Clinical Component

Navigating the Clinical Component

The Internal Medicine practice at Central Peninsula Hospital is a busy outpatient clinic focused on adult primary care. Physicians see 18 and older patients with a mix of chronic disease management, acute visits, and preventive care. The practice runs at a pace of 12 to 14 patients per day, which the hospital considers the target volume for a productive full-time provider. There is no inpatient rounding requirement, though physicians do carry a light call responsibility tied to patient continuity.

Practice Snapshot

Detail Description
Setting Hospital-employed outpatient clinic
Patient Population Adults 18 and older
Target Daily Volume 12 to 14 patients per day
Schedule 4 days per week; 36 patient-facing hours
Inpatient Rounding Not required
Call Type Phone-based; clinic continuity coverage
EMR Epic
AI Documentation DAX implementation pending
APP Support 2 APPs support the practice

Call Structure

Call at CPH is phone-based and tied to patient continuity rather than inpatient coverage. The hospitalist program, contracted through Alaska Hospitalist Group, handles all inpatient care. When an internal medicine patient is admitted, the hospitalist team notifies the patient's primary physician as a courtesy, but the outpatient physician does not round or manage the inpatient stay.

Day-to-day call coverage rotates among the physician group and covers situations such as after-hours refill requests, clinical questions, and same-day access needs for patients when their primary physician is out. APPs participate in clinic coverage but do not take part in the call rotation. Call is not overnight in the traditional sense and does not require coming into the hospital.

Call frequency will depend on group size. The expectation is that it will not exceed 10 days per month, and as the group grows it will be shared across more providers.

In-Office Procedures

Procedures are available but not required. The practice offers the following, and physicians can participate based on interest and training:

  • Dermatology biopsies, including punch biopsies
  • Stress testing (performed at the hospital facility)
  • Joint injections (available; participation optional)

Physicians with no interest in procedures are still a good fit for this role. The practice does not require procedural volume.

Residency Integration

The clinic runs a University of Washington internal medicine residency program in its first year of operation. Currently two to three residents are active, with additional elective rotation residents coming through nine months of the year. Residents have their own patient panels and see patients two days per week in the clinic.

Incoming physicians may be asked to precept residents. The expectation is that teaching time, if any, will represent no more than 10 to 20 percent of a physician's schedule. The medical director values the program and will likely discuss academic involvement with all new hires. Physicians who want no involvement in the residency will be considered, particularly for the higher-volume position replacing Dr. Berger.

Imaging and Diagnostic Support

Full on-site diagnostic support is available for Internal Medicine referrals, including:

  • Two CT scanners (120-slice and 160-slice)
  • Two MRI units (1.5T on-site; 3.0T at affiliated location)
  • Full laboratory with Mayo Clinic reference lab access
  • Sleep medicine and pulmonary services on-site
  • Diabetes Center with dedicated NP for diabetic education
  • Behavioral health services available for co-management

Additional Clinical Context

The Internal Medicine group prides itself on doing more than a traditional primary care clinic. Some physicians perform endoscopy and stress testing in addition to standard outpatient medicine. The practice was originally a private group that was acquired by the hospital, and the team has maintained some of its independent culture while integrating into the hospital system. Leadership is actively working to align the group's clinical output with the hospital's patient access goals.

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