I have had the privilege of practicing medicine with Kaiser Permanente since January of 2000. My initial contact with this organization was during my gastroenterology fellowship in 1995, when I participated in a research project with Dr. Joe Selby, Director of the Kaiser Permanente Division of Research, and Dr. Albert Palitz, Chief of Gastroenterology in the Diablo Service Area. We worked together on a study of the largest flexible sigmoidoscopy colorectal cancer screening program in the world, the Kaiser Permanente Colorectal Cancer Prevention (CoCaP) program. My first position after completing my fellowship was as an Assistant Clinical Professor of Medicine at the University of California, San Francisco (UCSF). While at UCSF, I maintained my research ties to Kaiser Permanente, and eventually moved my clinical practice and all of my research there, while maintaining my voluntary teaching position at UCSF.