate concerns that were raised.

The University expects that its personnel who are working or training at any clinical site – whether or not it is owned or operated by the University – will always practice medicine and make clinical decisions consistent with their professional judgment and considering the needs and wishes of each patient. This includes ensuring patients have access to women’s reproductive health services, LGBTQI-related care, and end-of-life care.

UC does not interpret any of its agreements as precluding its personnel from advising patients about all health care options, making referrals for services, or prescribing any medically appropriate interventions, including those not offered at a host facility.

These are important issues and we want to share the progress that UC is making on three action steps it announced in early August:

  • Pursuing amendments to certain existing contracts to revise language that may be inconsistent with UC values and expectations. Thus far, several dozen agreements are in the process of being updated and more such revisions are expected to follow.
  • Implementing interim guidelines for agreements under which our providers and trainees work with other health systems until longer-term guiding principles and compliance measures have been adopted. These guidelines are in place.
  • Convening the Working Group on Comprehensive Access (WGCA), a multidisciplinary group of academic and health system leaders to evaluate current practices and provide recommendations to ensure UC values are upheld in affiliations with other health care organizations.

The two of us, as well as a UCSF faculty member in Obstetrics, Gynecology and Reproductive Sciences, are members of the WGCA. We believe that the WGCA has made significant progress, and we know more work needs to be done. The WGCA will continue its work until the end of the year, with the goal of submitting its recommendations to the UC President.

Addressing this complex issue has reminded us of how fortunate we are to work alongside such passionate health care clinicians, learners, and researchers. Thank you for your commitment to UCSF’s public health mission, and for serving the needs of those who rely on our care, training, and research.


Sam Hawgood, MBBS
Arthur and Toni Rembe Rock Distinguished Professor

Mark R. Laret
President and CEO
UCSF Health