Clinical Component

Navigating the Clinical Component

Your Daily Practice: Full-Spectrum Family Medicine

Step into an exam room at the Burley clinic and you'll quickly discover that no two days are alike. This morning you might deliver a baby at Cassia Regional Hospital, round on a patient recovering from pneumonia, then return to clinic to see a diabetic patient for their quarterly follow-up, a child with an ear infection, a teenager needing a sports physical, and a farm worker with a work-related injury. This is family medicine as it was meant to be practiced—comprehensive, longitudinal care that builds deep relationships with patients and families over decades.

Patient Population: Serving the Underserved

Your patient panel will reflect the agricultural community of Mini-Cassia, with approximately 60–70% of patients being Hispanic, many of them Spanish-speaking farm workers and their families. These are hardworking individuals who face significant barriers to healthcare access—lack of insurance, transportation challenges, language barriers, and often years of deferred care. You'll frequently encounter patients who haven't seen a physician in years, presenting with multiple chronic conditions that require patient education, care coordination, and creative problem-solving.

The age range spans the entire lifespan: approximately 30% of your patients will be pediatric (newborn through age 18), with the remainder being adults including a robust geriatric population. Many families choose Family Health Services specifically because they can bring their entire family to one clinic, seeing the same provider who delivered their babies and now manages their diabetes or hypertension.

Payer mix: 40% self-pay, 30% Medicaid, 20% commercial insurance, 10% Medicare
Demographics: Predominantly Hispanic/Latino population (60–70%), with significant agricultural worker representation
Health literacy: Variable, requiring patient-centered communication and robust use of medical interpreters
Common presentations: Diabetes, hypertension, obesity, prenatal care, well-child visits, acute illness, work-related injuries, behavioral health concerns
Social determinants: High rates of food insecurity, housing instability, and transportation barriers—addressed by FHS support staff

Clinical Services: True Full-Scope Practice

Unlike metropolitan practices where family physicians increasingly limit their scope, here you'll practice the breadth of family medicine you trained for. Your clinic days will include:

Obstetric care: Prenatal visits, postpartum care, and deliveries (30–40 annually per provider)
Pediatric care: Well-child visits, immunizations, acute illness, sports physicals, adolescent care
Adult medicine: Chronic disease management (diabetes, hypertension, COPD, heart disease), acute illness, preventive care, health maintenance
Geriatric care: Managing complex medical conditions, medication management, end-of-life discussions
Procedures: In-office procedures including IUD insertions, Nexplanon insertions/removals, laceration repairs, abscess drainage, joint injections, minor dermatologic procedures, ingrown toenail removal, circumcisions
Behavioral health integration: Warm hand-offs to integrated behavioral health consultants available in the clinic
WorkMed services: Occupational medicine including DOT physicals, work injury care, and return-to-work evaluations

You'll have the clinical autonomy to practice within the full scope of your training and comfort level—if you prefer not to perform certain procedures, that's respected. But if you want to maintain procedural skills, this practice provides ample opportunity.

Obstetric Practice: Low-Risk, High-Reward

Your obstetric practice will focus on low-risk deliveries, providing an ideal balance for family physicians who want to maintain OB skills without the intensity of high-risk obstetrics. Cassia Regional Hospital accepts deliveries at 35+ weeks gestation, transferring earlier cases to higher-level facilities in Boise, Salt Lake City, or Pocatello.

Average deliveries: 30–40 per physician annually (approximately 2–3 per month)
Delivery setting: Cassia Regional Hospital's 11-room birth center, which delivers 500+ babies annually
Delivery coverage: You deliver your own patients whenever possible; when you're unavailable, the physician on call covers
C-sections: Not required—collaboration with OB/GYN group (Dr. Nick Parkinson and Dr. Jepsen, retiring)
C-section privileges available: For qualified candidates with documented advanced OB procedure experience during the last three years—a unique opportunity compared to St. Luke's in Twin Falls
Compensation: $300 per vaginal delivery, $150 per C-section assist (optional skill development)
Support: Three certified nurse midwives on staff provide first-call coverage, reducing call burden
Backup: Robust tele-health support from Intermountain Health's maternal-fetal medicine specialists available 24/7

Call Schedule: Manageable and Clearly Defined

The call system is designed for sustainability, allowing you to maintain your personal life while meeting patient needs. You'll take one week of call per month in a 1:4 rotation, covering all Family Health Services patients in Burley and Rupert.

Response time: 15 minutes from receiving the call to arriving at the hospital
Daytime coverage: You manage all FHS patient admissions and deliveries during business hours
Evening/overnight coverage: After 7:30 PM, a tele-nocturnist team handles medical admissions remotely
ICU admissions: You handle overnight ICU-level admissions rarely (around 6 times per year)
Typical call volume: 0–2 calls per night during call week; many nights have none
Deliveries on call: Your own OB patients contact you directly; others are managed by the OB/GYN group or midwives
No additional call pay: Call is part of your compensation model; light enough to remain balanced

During your non-call weeks, you focus entirely on your clinic schedule, scheduled deliveries, and elective hospital rounds—no emergency calls, no interruptions during family dinner.

Electronic Medical Records: Next Generation

The clinic uses Next Generation EMR (NextGen), known for being efficient and well-suited for FQHC workflows. While it's not Epic, staff are highly experienced in optimizing its use for smooth clinical operations.

Dragon dictation software: Voice recognition for efficient note creation
Freed AI scribe: AI-powered ambient documentation that drafts notes automatically
Clinical pharmacist support: Integrated medication management and co-visits
Template library: Established documentation templates for common visit types

Most providers complete notes during or immediately after encounters, with time allocated for administrative work. The clinic culture discourages "pajama time"—adequate time is built into the work week for chart completion.

Clinical Support: A True Team-Based Model

You'll be part of a collaborative, supportive team that enables you to focus on patient care without feeling isolated.

Nursing support: 2–3 nurses per provider pod (LPNs/RNs) with one charge nurse supervising
Medical assistants: Rooming patients, taking vitals, medication reconciliation, and education
Integrated behavioral health: Licensed social workers available for warm hand-offs
Clinical pharmacist: On-site PharmD for collaborative medication management
Registered dietitian: Provides nutritional counseling, diabetes education, and weight management
Care managers: RNs coordinating referrals, access, and follow-up for complex patients
Outreach specialists: Connect patients with insurance, housing, food, and transportation resources
On-site pharmacy: $5 prescriptions for FHS patients to improve adherence
On-site laboratory: Point-of-care and send-out testing available

Tele-health and Specialist Access: World-Class Backup

Despite its rural setting, Burley has exceptional access to specialty support through Intermountain Health. You'll have access to:

Tele-pulmonology/critical care: 24/7 access to intensivists for ICU patients
Tele-neonatology: Immediate specialist access for high-risk deliveries or stabilization
Maternal-fetal medicine: Tele-health consultations for high-risk OB cases
Primary Children's Hospital: Pediatric rehab and complex pediatric care support
Tele-outpatient specialty clinics: Reduce travel for patients needing specialty care

Local collaboration is strong, with nearby specialists in orthopedics, general surgery, and OB/GYN at Cassia Regional Hospital. When subspecialty care is required, patients typically travel to Twin Falls, Pocatello, Boise, or Salt Lake City.

Advanced Practice Providers: Collaborative Colleagues

The Burley clinic team includes three advanced practice providers (two PAs and one NP) who see their own patient panels independently. No supervisory duties are required—they're fully credentialed and privileged, creating a collegial, balanced environment with shared call and patient care collaboration.

Teaching Opportunities

Family Health Services has a history of hosting medical students and residents and may reintroduce teaching rotations. If you enjoy mentoring, you can help shape the next generation of family physicians—though participation is entirely optional.

The Bottom Line

This is authentic, comprehensive family medicine practiced at a pace that allows you to truly know your patients. With 20-minute appointments, a team-based model, and integrated services, you can practice thoughtful, relationship-based medicine that is increasingly rare in today's healthcare environment.