Patient Care

LAC+USC Medical Center

The training program in the Division of Endocrinology and Diabetes is designed to provide broad clinical training and education in the field of endocrinology and metabolism. The standard endocrinology and metabolism training program is two years in length, although trainees may elect to undertake focused training in clinical or bench research and complete their clinical training over a three-year period. In either case, the program’s curriculum is organized into four basic components: 1) inpatient and consultative services; 2) outpatient clinics; 3) didactic lectures and conferences; and 4) research. Clinical training primarily occurs in three settings: LAC+USC Medical Center, Keck Hospital of USC and USC/Norris Cancer Hospital.

Our three hospitals provide trainees with exposure to a wide range of endocrine and metabolic diseases in patients from varied ethnic and socioeconomic backgrounds. Research training is provided through the General Clinical Research Center at the LAC+USC Medical Center and through the basic science laboratories of the Division of Endocrinology and Diabetes at the Keck School of Medicine at USC.

Endocrine Clinics

Outpatient endocrine clinics are held twice weekly at LAC+USC Medical Center (LAC+USC). Since the addition of John Carmichael, MD, one of these clinics is now more devoted to pituitary disease, including diagnosis and management of individuals with functional and nonfunctional pituitary tumors. Full-time faculty members provide direct supervision (two per clinic). Each fellow evaluates four to six patients per clinic, while the remaining 25 patients are seen by house staff and medical students assigned to the Endocrine service on a monthly basis. In addition, fellows have the opportunity to perform thyroid ultrasound examinations and fine needle aspirations (FNA) in each clinic setting. The primary purpose of these clinics is to provide consultation and develop treatment plans for patients referred with endocrine problems, with the eventual goal to return the patients to their primary care physicians for long-term care.

The Endocrine-Pregnancy clinic at LAC+USC provides care to pregnant women affected by endocrine diseases, the most common of which are diabetes mellitus and thyroid disorders. Dr. Jorge Mestman is the director of the Clinic.

Roybal Diabetes Managed Care Program (DMP)

Based in a purpose-built diabetes center in the Roybal Comprehensive Health Center of the Los Angeles County Northeast Cluster Healthcare Network, the DMP provides team-based comprehensive diabetes preventative care (prevention of complications) under the co-leadership of Drs. Michael Roybal and Anne Peters, who also provides administrative support. Drs. Kathleen Page, Elizabeth Beale, Hussein Yassine and Helen Baron supervise the clinic on a day-to-day basis and oversee patient care. The center includes a clinical laboratory, a phlebotomy room and an education center. The patient care plan is established by use of written, case-based protocols. This care is implemented by diabetes nurses, nurse practitioners, social workers and dietitians in a case-based manner under the supervision of diabetologists. The majority of the patients are Latino and most of the doctors and nursing staff at the center speak Spanish. This program has served as a model for diabetes disease management throughout Los Angeles County.

Endocrinology fellows also attend a continuity clinic for the care of patients with type 1 diabetes one half-day per week. This clinic runs throughout the year and is under the supervision of Drs. Beale and Peters. The clinic provides a venue for patients with labile diabetes, especially type 1, to receive state-of-the-art care by a specialized team of providers. The clinic also provides fellows with the opportunity to follow these patients exclusively for the duration of their fellowships, allowing them to develop and implement long-term management plans and establish a sense of true doctor-patient relationships.

Thyroid Cancer Clinic

This clinic meets on a weekly basis and is designed to provide care for patients with thyroid cancer. In addition, patients with other endocrine diseases, including those patients with pituitary disease and disorders of bone and calcium metabolism, are seen in this clinic. The clinic is under the direct supervision of full-time faculty members (three per clinic). The fellow serving as the monthly endocrine consult performs thyroid ultrasounds and FNAs on those patients referred for the evaluation of a thyroid nodule. Each fellow performs, on average, four FNAs per week during the month.

Type 1 Diabetes Clinic

A continuity clinic in diabetes has been established at the Roybal Diabetes Center to allow fellows the opportunity to develop skills in the management of patients with complicated type 1 diabetes.

Diabetes and Metabolism Clinic

This clinic provides endocrine consultations for complex diabetes management and metabolic disorders. Patients are referred from their primary care medical homes for evaluation. The clinic operates five days a week and is directed by Dr. Wei-An Lee, the supervising physician.

Keck Medicine of USC

Division of Endocrinology and Diabetes faculty provide clinical care for private patients at Healthcare Center 2 (HC2) and Keck Hospital of USC (KH) on the USC Health Sciences Campus, Keck Medicine of USC-University Park Campus, at the USC Westside Center for Diabetes in Beverly Hills and at Keck Medicine of USC-Pasadena.

Health Sciences Campus

The USC Division of Endocrinology and Diabetes provides assessment and management services for patients with a variety of endocrine disorders, especially in the areas of diabetes, pituitary diseases, adrenal disorders and disorders of calcium and bone metabolism. Endocrine faculty members have extensive experience in the management of such disorders and, where necessary, utilize the state-of-the-art USC Endocrine Laboratory to assist in diagnostic assessment. In addition, the most advanced imaging modalities are available for diagnosis. The latest in medical management is available where surgery is not indicated. For patients who require surgery, a number of renowned USC surgeons who specialize in endocrine surgery, especially of the pituitary gland, thyroid and parathyroid glands and adrenal glands, are available. Clinical care is provided by Drs. Peter Singer, Jonathan LoPresti, Helen Baron, John Carmichael, Caroline Nguyen, and Nurse Practitioner Reiko Sasaki.

Pictured: The USC Westside Center for Diabetes Team

USC Westside Center for Diabetes

Directed by Anne Peters, MD, CDE, and staffed by Donna Miller, RNP, CDE, and Meg Moreta, RD, CDE, this fully functional clinic located in the USC Archway Medical Plaza in Beverly Hills provides state-of-the-art care to individuals with type 1 and type 2 diabetes and pre-diabetes. Services include diabetes education and management, and treatment of lipid disorders, hypertension and gestational diabetes. Areas of particular expertise include use of insulin pumps and sensors, diabetes in pregnancy and management of elite athletes. Staff members have accompanied patients to the Olympics as well as the Indianapolis 500 to help monitor their diabetes during extreme circumstances. The center is a participating member of the Helmsley Diabetes Registry, which includes 25,000 individuals and is the largest database ever created for individuals with type 1 diabetes. Dr. Peters, in conjunction with other providers in the clinic, has published a book entitled Conquering Diabetes and has completed a book entitled, The Type 1 Diabetes Self-Care Manual: A Complete Guide to Type 1 Diabetes Across the Lifespan for People with Diabetes, Parents, and Caregivers, which will be published in June. The clinic websites are www.uscdiabetes.com and www.conqueringdiabetes.com.

USC Thyroid Diagnostic Center

This program, led by Peter A. Singer, MD has brought together a group of highly experienced, nationally recognized endocrinologists who specialize in thyroid disease to work in an integrated team approach with experts in cytopathology, nuclear medicine and the surgical subspecialties in the diagnosis and management of thyroid diseases. This group has available to it one of the finest endocrine laboratories specializing in thyroid testing in the U.S. The team of physicians in the center has particular expertise in the diagnosis and management of recurrent thyroid cancers. Working with colleagues in surgery, oncology, radiology and nuclear medicine, the team has developed protocols to manage even the most difficult cases. The USC Thyroid Diagnostic Center sponsored its 38th Annual Symposium on Thyroid Disease, which continues to be the longest running and most successful clinical meeting in the United States.

USC Pituitary Center

The USC Pituitary Center is a unique clinical and academic program that is fully dedicated to the treatment and evaluation of patients with pituitary tumors and other disorders affecting areas of the hypothalamus and pituitary gland. The center provides a cutting-edge multidisciplinary approach toward patient care under the leadership of Co- Directors John Carmichael, MD of Endocrinology and Gabriel Zada, MD of Neurosurgery.

The center is staffed by a team of experts in neurosurgery, neuroendocrinology, neuroradiology, neuropathology, neuro-ophthalmology, radiation oncology and interventional endovascular neurosurgery. All patients are evaluated and discussed at weekly multidisciplinary pituitary conferences to streamline their care. Physicians provide a comprehensive focus on both surgical and medical management of pituitary tumors, including the treatment of acromegaly, prolactinomas, Cushing’s disease and non-functioning pituitary tumors. There is also a focus on the optimal treatment of pituitary deficiencies and hormonal replacement for patients with hypopituitarism.

The USC Pituitary Center also provides dynamic endocrine testing for both hormonal excess and pituitary deficiencies, including growth hormone stimulation testing, testing of adrenal insufficiency, dynamic testing for Cushing’s syndrome, and water deprivation testing for diabetes insipidus.

Keck Medicine of USC-Pasadena

Dr. Sharp returned to the faculty of USC in the spring of 2014 following a hiatus of 25 years where he served as Director of the Center for Metabolic Bone Disease in Pasadena, California, a practice dedicated to the investigation and management of osteoporosis and diseases involving the skeleton and mineral metabolism. Dr. Sharp has merged his practice into the Keck Medicine of USC-Pasadena, where he continues to offer consultative services in his specialty. Dr. Sharp was recently awarded the first Emeritus Professorship in Medicine at Huntington Memorial Hospital and continues to be an active member of the teaching faculty of the Internal Medicine Residency Program at Huntington. Dr. Sharp’s research interests include nutrition and bone, hypercalcemic disorders and pharmacologic treatment of osteoporosis.

USC Endocrine Services Laboratory

The USC Endocrine Services Laboratory is a fully licensed, CAP-accredited clinical laboratory that embraces the mission of offering research-quality endocrine tests at competitive prices to physicians at USC and throughout the U.S. The laboratory is committed to integrating new research methods and insights into clinical medicine and is widely recognized as a quality thyroid reference laboratory. The USC Endocrine Laboratory has been featured at recent American Thyroid Association and Endocrine Society meetings for playing an important role in transferring TSH and thyroglobulin (Tg) methodologies from the research environment to clinical practice. Under the leadership of Dr. Carole Spencer, the Endocrine Laboratory has become nationally and internationally known for its unique approach to measuring Tg and Tg antibodies, which are used as tumor-marker tests for managing patients with differentiated thyroid cancers.