Dr. Marina Martin graduated from UCLA School of Medicine in 2003, and from Stanford internal Medicine Residency in 2006. After serving as a chief resident from 2006-07, Dr. Martin began a 3 year fellowship in the Stanford Prevention Research Center. During that time, she became medical director of a Stanford student-run free clinic, Pacific Free Clinic, which provides preventive health services to low-income uninsured adults in the East San Jose area.
During her research fellowship years, Dr. Martin also volunteered in the Interdisiplinary Geriatric Medicine clinic at the Palo Alto VA Hospital, which kindled her interest in working with older adults and led her to pursue specialty training in Geriatric Medicine. In 2012 she joined the Geriatric Medicine faculty at Stanford as a primary care physician in the newly-formed Stanford Senior Care Clinic. In 2014, she became medical director of the clinic, and in 2015 became the first Section Chief of Stanford's new section of Geriatric Medciine in the School of Medicine. In this role, she oversees clinical, educational, and health services research programs that promote optimal, compassionate, personalized care of older adults, especially those with frailty, dementia, or very advanced age.
Dr. Martin's clinical practice currently consists of post-acute rehabilitation and long-term care at Webster House Health Center (nursing home) and transitional care at home after hospitalization at Stanford Hospital.
- Geriatric Medicine
Clinical Associate Professor, Medicine - Primary Care and Population Health
Section Chief, Geriatric Medicine, Division of Primary Care and Population Health (2015 - Present)
Medical Director, Stanford Senior Care Clinic (2014 - 2016)
Medical Director, Sequoias Portola Valley Health Center (2015 - 2017)
Honors & Awards
Phi Beta Kappa, Carleton College (1997)
Alpha Omega Alpha, UCLA School of Medicine (2003)
William B. Valentine Award in Medicine for distinction as a scholar of Internal Medicine, UCLA School of Medicine (2003)
Janet M. Glascow Memorial Achievment Citation (for women in top 10% of medical school class), UCLA School of Medicine (2003)
Award for Professionalism, Stanford University Department of Medicine, Internal Medicine Residency (2005 and 2006)
Physician's Award for Service to the Cardinal Free Clinics, Stanford University School of Medicine (2007)
Outstanding Community Preceptor (Pre-clerkship) Award, Stanford University School of Medicine (2010)
Advocacy and Community Service Award, Society of General Internal Medicine California-Hawaii Region (2014)
Boards, Advisory Committees, Professional Organizations
Member, The American Geriatrics Society (2011 - Present)
Medical Education: UCLA David Geffen School Of Medicine Registrar (2003) CA
Fellowship: Stanford University and VA Palo Alto Geriatric Medicine Fellowship (2011) CA
Residency: Stanford University Internal Medicine Residency (2006) CA
Board Certification: American Board of Internal Medicine, Geriatric Medicine (2011)
Masters in Public Health, UC Berkeley, Epidemiology (2008)
Board Certification: American Board of Internal Medicine, Internal Medicine (2006)
BA, Carleton College, Northfield, MN, Neuroscience (1997)
Current Research and Scholarly Interests
Providing quality interdisciplinary care to older patients with complex conditions, dementia, or frailty
Health care delivery in low-income and low English proficiency communities
Improving health care delivery systems for older adults, particularly those with advanced illness and caregiver dependence
Advance care planning
Association Between Implementation of a Geriatric Trauma Clinical Pathway and Changes in Rates of Delirium in Older Adults With Traumatic Injury.
Importance: Older adults (age ≥65 years) are at risk for high rates of delirium and poor outcomes; however, how to improve outcomes is still being explored.Objective: To assess whether implementation of a geriatric trauma clinical pathway was associated with reduced rates of delirium in older adults with traumatic injury.Design, Setting, and Participants: A retrospective case-control study of electronic health records of patients aged 65 years or older with traumatic injury from 2018 to 2020 was conducted at a single level I trauma center. Eligible patients were age 65 years or older admitted to the trauma service and who did not undergo an operation.Intervention: The implementation of a clinical pathway based on geriatric best practices, which included order sets, guidelines, automated consultations, and escalation pathways executed by a multidisciplinary team.Main Outcomes and Measures: The primary outcome was delirium. The secondary outcome was hospital length of stay. Process measures for pathway compliance were also assessed.Results: Of the 859 eligible patients, 712 patients were included in the analysis (442 [62.1%] in the baseline group; 270 [37.9%] in the postimplementation group; mean [SD] age: 81.4 [9.1] years; 394 [55.3%] were female). The mechanism of injury was not different between groups, with 247 in the baseline group (55.9%) and 162 in the postimplementation group (60.0%) (P=.43) experiencing a fall. Injuries were minor or moderate in both groups (261 in baseline group [59.0%] and 168 in postimplementation group [62.2%]; P=.87). The adjusted odds ratio for delirium in the postimplementation cohort was 0.54 (95% CI, 0.37-0.80; P<.001). Goals of care documentation improved significantly in the postimplementation cohort vs the baseline cohort with regard to documented goals of care notes (53.7% in the postimplementation cohort [145 of 270] vs 16.7% in the baseline cohort [74 of 442]; P<.001) and a shortened time to discussion from presenting to the emergency department (36 hours in the postimplementation cohort vs 50 hours in the baseline cohort; P=.03).Conclusions and Relevance: In this study, implementation of a multidisciplinary clinical pathway for injured older adults at a single level I trauma center was associated with improved care and clinical outcomes. Interventions such as these may have utility in this vulnerable population, and findings should be confirmed across multiple centers.
View details for DOI 10.1001/jamasurg.2022.1556
View details for PubMedID 35675065
Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment.
2022; 5 (2): e34326
Despite the increasing availability of telemedicine video visits during the COVID-19 pandemic, older adults have greater challenges in getting care through telemedicine.We aim to better understand the barriers to telemedicine in community-dwelling older adults to improve the access to and experience of virtual visits.We conducted a mixed methods needs assessment of older adults at two independent living facilities (sites A and B) in Northern California between September 2020 and March 2021. Voluntary surveys were distributed. Semistructured interviews were then conducted with participants who provided contact information. Surveys ascertained participants' preferred devices as well as comfort level, support, and top barriers regarding telephonic and video visits. Qualitative analysis of transcribed interviews identified key themes.Survey respondents' (N=249) average age was 84.6 (SD 6.6) years, and 76.7% (n=191) of the participants were female. At site A, 88.9% (111/125) had a bachelor's degree or beyond, and 99.2% (124/125) listed English as their preferred language. At site B, 42.9% (51/119) had a bachelor's degree or beyond, and 13.4% (16/119) preferred English, while 73.1% (87/119) preferred Mandarin. Regarding video visits, 36.5% (91/249) of all participants felt comfortable connecting with their health care team through video visits. Regarding top barriers, participants at site A reported not knowing how to connect to the platform (30/125, 24%), not being familiar with the technology (28/125, 22.4%), and having difficulty hearing (19/125, 15.2%), whereas for site B, the top barriers were not being able to speak English well (65/119, 54.6%), lack of familiarity with technology and the internet (44/119, 36.9%), and lack of interest in seeing providers outside of the clinic (42/119, 35.3%). Three key themes emerged from the follow-up interviews (n=15): (1) the perceived limitations of video visits, (2) the overwhelming process of learning the technology for telemedicine, and (3) the desire for in-person or on-demand help with telemedicine.Substantial barriers exist for older adults in connecting with their health care team through telemedicine, particularly through video visits. The largest barriers include difficulty with technology or using the video visit platform, hearing difficulty, language barriers, and lack of desire to see providers virtually. Efforts to improve telemedicine access for older adults should take into account patient perspectives.
View details for DOI 10.2196/34326
View details for PubMedID 35438648
HCV Prevalence in Asian Americans in California
JOURNAL OF IMMIGRANT AND MINORITY HEALTH
2017; 19 (1): 91-97
The World Health Organization estimates that 170 million persons are infected with HCV worldwide, but only 22 million are from the Americas and Europe, compared to 94 million from Asia. HCV prevalence in the general US population is 1.6 %, but data for Asian Americans are limited. Our goal was to examine HCV prevalence in Asian Americans in a large ethnically diverse patient cohort seeking primary care at a free clinic in Northern California. A total of 1347 consecutive patients were seen from September 2009 to October 2012 and were studied via individual chart review using case report forms. HCV infection was defined as positive HCV antibody (anti-HCV) or HCV RNA by PCR. 699 out of 1347 patients were screened for HCV. Asian Americans comprised 57.2 % of these patients and 29 (4.1 %) patients tested positive for HCV. Of these 29 HCV-positive patients, 22 (75.9 %) were Asian, yielding a prevalence of 5.5 % for Asians and 2.3 % for non-Asians (P = 0.038). The highest HCV prevalence was seen in Vietnamese patients at 7.9 %, and 6.0 % in Chinese patients. Of the HCV-positive Asians, none had a history of intravenous drug use (IVDU), tattoos, or sexual exposure. On multivariate analysis, significant independent predictors for positive HCV infection were male gender (OR 2.53, P = 0.02) and presence of known risk factors (OR 21.1, P < 0.001). However, older age and Asian ethnicity were found to be significant predictors of HCV infection (OR 1.03, P = 0.05 and 2.31, P = 0.066, respectively). In our study, HCV prevalence in patients seeking routine primary care was 5.5 % in Asian Americans, which was over double the prevalence for non-Asians at 2.3 %. Known risk factors were also notably absent in Asian patients with HCV infection. The high prevalence of HCV in Asian-Americans is likely reflective of the higher prevalence of HCV in their countries of origin in Asia. Asian-Americans immigrants from endemic countries are at higher risk of HCV infection and should be screened for HCV, regardless of their exposure risk profile.
View details for DOI 10.1007/s10903-016-0342-1
View details for Web of Science ID 000394213200012
- Implementing EOLA at Stanford SGIM Forum. 2017 (40 (3)): 8,12
Immersion medicine programme for secondary students.
The clinical teacher
Although the proportion of ethnicities representing under-represented minorities in medicine (URM) in the general population has significantly increased, URM enrolment in medical schools within the USA has remained stagnant in recent years.This study sought to examine the effect of an immersion in community medicine (ICM) programme on secondary school students' desire to enter the field of medicine and serve their communities. The authors asked all 69 ICM alumni to complete a 14-question survey consisting of six demographic, four programme and four career questions, rated on a Likert scale of 1 (completely disagree) to 5 (completely agree), coupled with optional free-text questions. Data were analysed using GraphPad prism and nvivo software.A total of 61 students responded, representing a response rate of 88.4 per cent, with a majority of respondents (73.7%) from URM backgrounds. An overwhelming majority of students agreed (with a Likert rating of 4 or 5) that the ICM programme increased their interest in becoming a physician (n = 56, 91.8%). Students reported shadowing patient-student-physician interactions to be the most useful (n = 60, 98.4%), and indicated that they felt that they would be more likely to lead to serving the local community as part of their future careers (n = 52, 85.3%). Of the students that were eligible to apply to medical school (n = 13), a majority (n = 11, 84.6%) have applied to medical school. URM enrolment in medical schools within the USA has remained stagnant in recent years DISCUSSION: Use of a community medicine immersion programme may help encourage secondary students from URM backgrounds to gain the confidence to pursue a career in medicine and serve their communities. Further examination of these programmes may yield novel insights into recruiting URM students to medicine.
View details for PubMedID 28805356
Chronic Hepatitis B Management Based on Standard Guidelines in Community Primary Care and Specialty Clinics
DIGESTIVE DISEASES AND SCIENCES
2013; 58 (12): 3626-3633
Prior studies have underlined the need for increased screening and awareness of chronic hepatitis B (CHB), especially in certain high-risk populations. However, few studies have examined the patterns of evaluation and management of CHB between primary care physicians (PCP) and specialists according to commonly-used professional guidelines. Our goal was to examine whether necessary laboratory parameters used to determine disease status and eligibility for antiviral therapy were performed by PCPs and specialists.We conducted a retrospective study of 253 treatment-naïve CHB patients who were evaluated by PCP only (n = 63) or by specialists (n = 190) for CHB at a community multispecialty medical center between March 2007 and June 2009. Criteria for CHB management and treatment eligibility were based on the American Association for the Study of Liver Diseases 2007 guideline and the US Panel 2006 algorithm. Required parameters for optimal evaluation for CHB included hepatitis B e antigen (HBeAg), HBV DNA, and alanine aminotransferase (ALT). Preferred antiviral agents for CHB included pegylated interferon, adefovir, and entecavir.The majority of patients were Asians (90 %) and male (54 %) with a mean age of 43 ± 11.6 years. Compared to PCPs, specialists were more likely to order laboratory testing for ALT (94 vs. 86 %, P = 0.05), HBeAg (67 vs. 41 %, P < 0.0001) and HBV DNA (83 vs. 52 %, P < 0.0001). The proportion of patients having all three laboratory parameters was significantly higher among those evaluated by specialists compared to PCP (62 vs. 33 %, P < 0.0001). A total of 55 patients were initiated on antiviral treatment (n = 47 by specialists and n = 6 by PCPs). Lamivudine was prescribed more often by PCPs than specialists (33 vs. 2 %, P = 0.05). Preferred agents were used 96 % of the time by specialists compared to 67 % of those treated by PCPs (P = 0.05).Patients evaluated by specialists for CHB are more likely to undergo more complete laboratory evaluation and, if eligible, are also more likely to be treated with preferred longer-term agents for CHB compared to those evaluated by PCPs only. A collaborative model of care involving both PCP and specialists may further optimize management of patients with CHB.
View details for DOI 10.1007/s10620-013-2889-1
View details for Web of Science ID 000327456500033
View details for PubMedID 24122622
High Prevalence of Hepatitis C Virus in Asian-Americans: Results of Office-Based Primary Care Screening
WILEY-BLACKWELL. 2013: 1308A
View details for Web of Science ID 000330252206226
- Consequences of Federal Patient Transfer Regulations: Effect of the 2003 EMTALA Revision on a Tertiary Referral Center and Evidence of Possible Misuse ARCHIVES OF INTERNAL MEDICINE 2012; 172 (11): 891-892