Clinical Component

Navigating the Clinical Component

This is an outpatient primary care practice built around continuity and in-person care. Serving a catchment area of approximately 20,000 people, the physician manages a full panel of mostly adult and geriatric patients, many of whom present with several active problems at once. The clinic values a provider who can prioritize the day, address the most pressing issues first, and bring patients back on a planned cadence rather than trying to solve everything in one visit.

Patient Population

• Predominantly adult and geriatric, roughly 70 to 80 percent of the panel
• A pediatric segment is served, though many families use outside pediatricians for vaccinations tied to insurance rules
• Payer base is heavily managed care, with about 60 percent of patients on the IEHP managed care plan, plus Medicare and Medi-Cal
• Many patients arrive with long lists of deferred needs and benefit from a physician who can pace care and keep them engaged

Clinical Environment

• Multi-specialty clinic with primary care working alongside orthopedics, general surgery, cardiology, rheumatology, endocrinology, psychiatry, chiropractic, and vision, with neurology launching this month
• On-site laboratory and point-of-care testing
• Referrals move in-house across the specialty lines, so patients stay on the mountain rather than driving down for specialty care
• No obstetric or delivery services on the mountain; pregnant patients are directed off-mountain for delivery

Visit Structure

The clinic's scheduling model gives providers two ways to structure the day. The expectation for a seasoned physician is a minimum of two patients per hour, with room to reach three using the 20 and 40 minute mix.

Productivity target: two to three patients per hour. Leadership is open to an alternative model for a physician with a proven track record, provided it maintains quality.

Call

This position carries no call responsibility.

Working With the APP Team

Mid-level providers carry much of the primary care volume, and the incoming physician serves as their clinical resource. The clinic runs a one-to-four supervising ratio. In practice this means:

• Being available in person as a point of contact for clinical questions
• Explaining findings and test results and helping the team work through cases
• Performing chart reviews when needed
• Setting a consistent clinical standard for the group

The clinic specifically wants a physician who shares knowledge openly and helps the team solve problems, rather than deferring questions outside their own focus.

EMR

The clinic currently uses DPSI TrueBridge and is transitioning to Meditech. The transition is expected to begin in roughly six to eight months, with the full changeover taking about a year. Meditech will also enable wRVU tracking going forward.