Care Systems & UCSF Work
My Role at UCSF
At UCSF, I serve as Chief of Audiology and as a clinician–scientist in the Department of Otolaryngology–Head and Neck Surgery. Clinically, I care for adults with hearing loss and tinnitus. In my leadership role, I focus on how our systems—pathways, teams, education, and infrastructure—either support or undermine good care, and how we can make those systems work better for patients and clinicians.
Problems I Focus On
Much of this work is a response to familiar, system-level problems:
- Hearing and tinnitus care that is fragmented across clinics and providers.
- Inconsistent explanations about diagnoses, prognosis, and realistic options.
- Limited time for counseling and education during visits.
- Overload of online information, much of it confusing or unreliable.
- Few trustworthy, reusable tools for families and caregivers.
The aim is to make it easier for patients and families to understand what is happening and what they can do next—and easier for clinicians to provide consistent, evidence-informed care in busy settings.
EARS: Patient Education Infrastructure for Hearing & Tinnitus
One major example of this work is EARS, a UCSF Audiology patient education hub (ears.ucsf.edu). EARS is:
- A free, public, plain-language website on hearing loss, tinnitus, and related topics.
- Designed for patients, families, and clinicians to use before, between, and after visits.
- Integrated into clinical workflows as a shared reference point, rather than an add-on.
It serves:
- People preparing for or recovering from audiology and ENT visits.
- Individuals trying to make sense of new or long-standing hearing and tinnitus symptoms.
- Families and caregivers who want to support communication and day-to-day life.
- Clinicians who need a curated, evidence-informed resource to recommend.
In practice, EARS is used as a pre-visit primer, a follow-up resource linked in visit summaries and portals, and a stable “home base” patients can revisit over time.
What Other Clinics & Health Systems Can Adapt
The specific tools at UCSF may not map exactly to every setting, but the design principles are widely transferable. A few practical takeaways:
- Start with real questions, not ideal content. Build around the 10–20 questions patients and families actually ask about hearing loss and tinnitus, rather than what fits neatly into textbook chapters.
- Co-design with patients and front-line clinicians. Involve patients, families, and the clinicians who will be recommending the resource. Their feedback shapes language, structure, and what is truly useful.
- Write for real reading conditions. Use clear headings, short sections, and concrete examples. Assume people are tired, worried, and often reading on a phone.
- Embed education into actual workflows. Decide explicitly where education “lives”: in visit summaries, patient portals, QR codes in rooms, follow-up messages, or structured counseling visits.
- Iterate rather than aiming for a perfect encyclopedia. Start small with high-yield topics, test them with a few teams, collect feedback, and refine over time.
Team-Based, Collaborative Work
None of this is solo work. These projects reflect:
- Contributions from UCSF audiologists and staff across multiple sites.
- Collaboration with otology, primary care, mental health, rehabilitation, and digital teams.
- Input from patients and families who shared their experiences and shaped content.
My role is to help connect these efforts, align them with clinical realities, and keep the focus on solutions that clinicians can actually use and sustain.
Selected Projects & Initiatives
Below are brief snapshots of representative projects. They are examples of the kinds of problems I work on, not an exhaustive list.
Building a Patient Education Hub for Hearing & Tinnitus (EARS)
Problem: Patients and families were relying on inconsistent explanations and unstable online information about hearing loss and tinnitus, while clinicians had limited time and no shared library of recommended resources.
What we are doing: Developed and launched the EARS patient education hub as a plain-language, clinically integrated resource: structured content on hearing, tinnitus, devices, and care navigation, designed to be linked from visits, summaries, and portals.
Why it matters: EARS gives patients and families a stable, trustworthy reference point and gives clinicians a common tool to support education and counseling without having to reinvent handouts in every clinic.
Tinnitus Care Pathways and Counseling Approaches
Problem: Tinnitus care was highly variable across clinicians and clinics, with uneven access to structured counseling, education, and appropriate referrals.
What we are doing: Designed and refined tinnitus care models that combine standardized assessment, structured counseling/education, and clear referral pathways (e.g., mental health, sleep, neurology) that can be delivered consistently across sites.
Why it matters: These pathways help move tinnitus care from ad-hoc reassurance or “nothing we can do” conversations toward predictable, evidence-informed approaches patients can actually follow.
Integrating Hearing Therapeutics & Clinical Trials Into Routine Care
Problem: Emerging hearing therapeutics and tinnitus-related trials often sit in a separate “research silo,” making it hard for appropriate patients to learn about or access them through routine care.
What we are doing: Worked with clinical and research teams to connect audiology workflows with trial screening and referral processes, so that trial opportunities can be discussed during standard visits when appropriate.
Why it matters: This helps ensure that research opportunities are offered in a structured, equitable way and that trials are grounded in real-world clinical pathways rather than operating on a separate track.
Training & Mentorship in Systems-Aware Hearing Care
Problem: Trainees and early-career clinicians often learn excellent diagnostic skills but have fewer structured opportunities to connect individual patient care with systems-level thinking.
What we are doing: Integrated systems-of-care concepts into teaching and mentorship—using real cases to explore pathways, education tools, implementation constraints, and quality-improvement opportunities in hearing and tinnitus care.
Why it matters: This helps the next generation of clinicians see themselves not only as test-performers or device-fitters, but as contributors to better-designed care systems.
Research & Writing
Framing
My research and writing span hearing and auditory neuroscience, tinnitus and sound tolerance, and systems of care and health services. I’m interested in how the auditory system works and changes, how people experience hearing loss and tinnitus in daily life, and how we can design clinics and pathways that deliver evidence-informed care reliably, not just in ideal trial conditions.
Below are selected examples organized by theme, with short summaries. They are illustrative rather than comprehensive.
Cochlear Implants & Music Perception
Using musical pitch interval comparisons to assess cochlear implant frequency-to-place maps
Develops a behavioral task where listeners compare musical pitch intervals across frequency regions to probe how well cochlear implant frequency-to-place maps preserve relative pitch. Includes both vocoder-simulated maps in normal-hearing listeners and early data from CI users, as a step toward a clinically usable way to compare traditional and CT-based maps for music-relevant pitch perception.
Speech, timbre, and pitch perception in cochlear implant users with flat-panel CT–based frequency reallocations
Tests whether anatomy-based, flat-panel CT–guided frequency allocations improve speech, timbre, and pitch outcomes compared to default clinical maps in experienced CI users. Group results are similar across maps, but benefit varies with electrode placement—especially apical mismatch—highlighting both the promise and limits of strict CT-based mapping in real-world users.
Perception of extreme musical dissonance in cochlear implant users using a novel listening task
Introduces a consonance–dissonance listening task that pushes to “extreme dissonance” to better match how CI users actually describe music quality. Normal-hearing listeners show the expected graded drop in pleasantness with increasing dissonance; CI recipients mainly distinguish the most extreme dissonance from more consonant tiers, suggesting compressed sensitivity and offering a candidate tool for assessing and optimizing CI configurations for music enjoyment.
Hearing & Auditory Neuroscience
Bench to booth: hair-cell regeneration through an audiologist’s lens
Looks at how work on hair-cell regeneration and cochlear repair intersects with clinical audiology—what these findings might mean for future hearing care, and where the translational gaps still are.
Atoh1 and hair-cell regeneration in the avian cochlea
Explores how the transcription factor Atoh1 contributes to regeneration of auditory hair cells in non-mammalian systems, and what this tells us about the biological constraints and possibilities of hair-cell repair.
Molecular limits on regeneration (e.g., BMP4 and supporting cells)
Examines how signaling pathways (such as bone morphogenetic proteins) can either support or inhibit regeneration, shedding light on why some systems can regenerate hair cells and others cannot.
Inflammation, synaptic damage, and sensorineural hearing loss
Investigates how inflammatory mediators can drive synaptic and neural damage in the cochlea, connecting immune processes with patterns of hearing loss that arise even when hair cells appear intact.
Tinnitus & Sound Tolerance
Audiometric predictors of tinnitus in adults with sensorineural hearing loss
Analyzes large-clinic data to identify audiometric patterns associated with tinnitus, with the goal of understanding which patients are at higher risk and how that might guide counseling and expectations.
Regenerative therapies for hearing loss and tinnitus (plain-language review)
Summarizes emerging regenerative approaches for hearing loss and tinnitus for a non-specialist audience, highlighting what is promising, what is preliminary, and how to think critically about new treatments.
Who uses tinnitus support lines and how they help
Examines patterns of use and reported benefit among people calling a tinnitus support line, offering insight into what people are seeking outside formal healthcare and how support services can be structured.
Public-facing overview of hair-cell regeneration and hearing
Provides an accessible explanation of hair-cell regeneration science and its potential implications for hearing loss, aimed at clinicians, patients, and advocates.
Systems of Care & Health Services
Mobile audiometry in acute care settings
Evaluates the use of mobile hearing testing in emergency departments to identify and triage sudden hearing loss, exploring feasibility, diagnostic value, and integration with existing workflows.
Data-driven audiometric aging phenotypes
Uses large clinical datasets to identify patterns of age-related hearing change, with implications for risk stratification, counseling, and potential personalization of hearing care.
Self-fit versus best-practice–fit hearing aids
Compares outcomes between self-fit hearing aids and those fit using best-practice clinical methods, to understand trade-offs in access, performance, and real-world usability.
Clinic pathways and appointment behavior in cochlear implantation
Looks at sociodemographic and system factors associated with appointment non-attendance and surgical conversion among cochlear implant candidates, identifying friction points along the pathway.
Patient education and systems-of-care: the EARS project
Describes the design and implementation of the EARS patient education hub as part of a broader effort to standardize and strengthen education within audiology services.
Patient Communication & Education
Hair-cell regeneration in plain language (Acoustics Today feature)
Translates complex molecular and cellular science into accessible language for clinicians, patients, and advocates, emphasizing realistic timelines and the importance of translational pathways.
Regenerative therapies and tinnitus: what patients should know
Provides a balanced overview of regenerative approaches targeting hearing and tinnitus, addressing common misconceptions, expectations, and how to interpret clinical trial news.
Q&A on auditory biotechnologies and clinical translation
A question-and-answer–style piece on how new hearing and tinnitus technologies move from bench research into everyday clinics, including regulatory steps, trial design, and practical barriers.
Full Publications & Outputs
For a more complete and regularly updated list of publications and presentations, please see:
Who This Is For & How to Use This Page
This page is intended for:
- Clinicians (audiologists, ENTs, neurologists, PCPs, psychologists, and others) who are working to improve their hearing and tinnitus care pathways, patient education, or integration of new therapies.
- Health systems, organizations, and policy/payor groups interested in models for patient education, care pathways, and systems-of-care work in hearing and tinnitus.
- Trainees and researchers looking for examples of clinically grounded projects or wanting to explore the research behind this work.
If you’re exploring ways to adapt patient education infrastructure, redesign tinnitus or hearing pathways, or connect research more tightly to day-to-day care, this page is meant as a starting point. From here, you can dive into specific projects, follow links to publications, or reach out through the contact options on the site to discuss collaboration or adaptation in your own setting.