The Vol Guy: A Conversation with Volney Van Dalsem, MD, Director of Outpatient Imaging at Sherman Avenue

I could tell that he liked images because he emailed me several during our chat to show me other famous "Shermans" over the course of time; our center is in good company. As he pointed out to me, one of the earlier "Shermans" was the cartoon character "my boy Sherman" of "The Bullwinkle Show" (1961), which had a talking dog genius named Mister Peabody who had a pet boy named Sherman (http://www.toonopedia.com/peabody.htm). Sherman Avenue is also the namesake for the famous General William Tecumseh Sherman, who was criticized for his "scorched earth" policies (http://ngeorgia.com/ang/William_Tecumseh_Sherman). General Sherman fought in the Civil War and led his troops on the "March to the Sea," in which they basically burned Atlanta to the ground and burned and pillaged their way to Savannah, Georgia. Dr. Van Dalsem assured me that currently, "arson of our competitors doesn't figure prominently in our business plan, but that's only currently. If push comes to shove, we have a model in place." I know he was only kidding, but he did reveal to me that he was the chairman of the bonfire committee when he was an undergraduate at Stanford.

While he contemplated hanging pictures of these two famous "Shermans" in the lobby of Sherman, I asked him about his experience as a resident at the University of California, San Francisco (UCSF), where so many of our faculty were his peers. He told me that when he was at UCSF 30 years ago, the chairman, Alex Margulis, MD, "who is a wonderful person and one of the really great figures in radiology, gathered a group of people around him who were brilliant but still personable, human, and fun. Now, it's 30 years later and it's the same thing. Gary [Glazer] has recruited some wonderful people to Stanford who had been at UCSF with me: Brooke Jeffrey, Bob Herfkens, Graham Sommer, and Rich Barth. So it's been a very comfortable transition for me and everyone has been so very welcoming."

Practicing for 27 years at El Camino, 11 of those as medical director, Dr. Van Dalsem fostered a close relationship with Stanford by working collaboratively on the interpretation of radiology examinations. While he really enjoyed working at El Camino Hospital, Dr. Van Dalsem could not turn down such a great opportunity to lead our Sherman Avenue outpatient imaging center at Stanford. Serving at El Camino has prepared him well for leading our center, and he brings exceptional clinical skills, local knowledge, and administrative expertise to our unique, new efforts in outpatient imaging: "I've had experience with the outside community by trying to provide for the consumers, not just the patients, but also for the physicians and the physicians' offices." While everyone at Stanford has made the transition very smooth and enjoyable for him, Dr. Van Dalsem did note that there were some adjustments he had to make: "I used to go to work in my dockers and scrub shirts, what I call my 'blood and barium' clothes. But here, I have to look vaguely professorial, so I had to go buy Oxford shirts and ties again." He pointed to his shirt and tie, which I noticed had small images of baseball fields that no longer exist.

I asked Dr. Van Dalsem about his goals for developing patient-centered radiology at Sherman. "When you are able to sit down with patients and go over their findings," he said, "it's really very helpful; people can take charge of their care. As radiologists, we have been willing to be very passive by not talking directly to the patient. Obviously, there are caveats. I think you need to be somewhat selective in the information that you give, whom you give it to, and what kind of follow-up you suggest. While we're part of the healthcare team and we share in the care of all patients, you have to remember that there is a bond and trust between a physician and his or her patients that has been built over time, and you don't want to intrude on this trust, so you need to be selective, and you have to tailor the consultation."

At the Sherman Avenue outpatient imaging center, Dr. Van Dalsem does envision direct communication between radiologists and their patients: "It may be possible to have a menu that a patient can choose from so that patients can receive their results by email, or email with a follow-up telephone conversation, or a consultation where they can come in and look at their images and discuss them with one of the radiologists." Toward this goal of developing more patient-centered care, Dr. Van Dalsem has worked locally on the healthcare arm of the Smart Valley Initiative by trying to establish a regional health information organization (RHIO) so that patients can transfer healthcare information among their healthcare providers.

Dr. Van Dalsem would also like to improve patient scheduling at our Sherman center. "I'd really like to try to implement some online system of scheduling so that patients can choose a time that works for them and not the other way around. I know there are scheduling issues, and Radiology is very complex. I think that Sherman will be fairly simple. There are only two modalities, so I think it's going to be easier for us to do something about scheduling. I'd like it to be a pilot for what scheduling in the rest of the Department could become."

In addition to patient care, volunteerism is also very important to Dr. Van Dalsem. He is currently the president of the California Radiological Society (CRS), and he is very involved in the American College of Radiology (ACR). His commitment is a way of "ensuring the quality and viability of the specialty," he told me. "I'm just so impressed with the leadership of the ACR and the physicians who care enough about the specialty that they are willing to put in extra time to maintain the quality and integrity of diagnostic imaging. I feel very privileged to be involved in the CRS and the ACR."

Given his commitment to volunteerism, it's fitting that he has a picture of "The Vol Guy" taped to his office door. "The Vol Guy" is the Vols (or "Volunteers") quarterback from the University of Tennessee at Knoxville football team. As a former Cal graduate, I couldn't resist asking about the Cal-Stanford Big Game, and I knew that he would probably appreciate, and maybe even welcome, a question about the Big Game because he was a former Stanford rugby player (he broke his left ulna in a rugby match weeks before his San Francisco General Hospital [SFGH] internship). Here's the X-ray of his fracture that he gave me to include with this article.

"Last year, they [Cal] kicked us around, but that's okay because every year, we have a couple more Nobel Prize winners, and we kicked Cal's XXXX in rugby routinely when I played for Stanford," he told me. "Even though I went to Cal's radiology program [UCSF], I still bleed Cardinal red, but I hate the tree. I do enjoy the band, though."

He met his wife of 33 years, Jeanine, at Stanford when she was a psychology major. She now does interior design. Although neither his son, Matt, nor his daughter, Kate, went to Stanford, Kate works at Stanford in travel/study in the Alumni Department. She is a University of California, Santa Barbara, graduate who may return to school for her degree in landscape architecture. His son, Matt, went to the University of California, Los Angeles, and then to Pepperdine for his MBA. He currently works in media marketing.

At the end of the interview, Dr. Van Dalsem did leave me with some words of wisdom, the same wisdom he shared with his children many times when they were growing up: "There is always going to be someone who is better, stronger, smarter, faster, and funnier than you, but don't ever let anyone outwork you or be nicer than you. Besides, if you're nice, you can get away with almost anything."