She is a researcher and staff physician at the San Francisco VA Medical Center. She is a practicing primary care internist and a health services researcher. Her research interests include the examination of the quality of health care and health policy research. Her quality of care research to date has focused on examining the underuse and overuse of medical procedures and comparing receipt of appropriate preventive care in different systems of care. She has examined the quality of health care guidelines, the prevalence of conflicts of interest in medicine and she has also surveyed physicians on their views regarding coverage expansions defensive medicine, comparative effectiveness research and reimbursement reform.