Emily Finlayson, M.D., M.S., FACS, Professor of Surgery and Health Policy, Vice Chair of Faculty Affairs and Development and Director of the UCSF Center for Surgery in Older Adults (CSOA). Her clinical areas of expertise include colon and rectal cancer, ulcerative colitis and Crohn's disease, with a focus on minimally invasive surgical techniques.
After completing her medical degree at Harvard Medical School, Dr. Finlayson trained in general surgery at UCSF and in colon and rectal surgery at the Mayo Clinic in Rochester, Minnesota. In her post-doctorate training, she received a Master of Science from the Center for Evaluative Clinical Sciences at Dartmouth Medical School and completed a research fellowship with the VA Outcomes Group in White River Junction, Vermont. She was on faculty at the University of Michigan Department of Surgery and the Michigan Surgical Collaborative for Outcomes Research and Evaluation until she returned to UCSF in 2009. Her current research is in population-based surgical outcomes with a focus on functional outcomes in the frail elderly.
Dr. Emily Finlayson is also Director of the Department of Surgery Faculty Mentoring Program, one that facilitates the development and implementation of robust career plans for incoming faculity. She is also Co-Chair of the Data Registry Subcommittee for the The Coalition for Quality in Geriatric Surgery Project.
Dr. Finlayson's research focuses on using administrative data to examine ‘real world' surgical outcomes in the elderly. For example, in an analysis of operative mortality in 1.2 million Medicare beneficiaries age 65 and older undergoing elective diagnostic high-risk surgery, she found that the risk of death increased dramatically with age. Her work examining the impact of age and comorbidity on operative mortality and survival among octogenarians undergoing cancer surgery demonstrated population-based mortality rates in octogenarians that were considerably higher than those reported in published reports from case series or trials. To better understand surgical risks in elders, she has explored the role of institutional factors in surgical outcomes. As is now widely recognized, her work demonstrated that provider procedure volume is inversely related to operative mortality for many high-risk operations and that this association was greatest in elder surgical patients.
In Dr. Finlayson's most recent work, she uses a national nursing home registry to evaluate outcomes after surgery in long stay nursing home residents. She found that nursing home residents experienced high operative mortality for ‘low risk' procedures. After operations to remove the gallbladder or appendix, more that 1 out of 10 nursing home residents died after surgery. She has also used this data to evaluate survival and functional status after colon cancer surgery and found that nursing home residents experience substantial and sustained functional decline after surgery. One-year survival was less than 50%.
The findings in her epidemiology research inspired the creation of the UCSF Center for Surgery in Older Adults. Under her leadership, the interdisciplinary team of stakeholders from surgery, anesthesia, rehabilitation services, geriatrics, palliative care, nursing, education, and health policy with expertise in quantitative research, qualitative research, and implementation science are working together to develop, implement, evaluate best practices in geriatric surgery through the development of a geriatric surgery registry. Our overarching goal is to discover best practices in geriatric surgery through patient-centered outcomes assessment, comparative effectiveness analyses, and interventional trials. In addition, we identify and explore barriers to delivery of optimal care with the aim to improve implementation of interdisciplinary patient-centered surgical care for older adults at UCSF and beyond.