Clinical Component

Navigating the Clinical Component

The Center of Aging operates as a post-discharge and panel-based outpatient clinic, primarily serving a senior population in the Inland Empire. The clinic is not a federally qualified health center or public walk-in facility. Patients are drawn from hospital and skilled nursing facility discharges, as well as the group's established panel. Same-day appointments may occur when existing patients call with urgent needs, but open-access walk-ins from the general public are not part of the model.

The clinic is housed in a brand new building off Arrow Highway in Rancho Cucamonga, approximately three miles from San Antonio Regional Hospital in Upland. The facility will include 12 exam rooms and is designed as a multi-specialty "one stop shop" for seniors, with primary care, specialists, imaging, pharmacy, lab, and physical and occupational therapy all under one roof. Cerner is the EMR platform and is integrated with the hospital system, giving the physician full visibility into inpatient records for post-discharge continuity. The center is expected to open in 2026.

Clinical Environment

This is a teaching clinic built around a resident-driven care model. The incoming physician will not carry a traditional physician panel. Instead, the residents manage the patient workload under the physician's supervision. The structure is designed so the physician can focus on education and clinical oversight rather than high-volume direct patient care.

The clinic is expected to accommodate approximately 40 patient visits per day across the full care team. The breakdown is as follows:

Provider Estimated Daily Visits
4 Internal Medicine Residents (8 each) 32
1 Nurse Practitioner ~15
Attending Physician (direct, worst case) Up to 5
Total Clinic Capacity ~40–45 visits/day

On most days, the attending physician will see few to no patients independently. Direct involvement increases when residents are absent or a patient situation requires attending-level assessment.

Patient Population

  • Primarily seniors, Medicare HMO (approximately 85% or more of the panel)
  • Some commercial insurance and Medicaid
  • Traditional Medicare represents a small and declining share of the payer mix in this market (under 15%)
  • Post-discharge patients from San Antonio Regional Hospital and an affiliated skilled nursing facility
  • Established panel patients who may request same-day appointments

Supervision Structure

The physician serves as the preceptor for all residents rotating through the clinic. Supervision intensity varies by resident year:

  • First-year residents: Require direct supervision; the physician will participate actively in their encounters, often seeing patients alongside them
  • Second-year residents: Transitioning toward indirect supervision; the physician reviews cases and provides guidance as needed
  • Third-year residents: Near-independent; the physician remains available for questions and case review but rarely needs to enter the room

At any given time, the clinic expects four residents to be active. The physician is responsible for overseeing the NP's clinical questions when they arise, though the NP functions independently in most encounters.

Schedule Details

  • Monday through Thursday: Full clinical day, first appointment available from approximately 7:30 AM; last patient scheduled around 4:00 PM
  • Friday morning: Clinic runs until approximately noon; residents attend didactic sessions during this time, reducing the patient volume considerably
  • Friday afternoon: Dedicated administrative time for inbox management, chart completion, and paperwork
  • No call, no nights, no weekends (clinical obligation)
  • Moonlighting: Optional weekend hospitalist shifts available through the group at $1,500 to $1,650 per shift (12-hour shifts, flexibility on arrival/departure timing)

Support Staff

Role Count Notes
Medical Assistants 3 Dedicated to clinic patients
Front Office Staff 2 Patient intake and scheduling
Office Manager 1 On-site, handles pre-authorization and admin coordination
Nurse Practitioner 1 Works 4 days per week, independent panel

Clinical Technology

  • EMR: Cerner
  • Fully integrated with San Antonio Regional Hospital
  • Electronic building access (badge-based entry)
  • Residents have individual laptops; conference room and physician offices are available on-site

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