Clinical Component

Navigating the Clinical Component

This is a continuity-based outpatient internal medicine practice. Physicians see an established adult patient panel across a range of acute, subacute, and chronic conditions. The main campus clinic is the primary practice site and the most modern facility in the network, organized into hallway-based practice units that keep physician workflow efficient and support staff close.

The clinic is not an urgent care or walk-in model. Physicians build and maintain their own patient panels, with the option to layer in hospital rounding, nursing home visits, or other practice additions based on personal preference.

Clinic Network

Location Distance from Main Campus
Main Campus (primary site for new hires)
Nelson Road Clinic ~5 miles south
Jennings Clinic ~40 miles east

New physicians are placed at the main campus clinic. Satellite clinic involvement, if any, is determined over time based on practice needs.

Patient Volume

Detail Information
Target daily volume 18–20 patients per day
Ramp period Graduated increase over the first year
End-of-year goal 18–20 patients per day

A structured ramp period allows physicians to build their panel steadily through the first year without being thrown into full volume immediately.

In-Office Procedures

The clinic does not have a dedicated procedure room, but exam rooms are stocked for common outpatient procedures.

Typical procedures performed include:

  • Vaccinations and injections
  • Basic wound care
  • Minor suturing
  • Removal of small cysts or lesions

Schedule

Day Clinic Hours
Monday – Thursday 8:00 AM – 5:00 PM
Friday 8:00 AM – 3:00 PM

Physicians work four full clinic days per week. The half-day of administrative time is flexible and can be completed remotely. Physicians who stay current on documentation often find this functions as a genuine half-day.

Call Structure

Call is practice-based only, shared among the internal medicine group. There is no unassigned hospital call.

Detail Information
Call type Practice call only
Coverage model Answering service routes after-hours calls
Rotation Shared across the internal medicine group
Frequency Approximately 1 in 9–11 depending on group size
Holiday call One holiday per year on rotation

Physicians who choose to round on their own admitted patients take that call responsibility themselves. It is not assigned to others in the group.

APP Support

The clinic employs both nurse practitioners and physician assistants. Two care models are available depending on physician preference.

Independent Panel Model APPs carry their own patient panels and function autonomously. Physicians do not need to sign off on a percentage of APP charts; collaborative agreements are in place to satisfy state requirements without creating a significant chart review burden.

Physician Extender Model APPs support the physician's volume directly, helping manage same-day capacity and follow-up visits.

The model used in each physician's practice is determined by physician preference and clinic demand.

Support Staff

Each physician is supported by a dedicated team:

  • 1 nurse
  • 1 medical assistant (or 2 MAs if nursing shortages occur)

Laboratory and Diagnostics

Service Details
In-house lab On-site at main campus clinic
Lab turnaround 24 hours or less for routine tests
Results delivery Integrated into Epic and patient MyChart portal
Imaging Not in-clinic at main campus; available nearby on campus
Off-site clinics Some satellite locations have imaging on-site

EMR and Documentation

The system runs on Epic, implemented in October 2024. Epic is the most widely used EMR in residency programs, which means most incoming physicians are already familiar with it.

AI Documentation Tools

Epic's built-in AI scribe functionality is available and actively used across the medical group. Physicians report:

  • Completing notes before leaving clinic
  • Reduced after-hours documentation burden
  • Improved coding accuracy and visit level capture

The AI tool learns physician preferences and improves over time. Physicians have flexibility to use desktop computers in exam rooms, laptops, traditional dictation, or any combination.

Billing Support

All billing is managed in-house by a dedicated coding team. Physicians do not handle billing independently. The team audits documentation, coaches on coding accuracy, and handles all claim submission.

Optional Clinical Additions

The following are available but not required:

  • Hospital rounding on personal patients (currently 4 of the group's physicians do this)
  • Nursing home rounding (performed during administrative time; labor-intensive, many physicians opt out)
  • Inpatient rehabilitation rounding
  • Long-term acute care rounding
  • Directorships and administrative roles

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