Clinical Component

Navigating the Clinical Component

The endocrinology APP at Good Shepherd practices in a stable outpatient setting with a clearly defined scope, a consistent referral base, and meaningful ancillary support. Patient volume is predictable, the schedule is protected, and there is no call obligation. The role centers on chronic disease management and long-term follow-up.

Patient Population

  • Adults, 18 and older
  • Mix of new referrals and established follow-up patients
  • Rural service population of approximately 75,000 across Umatilla and Morrow Counties
  • Patients referred from Good Shepherd's primary care network and from specialists throughout the region

Clinical Scope

Day-to-day care focuses on the bread of general endocrinology. The staff endocrinologist handles the most complex pituitary and adrenal pathology, giving the APP room to own a high volume of diabetes and thyroid continuity care while still rotating into the broader case mix.

  • Type 1 and Type 2 diabetes management, including insulin therapy and pump or CGM oversight
  • Thyroid disorders, including hypothyroidism, hyperthyroidism, and nodular disease
  • Hormone conditions affecting the adrenal and pituitary glands
  • Metabolic and chronic endocrine care, including long-term follow-up
  • Lifestyle and medication optimization for pre-diabetes and metabolic syndrome

Clinical Workflow

Detail Information
Setting Outpatient clinic, Suite M-103
Clinic Days Monday through Friday
Hours 8:00 AM to 5:00 PM
Patient-Facing Hours Approximately 32 per week
Daily Volume 15 to 20 encounters
Call None
Inpatient Rounding None

Clinical Support

The APP practices alongside a direct support team and benefits from the Good Shepherd Medical Group infrastructure.

  • Dedicated medical assistants
  • Shared care coordinator
  • Practice manager for clinic operations
  • On-site lab and diagnostic imaging within the main hospital campus

Ancillary Resources

Good Shepherd operates a dedicated Diabetes and Nutrition Center recognized by the American Diabetes Association. This is a significant asset for endocrinology patients and reduces the teaching and education burden on the provider.

  • Comprehensive diabetes self-management education for all types of diabetes
  • Personalized nutrition counseling
  • ACT (Achieve, Conquer, Thrive) Program: a 9-week healthy lifestyle program covering nutrition, physical activity, and stress management
  • Certified Diabetes Care and Education Specialists on staff to co-manage patient education

Collaboration Model

The APP practices under the collaborative agreement of Sandeep Kunwar, MD, who remains available for consultation on complex cases. Day-to-day practice autonomy is high. The collaborative structure is designed to keep the APP fully productive while maintaining access to physician expertise when needed.

© Copyright 2023 Pacific Companies. All Rights Reserved.