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Each resident will have a panel of patients for whom he/she is the primary care
physician. New patients will be assigned on a rotating basis by the scheduling
desk. Patients of recently graduated residents are reassigned to team members
unless specified for a particular resident and accepted by him/her.
Generally, first year resident will have 50-100 families, second year
residents will have 100-150 families and third year residents will have 150+
families. Residents will maintain the charts, order appropriate tests and submit
charges for services rendered.
Each first year resident must confer with the preceptor prior to discharging
the patient on each visit. Second year residents are encouraged to confer during
office hours. Third year residents will confer as needed. Charts must be
reviewed and signed by a preceptor within 24 hours. Faculty will not review
every out patient visit note. Representative out patient chart notes will be
reviewed by the faculty as follows: 1st year residents - all notes will be
reviewed and all cases discussed; 2nd year residents – half of the notes from
each session will be reviewed; 3rd year residents - only one note from each
session will be reviewed by faculty. Please make every effort to present for
note review those cases that may have been discussed with/seen by the preceptor.
A Quality Assurance set of indicators will be developed for your use in patient
care and for faculty’s use in evaluating notes. At least one faculty physicians
serves as clinical preceptor for every clinical session. All invasive procedures
must have faculty approval and direct supervision. “Externs” (visiting third or
fourth year medical students) will see patients with attendings and upper year
residents and be supervised directly by that attending or resident. All Medicare
patient, Medical Assistance, and BC/BS patients MUST be reviewed at the same
session with an attending regardless of resident year.
All residents are encouraged to familiarize themselves with the following
procedures routinely performed in the Family Practice Center:
- Glucose testing
- Throat culture
- UA and microscopic evaluation
- KOH and hanging drop of vaginal smear
- EKG
- Spirometry
- Colposcopy
- Casting
- Arthrocentesis and injections
- Screening Audiometry
- Dermatologic procedures
First year residents will see patients one half-day per week. Second year
residents will see patients three half-days per week. Third year residents
will see patients three to five half-days per week, depending on current
rotation. During the Family Practice Center months, second and third year
residents will see patients all day, except for conference mornings. During
the last six months of the year, first year residents will be scheduled in
the office an additional half-day per week, rotation dependent.
Every
attempt will be made to have third year residents see four patients per
hour, second year residents see three patients per hour, and first year
residents will initially see one to two patients per hour. If more time is
needed for a particular patient, it is the responsibility of the resident to
alert the scheduling secretary to allow additional time for the anticipated
visit. Interns and residents will be given add-on patients first to ensure
that they see an adequate number of patients/session. Interns will start
with three patients/session with a goal of five, PGY-2’s with six
patients/session with a goal of seven, and PGY-3’s with eight
patients/session with a goal of ten.
Each resident is expected to answer
phone calls concerning his/her patients in the Family Practice Center and to
document in the chart all patient contact (problems and recommendations.) In
addition, if you are the designated person for your team you must answer the
calls for all patients of your team located in the call back box including
date and time. Additionally, all test results will be screened and initialed
to document that the results of the test were observed. Ancillary actions
should be taken and documented in the medical record as well. Acknowledgment
and action on abnormal test results are the responsibility of the ordering
physician or a designated physician (in the primary provider’s absence).
Patients assigned to a particular resident remain under that resident’s care
until completion of the residency at which time patients will be reassigned
to remaining residents on the same team. Changing physicians “mid-stream” is
discouraged unless requested by the patient for valid reasons, after review
by the Program Director.
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