A Conversation with Natalie Young, MD

So, Natalie, I heard from little birds around the division that you are actually from SF—you grew up here—and you come from a very large family. Could you share a bit more about your family and what it was like growing up in San Francisco?

Sure! I feel really lucky to have grown up in San Francisco and to live here now, which has been such an honor and a dream.  I was even able to convince my husband, a die hard Dodgers fan, to move back to San Francisco after we finished our residency and fellowship training. 

My family still lives here in San Francisco, too. I grew up in the Cow Hollow neighborhood. Both of my parents are physicians and worked at CPMC.

My dad is an endocrinologist and primary care doctor, and my mom is an OBGYN. Some of my fondest memories growing up as a kid are walking down the street with her and meeting a bunch of her patients. They would come up to her and say, “We love you so much, Dr. Chen, and we’re so grateful for the care you provided.” The number of babies that she delivered is pretty incredible.

I have a little sister—she’s always my little sister, even though she’s not that little anymore. She didn’t go into medicine; she’s an architect here in the city and lives two blocks away from me. My parents still live in the same house that I grew up in, and my sister has three kids who are the same ages as my two kids, so it gets quite loud and chaotic when we’re all together—but we love it.

We recently spent Lunar New Year together as a family. We got together with my grandmother, who is still with us at 97, which is incredible, and my uncle, who also has a big family in the Bay Area. It was just lovely. I feel so lucky.

One of the coolest things is that my dad is a big bike rider. He rides to our house every Saturday morning, we have breakfast together and hang out, and then he heads back on his merry way. It’s been the best tradition.

I have a son who is nine and a daughter who is six and a half, so life is very busy and they keep us on our toes. They’re in school and at this fun age where they want to hang out and snuggle, but they’re also more independent. They can get their own milk, shower, and put themselves to bed. They’re developing their own interests and humor, so it’s been really fun.

You mentioned you celebrated Lunar New Year—tell us about some of your LNY traditions with your family.

We always enjoy hot pot for Lunar New Year. We make a big production out of it. It’s one of my favorite meals because it takes as long as it takes and encourages longer conversations and more time together.

Recently, all the grandkids have been getting dressed up for LNY. We’ve been getting them outfits from Chinatown, and they all get their red envelopes from their elders, which they get very excited about. And of course, we see lion dancers.

Since you’re from SF, what are your favorite hobbies or things to do?

One of the things we really like to do as a family is explore different neighborhoods. We’ll pick a new neighborhood, walk around, eat something delicious, peek into stores, and go to a park.

One fun thing we did a couple summers ago: the San Francisco Public Library put out a map where each branch had a unique sticker. We made it a goal to collect them all and place them on the map. That was a really fun way to explore the city.

I feel really lucky to live near the Presidio. I love going on small hikes, walking out to the beach, and going to Lands End. The Parade Grounds and Tunnel Tops have been such incredible additions. It brings me so much joy to be out there.

So you went to medical school and residency at UCSF?

Yes, I did! I left briefly, but I did medical school and internal medicine residency here at UCSF. Steve Pantilat was actually my attending when I was a fourth-year medical student. Anne Kinderman was my attending at the General when I was a third-year medical student, Kara Bischoff was one of my chief residents, and Carly Zapata was one of my co-residents. I feel very lucky to have continued these relationships with people who have taught me so much.

Then I went to Mount Sinai in New York, where I did my Geriatrics and Palliative Care fellowship. I was in New York for three years—two years as a fellow and one year as an attending—before moving back.

At what point in your career did you decide, “I want to be in both of these specialties,” and how do they come together for you?

When I was a resident, I was always excited about primary care. My interest stemmed from forming longitudinal relationships with patients and getting to know people over time, thinking about them holistically.

During residency, I found myself drawn to older adults. In geriatrics, I really enjoyed what felt like the art of medicine—understanding what is important to someone and how to make that happen in the context of all their conditions. It felt less algorithmic and more creative and intellectually challenging.

I had always enjoyed my experiences with palliative care, but I hadn’t initially thought of it as a career. During my geriatrics fellowship, I did a palliative care rotation, and my attendings encouraged me to pursue it. I remember calling Anne Kinderman, and she said, “Yes, do it—it will only open doors.”

I joined the integrated geriatrics and palliative care fellowship, and after that, I came back to UCSF. I initially joined the Division of Geriatrics, just before the Division of Palliative Medicine was established. Because of my palliative care experience, I started with a couple of half-days in the Symptom Management Clinic—and I fell in love with it.

It checked so many of the boxes I was looking for: really getting to know patients, forming meaningful relationships over time, thinking about them as whole people, approaching symptom management and goals of care creatively, and working with families and interdisciplinary teams.

After about four years, I transitioned fully into the Division of Palliative Medicine and now practice exclusively in outpatient palliative care.

I spent a lot of time wondering how to use both the geriatrics and palliative care lenses together. Something Eric Widera said really stuck with me, and I think I’ve found that balance in my current role, that I can bridge both based on the population I am caring for. Technically, I’m not practicing geriatrics in the traditional sense—I’m not doing outpatient primary care or working in an ACE unit or skilled nursing facility—but the population I care for is largely older adults. In the Symptom Management Service and OPCS, most of my patients are in their 70s, 80s, and 90s, often with dementia or frailty.

So I still get to use that skill set—thinking about function, what’s important to patients, falls, frailty, dementia—all within a palliative care framework. I feel like I get to do both, and our system allows me to do that well.

Your patients are very lucky—they get a two-in-one with you!

I try! It’s hard because there are things I’m not set up to do, like managing blood pressure or diabetes or ordering osteoporosis treatments. Sometimes patients look to me for that because there’s such a shortage of primary care doctors, and I have to explain that I can’t take that on.

Sherry Chen: I’m always interested in people who merge different interests into their careers. That’s what’s so special about the DPM—there’s real support for shaping the career you want.

I completely agree. I’m so grateful that division leadership recognizes that and encourages us to bring our expertise forward. There’s a strong culture of sharing knowledge and supporting each other. It’s really special.

Andrea had a question for you about your work in neurology and Dementia Day—where does that work stem from?

I’m really grateful to work with Kwame Adjepong, and previously with Bridget Sumser, and now with Susanna Fong, Eve Cohen, Kara Bischoff, and others to think about how we care for patients with dementia and their families.

That work really stems from my geriatrics background. I spent many years doing home-based primary care, and seeing firsthand how challenging it is to have dementia and to care for someone with dementia, really shaped my perspective.

It made me want to think more critically about how we can improve our systems and introduce new models of care. Bringing a palliative care lens means thinking about how to support the whole family and address psychosocial needs, which our system often isn’t well set up to do.

I’ve been fortunate to partner with colleagues across the Memory and Aging Center, neurology, geriatrics, and population health to work on this. It’s a big challenge, but it’s exciting to be part of that conversation.

Dementia Day is a full-day conference hosted by the Memory and Aging Center. This year, we helped make it more clinically focused and hosted a panel with UCSF leadership to discuss challenges and opportunities in dementia care. It was really exciting to bring so many passionate, thoughtful people together.

Dementia is hard—it’s a difficult disease for patients and families. I’m grateful to be able to support people through that journey as best I can.

We’ll end on a fun note—what are your favorite places to eat in the city?

That’s a tricky question!

I recently went to a new place that’s quickly becoming a favorite: Early to Rise on McAllister and Baker. It’s a brunch-lunch spot with amazing food—they cure their own meats, bake their own bread, make their own butter—and everything was delicious. The staff is incredibly friendly, and the space has great energy.

I also love Zuni Café—it’s such an old-school San Francisco institution. A martini, oysters, a great burger, and fries—it’s perfect. And similarly, I love Foreign Cinema. Sitting in that courtyard and watching movies is such a classic experience.

Benihana in Japantown is another favorite—it’s unchanged from when I was a kid. We used to celebrate birthdays there, and it’s still just as fun. It’s dinner and a show—10 out of 10.

For barbecue pork buns and egg custard tarts, I love Long Fung Bakery on Clement and 19th. It’s cash-only, and there are always Chinese grandfathers outside playing cards—it’s the best sign you’re in the right place.

And my favorite burrito spot is Gordo’s Taqueria on Clement. I’ve been going there since high school—it’s the best. I know that’s controversial, but I stand by it.

I know I’m very Richmond-heavy, but that’s where I live!