The UCSF ALS & Neurodegenerative Disease Center has seen significant growth in recent years with a hybrid model of care that combines in-person visits with telehealth services. The expanded range of services enhance access for patients with ALS, a disease marked by medical complexity and mobility challenges.
“It’s incredibly rewarding to help patients with ALS adapt as the disease progresses, especially when their goals change over time,” said Assistant Professor Natalie Anzures, PT, DPT, who has been instrumental in the clinic’s growth. “It’s not about curing ALS, but improving patients’ quality of life through the right tools and support.”
With the addition of two neurologists, bringing the clinic’s total to five, the clinic has increased the frequency of appointments and expanded its reach beyond the Bay Area. New satellite clinics have been established in Stockton and Santa Barbara, addressing gaps in ALS care in underserved regions of Central California.
In addition to providing clinical services, the UCSF ALS team engages in community outreach. For instance, during a visit to Santa Barbara, the team hosted a community event where members shared their expertise with local patients and families, fostering connection and education around ALS care.
Depending on their location and severity of symptoms, patients can be seen either at the San Francisco clinic, satellite locations, or via telehealth. The frequency of visits ranges from monthly to every six months. Telehealth allows for continued care without the need for frequent travel, offering patients flexibility.
“In the ALS clinic, team members work together so the patient receives timely care,” said Dr. Anzures. “We evaluate the patient, make recommendations, and implement those changes on the same day.”
Even patients who visit satellite clinics only once a year can experience significant benefits. In Santa Barbara, for example, the team evaluated a patient for a power wheelchair, processed the paperwork, and delivered the chair within four weeks – a much faster turnaround than the typical six-month wait.
A collaborative approach to care
The clinic’s multidisciplinary approach allows patients to receive comprehensive care in a single visit. Over the course of three to four hours, patients rotate between various providers, including physical therapists, occupational therapists, neurologists, speech language pathologists, respiratory therapists, dietitians and social workers. This all-in-one approach ensures patients feel supported and informed about their health.
Daily team huddles coordinate patient priorities and care plans. At the end of each clinic day, the team reconvenes to finalize care recommendations, enabling patients to leave with prescriptions and care plans in hand.
In-person collaboration among providers, such as physical therapists and neurologists, allows for quicker decision- making and problem-solving. In outpatient settings, providers often rely on written communications and asynchronous messaging, which can slow the process. At the ALS clinic, in contrast, team members can immediately address patient needs, such as evaluating and ordering mobility equipment during a single visit.
A model for other conditions
The success of the UCSF ALS clinic offers a model of care that can be replicated for other complex conditions. It has already inspired the creation of UCSF clinics for traumatic brain injury, neurorecovery and spasticity. By expanding access and coordinating care, the ALS clinic is setting a standard for how interprofessional teams can improve outcomes, especially for patients with complex, evolving needs.
For those looking to establish similar interprofessional clinics, Dr. Anzures advises first identifying the patient population and the necessary providers. “Set clear expectations with patients and create an efficient clinic flow that benefits everyone,” she said. “It’s important that every provider works at the top of their license and that the clinic feels worth the effort.”