San Francisco General Hospital

Zuckerberg San Francisco General Hospital and Trauma Center
San Francisco Department of Public Health
San Francisco General Hospital (seen against the backdrop of Potrero Hill and the Bay Bridge, and parts of the Mission District in the foreground)
Geography
Location	1001 Potrero Ave San Francisco, California 94110, United States
Coordinates	37°45′20″N 122°24′18″W
Organization
Care system	Medicaid, Medicare, Public
Type	Teaching
Affiliated university	University of California, San Francisco
Services
Emergency department	Level I trauma center
Beds	403 General Acute Care 22 Acute Psychiatric 59 Skilled Nursing Mental Health 30 Skilled Nursing Med/Surg
History
Opened	1850
Links
Website	zuckerbergsanfranciscogeneral.org
Lists	Hospitals in the United States

The Zuckerberg San Francisco General Hospital and Trauma Center (SFGH) is a public hospital in San Francisco, California under the purview of the city's Department of Public Health. It serves as the only Level I Trauma Center for the 1.5 million residents of San Francisco and northern San Mateo County. It is the largest acute inpatient and rehabilitation hospital for psychiatric patients in the city. Additionally, it is the only acute hospital in San Francisco that provides 24-hour psychiatric emergency services.

In addition to the approximately 3,500 San Francisco municipal employees, the University of California, San Francisco (UCSF) provides approximately 1,500 employees (including physicians, nurses and ancillary personnel), and the SFGH serves as one of the teaching hospitals for the UCSF School of Medicine. The hospital, especially its Ward 86, was instrumental in treating and identifying early cases of AIDS. A new San Francisco General Hospital acute care building was completed in 2016 for a total approximate cost of $1.02 billion. A $75 million donation by Facebook founder Mark Zuckerberg and his wife Priscilla Chan covered approximately 7% of the overall cost. In recognition, the hospital was renamed after the couple.

The hospital is a safety net hospital additionally serving poor, elderly people, uninsured working families, and immigrants. About 80 percent of its patient population either receives publicly funded health insurance (Medicare or Medi-Cal) or is uninsured. SFGH also cares for the homeless, who make up about 8 percent of its patients.

SFGH is rare in that its emergency rooms do not have agreements in place with private health care insurance providers. Through 2019, privately insured patients were often billed the balance of their care, which could be sizable. This practice was changed after media attention.

Timeline 

The following events occurred for this hospital:

• 1850: San Francisco Granted a city Charter and creates a Board of Health; cholera strikes, temporary hospital set up.
• 1857: City and County opens its first permanent hospital in the former North Beach schoolhouse at Stockton and Francisco streets.
• 1864: “In the fall of 1864, Hugh Toland opened his new medical school, which in 1872 would become part of the University of California. The Medical School building was located on Stockton Street near Chestnut adjacent to the City and County Hospital ... In 1865, Toland was granted permission to use the hospital for clinical instruction.” 
• 1872: “On August 28, 1872, the New City-County Hospital on Potrero Street was opened ... it was described as a two-story, wooden frame building with a brick foundation...” 
• 1873: Agreement allows City and County Hospital to serve as the clinical facility for the University of California Medical School.
• 1906: “The Earthquake and Great Fire devastate the City in April 18, 1906 ... the Hospital with its wood frame structure anchored on the firm rock of Potrero Hill survived more or less intact, with minimal injury to inmates or staff.” 
• 1907: Children's ward and contagious pavilion open.
• 1908: Second plague epidemic strikes; hospital pronounced unfit for patient care when plague infested rats and fleas are found there; wooden buildings burned to the ground by city order and patients moved to the old Jockey Club Racetrack in the Ingleside district, where box stalls and grandstands are converted into a temporary hospital; “Mission Emergency” Hospital, one of the city owned network, operates out of a shack on the Potrero Ave site.
• 1915: New San Francisco General Hospital, landscaped, red brick, Italian Renaissance-style complex, dedicated during the city's celebration of the completion of the Panama Canal; motorized ambulances replace the horse-drawn vans.
• 1924: Psychiatric ward opens to treat acutely ill patients and reduce state hospital admissions.
• 1959: “In May 1959 in the first contract with the University of California was signed and amounted to 1% of the total hospital budget or $154,000 ... the value of teaching programs to a public hospital was emphasized by the university in their negotiations with the city...” 
• 1963: “...a modern medical library funded primarily by UC was opened on Ward 31. It was named the Briggs-Barnett library after two former chiefs of medicine on the UC and Stanford service.” 
• 1965: “The pressing need for more psychiatric beds, the general overcrowding, and the problems of maintenance and staffing all combined to emphasize the inadequacy of the 50-year-old hospital ... a $33.7 million bond issue ... passed overwhelmingly with the highest support of any bond since the earthquake of 1906.” 

The San Francisco General Hospital from the air in 2008 prior to the construction of the 2016 hospital block, illustrating the surviving 1915 blocks and the 1976 block.

New facade of SFGH after construction completed in 2016

• 1971: Groundbreaking for the new hospital. The original brick main building was replaced with a concrete one with construction started in 1971; four remaining 1915 five-story edifices are among the tallest brick buildings in the city.
• 1972: Trauma Center opens at Mission Emergency, with a grant from NIH.
• 1973: Outpatient department, Stroke Research Center, coronary and respiratory ICUs, Family Practice residency starts.
• 1976: New SFGH Medical Center opens after three years of planning by community advisory boards.
• 1979: Specially equipped Burn Unit, San Francisco's second, becomes part of the Trauma Center; Gladstone Foundation Cardiovascular Laboratories open.
• 1980: Ernest Gallo Clinic and Research Center established to study basic neuroscience and the effects of alcohol on the brain.
• 1983: UCSF clinicians and researchers develop the country's first outpatient AIDS clinic and inpatient ward at SFGH.
• 1991: Trauma Center designated the only Level I Trauma Center in San Francisco providing around the clock medical and psychiatric emergency services.
• 1993 :The Gladstone Institute of Virology and Immunology opens at SFGH, second largest basic research institute in the US. In partnership with UCSF, conducts research on new drugs and treatment for HIV/AIDS, along with clinical trials, prevention, outreach, and professional education programs.
• 2004: Avon Foundation Comprehensive Breast Center opens, more than doubling SFGH's breast cancer screening capacity.
• 2008: San Francisco passes an $888 million bond to build a new hospital at SFGH between the historic 1915 red brick buildings. The bond received 84% approval.
• 2015: Facebook founder and CEO, Mark Zuckerberg and his wife Priscilla Chan give $75 million to help fund equipment and technology for the new hospital.
• 2016: The new hospital building is completed. The new building was the first hospital in San Francisco to be constructed with a base-isolated foundation for protection against earthquakes. Notable improvements include expanding the capacity of the emergency department and increasing the number of general admission beds, increasing the number of intensive care unit (ICU) beds, and combining the previously separate surgical and medical units into one ICU.

Billing practices

Through early 2019, SFGH did not participate in any private health insurance networks and practiced balance billing. A Vox analysis (derived from a database of more than a thousand emergency room bills) characterized the hospital's billing practices as "aggressive" and "surprising": one privately insured patient arriving at the hospital after a bicycle accident was billed more than $20,000 for diagnostic scans and treatment for a broken arm; the bill was 12 times the Medicare billing rate. After media attention, SFGH changed its billing policy so that privately insured patients would be billed at rates consistent with their insurers' network rates, with an income-based maximum.

Artwork

The hospital owns and displays two paintings by Frida Kahlo and Diego Rivera, donated to the hospital by Dr. Leo Eloesser. Eloesser interned at SFGH and was Kahlo's physician.

The Pediatric Emergency Department features a mural by artist Sirron Norris entitled The Land of the Helping Hand, which features local iconography.

Notable deaths

• Diane Whipple, American lacrosse player and coach, dog mauling victim
• Ed Lee, attorney, politician and mayor of San Francisco, died from cardiac arrest

See also

• List of hospitals in California

External links

• SFGH site at SF Dep't of Public Health
• UCSF SFGH site
• SFGH campus maps
• Center for Vulnerable Populations
• This hospital in the CA Healthcare Atlas A project by OSHPD
• Brain and Spinal Injury Center
• Orthopaedic Trauma Institute