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Transitioning from Residency to Practice- a Guide for Monte PCSM Residents
Jonathan Arend, class of 2007

 

I. Evaluate career interests (PGYI: be aware of options, PGYII/III: research options, shadow practitioners)

 Some options to consider:

1) Clinical Practice

·         Primary Care/General Internal Medicine: hospital- based clinics—eg, Monte Medical Group (Mentor Sejdiu, class of 2005), private practice (Alex Wright/Darren Esposito, class of 2005), community health centers—eg, Washington Heights Family Health Center (Columbia University; Cyrus Boquin, class of 2006), other models--eg, Comprehensive Care Management (CCM; Shari Mann), UNITE Health Center (Jonathan Arend, class of 2007; see below)

·         HIV/Primary Care- in New York State, any PCP can become credentialed to provide HIV care via a credentialing program developed by The American Academy of HIV Medicine (AAHIVM). The program requires a minimum volume of HIV patient management and a certain number of CME units in HIV medicine. An alternative vehicle for HIV medicine credentialing in NY is the HIV Clinical Scholars Program (see below). Many community health centers require all their Internists to be credentialed in HIV medicine.

·         Substance Abuse, eg MMTP’s (Kelly Ramsey, class of 2006; Hillary Kunins)

·         Prison Health- as of 2007, paying very well in California (Lara Charneco, class of 2007 has researched this)

·         Homeless Clinics, eg St Vincent’s Hospital Department of Community Medicine (contact: Blanca Sckell, PCSM faculty until 2007), ?armory (PCSM grad, class of ?)

·         Hospitalist positions, direct care or teaching—eg Mt. Sinai (Rupali Kotwal, class of 2007)

·         Locum tenens

·         International Health, eg MSF (Ramin Asgary), Clinton Foundation (Karen Wang, class of 2007)

            2) Academics

·         Clinician Educator- may or may not require further training—eg, Harlem Hospital (Claudia Levine, class of 2006), North Central Bronx (Juliet Widoff, class of 2006), Mt Sinai (Ania Wajnberg, class of 2007)

·         Clinician Investigator- usually requires further training (Chinazo Cunningham)

·         Full-time clinical research- almost always requires further training (Nichola Davis)

            3) Administration, eg Tom Tsang, CEO, Charles B Wang Community Health Center; further

     training helpful, eg MPH

4) Public Health (eg, CDC, State/City Departments of Health), usually via further training (see

     below)

·         Government agencies, eg NYC DOH (Dr. Jane Bedell, PCSM graduate, Assistant Commissioner, Bronx District Public Health Office, NYC DOHMH) -administration/programs/ epidemiology/research

·         Professional & Advocacy Organizations

·         Community-Based Organizations, eg TruthAids (Mehret Mandefro, Manel Silva, class of 2007; founders)

·         Clinical, eg DOH TB clinics, STD Clinics (Dr. Jeff Gilbert, Montefiore/STD Center of Excellence)

5) Health Policy, eg research (Joe Ross), government positions (eg, Medicare)

6) Further Training

·         traditional fellowships, eg ID (Chris Evans, class of 2006), geriatrics (Misha Kogan, class of 2007), adolescent medicine (Manel Silva, class of 2007)

·         HIV Clinical Scholars Program (collaboration between the New York State Dept of Health AIDS Institute and selected academic medical centers, eg SUNY Downstate)- training for leadership roles in HIV care delivery systems (Pam Mund)

·         GIM fellowships- training in research skills for careers in academic GIM (eg, clinical epi, health services research, biostatistics and research methods; examples of areas of research: evidence-based medicine, health disparities, women’s health, quality of care, medical errors, palliative care, medical education, public health, medical informatics; programs usually include mentored research, teaching, some direct patient care; some programs offer master’s degrees)

                                    New York Programs: NYU (Sheira Schlair, chief resident 2007, Homer

Venters, class of 2007), Montefiore/AECOM (Mindy Sabota, class of

2006), Columbia (contacts: Dr. Gbenga Ogedegbe, [N1] Behavioral Cardiovascular Health and HTN Program in the Division of GIM, PCSM graduate, friend of Debbie Swiderski; Dr. Olveen Carasquillo, director of GIM fellowship, well-known to Monte faculty), Mt Sinai, Cornell

·         Public Health Residency Program (NYC DOH/Columbia University) – MPH from Columbia + rotations through divisions of NYC DOH, board certification in Preventive Medicine (Galit Sacajiu)

·         Robert Wood Johnson Clinical Scholars Programs- postdoctoral fellowships in public health/social determinants of health (Health and Societies) and health policy, with emphasis on leadership development (www.rwjf.org/reports/npreports/scholarse.htm, http://rwjcsp.unc.edu/scholars/index.html); sites:

U Penn (www.med.upenn.edu/rwjcsp/index.htm; Mehret Mandefro, class of 2007)

UCSF (www.hss.medschool.ucsf.edu/about.html; Adam Richards, class of 2008)

Yale (http://rwjcsp.yale.edu; Joe Ross)

U Michigan (www.sph.umich.edu/rwj/index.htm)

·         MPH, alone or via GIM fellowships or Public Health Residency Program, as above. One PCSM grad in the past (Marcelo Venegas, class of ?2003) has taken advantage of the quasi-formal agreement between Monte PCSM and Columbia University to use the Monte PCSM curriculum as partial credit toward the MPH at Columbia.

·         Epidemic Intelligence Service (EIS) of the CDC- unique postgraduate program in applied epidemiology, involving surveillance and response to various types of epidemics, from infectious disease outbreaks to chronic diseases (Saumil Doshi, NYU IM grad 2006—husband of Rupali Kotwal [class of 2007])

·         NIH (www.training.nih.gov/) – eg, bioinformatics, cancer epidemiology, women’s health

 

II. Consider loan repayment options

  • National Health Service Corps (http://nhsc.bhpr.hrsa.gov) – up to $50,000 for a 2-yr contract, with the possibility of extending the contract for 1 or 2 additional years. Awards for the 3rd and 4th year are up to $35,000 each (total possible award = $120,000).
  • The Regents Physician Loan Forgiveness Award Program, New York State Education Department (www.highered.nysed.gov/kiap/scholarships/rplfap.htm) – up to $20,000 for 2 years, with the opportunity to re-apply for a second 2-year contract, also for $20,000. Recipients must have graduated from residency within 5 years of the period in which the first award would be granted. Recipients can not be simultaneously enrolled in a federal loan repayment program.
  • Forgive me for putting in a plug for my hometown, but until at least September of 2009, The Greater New Orleans Area Health Service Corps—a program implemented to address the severe physician shortage post-Katrina—offers up to $110,000 for a 3-year service commitment. As is the case with the National Health Service Corps and the NYS Regents program, the award is completely independent of the salary associated with the position you find. The web site is www.dhh.louisiana.gov/offices/page.asp?ID=88&Detail=7589.
  • Indian Health Service (www.ihs.gov/)—up to $20,000 per 2-year period
  • NIH Loan Repayment Programs (http://lrp.info.nih.gov/)

 

III. Begin planning for the transition—general considerations and logistics

Below are some readily available resources for practical advice:

“Preparing for Practice,” by Greg Solomon (© 2005), handed out at PCSM Career Day

“Planning Your Entry into Medical Practice,” by Patrick Molly, Molly & Co, 1207 Pond  Rd.,

  Spring Lake Heights, NJ 07762, 732-974-6224, handed out at House Staff Career Night

  (sponsored by the Montefiore Staff and Alumni Association)- 94 pages of info

“Understanding Physician Employment Contracts,” by Kern Augustine Conroy &  Schoppman,

  PC, presented at House Staff Career Night

 

IV. Save money for credentialing

Step 3, your medical license, and the ABIM Certification Exam, together, will end up costing upwards of $3000. Keep in mind that moving/travel expenses may also come into play at the end of residency.

 

V. Get credentialed

USMLE Step 3

Ideally, you should take Step 3 before January PGYIII. Apply far in advanced of desired test date to insure appointment availability. To apply, go to the Federation of State Medical Boards (FSMB) website: www.fsmb.org. The 2008 application fee is $670. In order to complete the application, you have to select the state medical board through which to apply. It doesn’t matter what state you select at this point. You can subsequently apply for licensure in any state, regardless of which state board through which you apply for Step 3. Some states, including NY, require that an application for licensure be on file before you can apply for Step 3. So, if you want to go ahead and sign up for Step 3 before initiating your application for state licensure (what most residents do), you can do so by selecting a state board that allows you to apply for Step 3 without initiating an application for state licensure. Most of us just pick Connecticut for the purposes of applying for step 3, and then apply for NY state licensure at the same time. That way, your test date for Step 3 will already be locked in while you work on your license application, which can be time consuming.  

During the Step 3 application process, you will be given the option to use the Federation

Credentials Verification Service (FCVS), which collects and maintains all documents required for

future credentialing purposes, eg, med school transcripts, USMLE transcripts, postgraduate

training verification form. This service establishes a permanent, lifetime portfolio of primary-source verified credentials, which can be used throughout your career for state licensure, hospital privileges, employment, and professional memberships. It saves a lot of hassle, is particularly useful for folks who may apply for additional state licenses in the future, and is actually required for licensure by some states. It costs $295.

In terms of studying for Step 3, most residents devote 2 - 4 weeks, ideally during a light month.

Many use Crush Step 3 for a quick review and Kaplan’s Q Book for questions. Don’t study

internal medicine! Focus on the other specialties.

 

Medical License

Application for licensure should also be initiated earlier than later, ideally before the fall of PGYIII. The USMLE, however, will be the rate-limiting step, as this will likely be the last piece of credentialing added to the license application.

Different states have different procedures for applying for medical licensure. To apply for a NYS

license, go to the New York State Education Department’s Office of the Professions, at  

www.op.nysed.gov and search on “medical license,” then select either link that appears (“NYS Physician - 3-year Limited License Requirements” or “NYS Medicine Requirements”); or go directly to www.op.nysed.gov/medlic.htm. Select “Application Forms” and then selectForm 1 - Application for Licensure and First Registration.” The application fee is $735. FYI, in order to complete the application, you’ll have to take the on-line certification for child abuse reporting, if you haven’t already. You can go to the Office of the Professions website and search on “child abuse reporting” for a list of approved on-line certification services. You’ll eventually have to do the same thing for infection control in order to get hospital privileges at your worksite, if applicable.

Your registration certificate comes with your license.

 

DEA #

After receiving your license and registration, you can go online to apply for your DEA #. Go to the DEA website and select “Registration” under the heading “Diversion Control & Prescription Drugs.”

 

The ABIM Certification Exam

All test dates are in August. Many spend 6 - 10 months studying. Most use MKSAP ± MedStudy, ie MKSAP curriculum + MKSAP questions or MedStudy curriculum + MKSAP questions. In the past, the chief residents have purchased the MKSAP questions and allowed everyone to make copies. The test is $1170.

 

VI. Put together your CV and corral your letters of recommendation

Needless to say, get your CV to your letter-writers early.

           

VII. Hit the pavement

If you’re looking for a job rather than applying for a training program, start putting out feelers in January PGYIII. Make a bunch of cold calls, send CV’s, and set up interviews. Most importantly, take advantage of your contacts and word-of-mouth opportunities. Be prepared to evaluate and negotiate employment contracts, and consider getting a lawyer.

 

CONTACT LIST—NYC (some info may be outdated):

 

Community Health Centers/Federally Qualified Health Centers (FQHC’s)

 

An updated list of CHC’s  is made available by the Communiy Health Center Association of New York (CHCANYS; www.chcanys.org). FQHC’s vary in their quality and scope, but most are similar to CHCC. They are somewhat uniform in many respects, as their federal funding is tied to strict government regulations on clinical standards and operations. In the spring of 2007, many were making plans to implement an EMR and to bring in outside consultants to help re-design patient flow.

Another way to look for openings at CHC’s (in NY and nation-wide) is to search the job postings on the National Health Service Corps website. That way, you might get lucky and find a place you like, that’s hiring, and that’s eligible for loan repayment.

Paul Meissner, grants manager for the Monte Department of Family Medicine, has many contacts in the CHC world and may be a helpful resource. He is on Groupwise.

 

Hospital-based clinics, hospitalist positions, and faculty positions

 

Montefiore

direct inpatient and outpatient care, outpatient teaching, teaching hospitalist

positions

Outpatient: talk to Eric Green

Hospitalist: talk to John Loehner

 

North Central Bronx- PCSM alumni contact- Juliet Widoff, class of 2006

            outpatient, clinician educator positions

Dr. Michael Lin, Co-director, Ambulatory Medicine, michael.lin@nbhn.net

 

NYU (Bellevue, Ticsh,VA)- PCSM alumni contacts- Sheira Schlair, chief resident 2007; Homer Venters, class of 20007

Inpatient:

Dr. Daniel Shine, Chief of Medical Services, NYU Hospitals Center

daniel.shine@med.nyu.edu

secretary: Lutricia Perry, 212-263-0740, lutricia.perry@nyumc.edu

Outpatient:

Dr. Marc Gourevitch, Chief, Division of GIM, marc.gourevitch@nyu.org.

 

Columbia

Inpatient: New York Presbyterian

Dr. Paul Lee

Division of Hospital Medicine

Milstein Hospital Building, 8th floor

177 West Ft Washington Ave

New York, NY 10032

212 305 5138 -- hoespitalists line (voicemail)

212 342 3882 dept of medicine

Hector Torres HHT2104@columbia.edu

www.hospitalist.cumc.columbia.edu

New York Presbyterian - Allen Pavilion

Ms. Fatima Susana

Room 2095

5141 Broadway

New York NY 10034

letters to Dr. John Novotny, Director of Hospitalist Program FS2184@columbia.edu 212 932 5258 fax 212 932 5218 phone

Mabel Cruz, room 2FW-095, Allen Pavillion fax 212-932-5258

Mlc2134@columbia.edu

Outpatient: Columbia Physician Network- PCSM alumni contact- Cyrus Boquin, class of 2006

549 W 180th St ACNC

NY, NY 10033

212-305-3062

HR: 212-305-2990

Dr. Elaine Fleck

212-342-3062

Emf12@columbia.edu

 

Harlem Hospital- PCSM alumni contact- Claudia Levine

outpatient clinician educator and teaching hospitalist positions

Dr. Linnea Capps- active board member of DGH, close friend of Lanny Smith

Assistant Clinical Professor of Medicine, 

Columbia University College of Physicians and Surgeons

Associate Director, Department of Medicine, Harlem Hospital Center

Harlem Hospital, 506 Lenox Ave, Room 14-101, New York, NY 10037

Phone 212-939-1423, Fax 212-939-2429, email lc9@columbia.edu

 

Mount Sinai- PCSM alumni contact: Ania Wajnberg, class of 2007

Dept of Medicine: April Armstrong 212 241 0529

Inpatient:

Dr. Andrew Dunn, Practice Chief, General Medicine

Outpt: Dr. Thomas McGinn, Division Chief, GIM

212-869-7636, thomas.mcginn@mssm.edu

Mount Sinai Hospital

1470 Madison Ave

New York NY 10029

Secretary: devi.gangadeen@mountsinai.org

 

St. Vincent's Hospital—Manhattan

            contact- Blanca Skell, former PCSM faculty

www.svmc.org--> “view all open positions”

           

St. Luke's / Roosevelt / Beth Israel / LIC

all are managed by Continuum Health Partners

212 523 5776 fax

212 523 4050 phone

Ken Handler

Corporate Human Resources

Continuum Services

555 W 57th St

New York  10019

www.chpnycareers.com

 

Maimonides

HR 718 283 7510

HR fax 718 635 8157

 

Bronx-Lebanon

Dr. Chili Muri

Dept of Medicine

718-960-1032

1650 Grand Concourse

Bronx, NY 10457

 

Metropolitan Hospital

Ms. Justice Shillingford

j_shillingford@nymc.edu

16th floor

New York Medical College at Metropolitan Hospital

1901 1st Ave

New York NY 10029

(affiliations dept) 212 423-6042

 

King's County Hospital

medical director office 718 245 3921

main number 718 245 2142

medical director fax 718 245 5347

Dr. Kathie Rones

Room B1147

Kings County Hospital

451 Clarkson Ave

Brooklyn, NY 11203

 

Parkway Hospital

718 990 4100

Dr. Girish Desai (VP medical affairs, etc)

Dr. Aquino (CEO)

attn: Administration

70-35 113th St

Forest Hills NY  11375

Helen 718 990 4130

(also contact Dr. Alberto Rosa for 50/50 inpt/outpt gig 718-457-7000)

 

Jacobi

HR 718 918 3520 (but needs transfer to Affiliations)

Merna Adams

attn: Human Resources

New York Medical Alliance

1400 Pelham Parkway South

Basement South 32

Bronx, NY 10461

 

Lincoln Hospital

Dr. Suresh Kumar

Dept of Internal Medicine

Lincoln Medical Center

718-993-3860

234 E 149th St

Bronx, NY 10451

 

Woodhull

Woodhull Medical Group

attn: Gary Astenberg

760 Broadway

Brooklyn NY 11206

718 963 8672

 

Brooklyn Hospital Center

                                    718 260 2740 HR

Ms. Cheryl Weekes

Director, Staffing & Recruitment

Brooklyn Hospital Center

121 DeKalb Ave

Brooklyn NY 11201

 

Jamaica Hospital Medical Center

Dr. Thomas Santucci

Chairman, Dept of Medicine

Jamaica Hospital Medical Center

8900 Van Wyck Expressway

Jamaica NY 11418

(dept of Medicine 718 206 6768)

 

Lutheran Medical Center

Dr. George Martin

Chairman, Dept of Medicine

Lutheran Medical Center

150 55th St

Brooklyn, NY 11220

 

Mount Sinai Hospital of Queens

Ms. Claudia Edwards

Dept of Medicine

Mount Sinai Hospital of Queens

2510  30th Ave

Astoria NY 11102

718 267 4256

 

New York Methodist

Dr. Harvey Dosik

Chairman, Dept of Medicine

New York Methodist Hospital

506 6th St

Brooklyn, NY 11215

 

Elmhurst Hospital / Queens Hospital Center

Ms. Anna Pintsov

Assistant Director of Human Resources

Room N607

82-68 164th St

Jamaica NY  11432

718 883 4007

 

St. Barnabas Hospital

Ms. Lopa Adhikary

Dept of Human Resources

St. Barnabas Hospital

183rd St & 3rd Ave

Bronx NY 10457

718 960 6502 HR

 

Wyckoff Heights Medical Center

medical staff recruitment 718 963 7741

Sharon Tietze

AVP Medical Staff & Development

[attn: Administration]

Wyckoff Heights Medical Center

374 Stockholm St

Brooklyn, NY 11237

 

North General Hospital

Mr. Bruce Wilson

Dept of Human Resources

North General Hospital

1735 Park Ave

New York NY 10035

212 423 4590

 

Interfaith

Dr. Eric Jaffe

Chairman, Dept of Medicine

Interfaith Medical Center

1545 Atlantic Ave

Brookln N 11213

718 613 4246  (medical affairs)

 

New York Hospital Queens

Dr. Terence Brady

Chairman, Dept of Medicine

New York Hospital Queens

56-45 Main St  (note actual hoespital is at 25-10 30th Ave in Queens) Flushing NY 11355 718 670 1231  (then 8, then 3 for Dept of Medicine)

 

Victory Memorial Hospital

718 567 1268 HR

 

Brookdale

Michael Farca

Administrator, Dept of Medicine

fax 718 240 6516

phone 718 240 6204  (x6206 is Violetta)

 

Peninsula Hospital Center

(has a family practice residency, starting a teaching hospitalist

program)

Dr. Galvin

718 734 2000 is main number for hoespital

718 734 3018 Dr. Hadpawat , Chair of Medicine

 

North Shore University Hospital

516 465 8855  medical board

516 562 2620 dept of medicine (michelle)

 

 

 

Lenox Hill Hosp

100 E 77th St 10021

212-434-2000

 

NY Downtown Hosp

170 William St

NY, NY 10038

jobs@downtownhospital.org

 

Alternative Models of Primary Care

 

            Comprehensive Care Management (CCM; Shari Mann, presented at Career Day)

 

UNITE Health Center- primary care for union workers and retirees (Jonathan Arend, class of 2007)- info below, as there is no website

                       

UNITE HERE Health Center

275 7th Ave, NY, NY 10001 (Chelsea- 7th ave, 25/26)

Est. 1914 by the International Ladies Garment Workers Union (ILGWU; est 1900) due to  high rates of TB among garment workers

1995: ILGWU + Amalgamated Union (clothing and textile workers) = UNITE (Union of Needletrades, Industrial and Textile Employees)

2004: UNITE + HERE (Hotel Employees and Restaurant Employees International Union; est 1891) = UNITE HERE (North America: US/Canada)

            - Garment workers (eg, seamstresses)

            - Clothing retail (eg sales reps)

- Industrial laundry workers

- Hotel workers

- Restaurant and food service workers

- Amalgamated Bank employees (bank established in 1923 for Amalgamated  

  Union workers)—including senior staff

UNITE HERE population: US: 450K active members, 400K union retirees

NYC: ILGWU- early hx: European immigrants (Italian); c 1990: 40K, mostly Chinese; 9/10/01: 10K 9/12/01: 1500 (s/p economic downturn and outsourcing of garment workers post 9/11)

 

Health Center population: 20K pts; >100K visits/yr

- 70% active union workers (UNITE HERE, Service Employees International

   Union Local 32 BJ [building service workers, eg doormen, superintendents,

   maintenance workers])- many healthy pts, many w/chronic dz. HIV rare, no

   on-site care (SVH HIV clinic or faculty practice)

-          capitated (self-insured by union)

-          employer-sponsored private health insurance of local affiliates (negotiated lower copays at UHC vs outside providers)

- 25% union retirees – chronic dz (HTN, DM, asthma, CAD, CHF, CKD, COPD)

- 5%- nonunion pts with private insurance- Chelsea residents, eg professionals,

   artists

Ethnicity:

   - 90% nonwhite:

- Majority- immigrant: DR, Haiti, Carribean, SA, CA, Mexico, Europe

(Italy, Greece, Poland, Russia, Eastern Europe, France), Africa, 

South/South East Asia, China)

                        - African American

Language: ?65% Spanish (?50% Spanish only), 25% English, 5% French, 4%

   Chinese, 1% Italian, other

Residence: ?30% Manhattan, 25% Brooklyn, 25% Bronx, 15% Queens, 5% NJ

            Average income: $15K

 

Facility: accredited diagnostic and treatment center, 54 exam rooms, state of the art

-          11 PCPs (9 IM, 1 FM, 1 NP), 2 OBGYN (4 former Monte PCSM)

-          1 MA assigned to each PCP, 2 floor coordinators, 2 RN, 1 nurse mgr

-          30 part-time subspecialists (ophtho, derm, podiatry, GI, card, pulm, renal, endo, hem/onc, neurology, ENT, GU, gen surg, breast sx, ortho)

-          1 Full-time SW and 1 full-time psychotherapist

-          Full-time nutritionist

-          PT suite, 2 full-time physiatrists (including pain mgmnt)

-          Card group (with echo/stress, LE Doppler, arterial PVR)

-          Sleep medicine group (with 8-bed sleep lab)

-          Lab

-          XR, DEXA, mammo, U/S

-          EMR 1996 (templates: HM, DM, PE, labs)

-          Patient Support Services– referrals, medical records)

-          Pharmacy

 

Hospital/academic affiliation: SVH/NY Medical College- admissions, faculty appts (resident, medical student supervision)

 

Journal Club

 

Funding: union (self-insured- United Food and Commercial Workers International Union National Health and Welfare Fund), private insurance, grants (eg, United Hospital Fund [NYC], NYS Health Foundation); annual budget: $15 million; Not a FQHC

 

Development:

 1999: - facility renovation

- redesign– PCDC (consulting)

- flow- total cycle times > 2 hours à 45 min

  (pt-centered, eg, MA’s come into room to schedule f/u appt’s, referrals)

            - open access

 

Programs:

Capitation- allows for implementation of innovative programs to improve quality of care and cut health care costs via services not re-imbursed by fee-for-service insurance

à intensive programs designed to maximize pt self-management by heavy reliance on

     MA’s, leaving MD’s to focus on medical issues

            - 2003- present: joined NYC DOH Diabetes and Depression Collaborative

- multidisciplinary model- MA’s trained in DM education (according to evidence-based curricula, eg ADA), managing DM protocols via EMR templates (trained in and responsible for monofilament exams, monitoring vaccination schedules, scheduling ophtho/pod/nutr appts), glucometer checks, self-management, goal-setting, motivational interviewing, phone support. DM support groups. Pharmacy, nutrition, PT involvement. Eg, pharmacist has a copy of DM registries, evaluates Rx adherence in uncontrolled diabetics when they come to pick up their Rx, flags PCP with info. PT often checks FS when diabetics come for PT, discusses DM control with pts.

    EMR-

    - DM registries- ID high risk, eg A1c > 9 à targeted interventions, eg

       phone support per MA’s

    - outcomes- A1c, LDL, BP, foot exams, ophtho appt- statistically and clinically  

       significant improvements

-          poster presentations:

o         Greater NY Hospital Assoc annual meeting 11/06

o         Institute for Healthcare Improvement (Cambridge-based non-profit- consulting, professional development, conferences)

- 2005- United Hospital Fund grant-

1st health center in the US to pilot a new model of health care delivery formulated by the California Health Care Foundation—“Ambulatory Intensive Care Unit” (Specialty Care Center [SCC] at UHC)

-          designed to reduce health care costs and improve quality of care for working pts in a given in insurance pool. Evidence base: 20% of pts are responsible for more than 60% of total health care spending. Target the 20% à enhanced resources for working pts with chronic dz (essentially, DM collaborative model extended to all chronic dz)

- further expansion of MA role:

            - DM support, as above (educ, glucometer checks, bx

  change, phone support, support groups)

- HTN- non-MD visit BP checks, support with home BP

   monitoring

- asthma- educ, phone f/u

- smoking cessation- stages of change, MI, free patches,

   regular phone f/u

            - ?2007- Institute for Health Care Improvement (IHI) grant-

Collaborative Self-Management Support Team

- obesity initiative

- Healthy Living with Chronic Dz (HLC) groups

            - 1/08: NYS Health Foundation grant-

Bridgecare: expansion of SCC model to elderly DM (HIP-insured,

not capitated; negotiating with HIP to capitate next year in order to

sustain funding after grant). SCC + beyond (eg, CHW model [s/p training in Santa Anna, CA by Latino Health Access], more formal case management, MA panels)

 

            A day in the life:

9-5, 1 Sat /mo

Private offices

                        Pt review

                        Huddle

                        Ave 15 pts/day (max 20); 20 min time slots

                        1-2 afternoons/week- admin time for projects

                        1 day/week- precepting @ SVH

3-4 afternoons/month- other meetings, eg SCC, DM team, QA

1 am/mo- Journal Club

            Salary/benefits- competitive (> FQHC)

           

Alumni Contact List (alumni cited above)

 

Boquin, Cyrus 646-316-7732

Charneco, Lara L_charneco@yahoo.com

Levine, Claudia levi0120@umn.edu 516-574-9709

Wajnberg, Ania aw100@hotmail.com 917-5825559

Venters, Homer hdventers@yahoo.com

Wang, Karen kaxwang@gmail.com 917-557-5876

Silva, Manel mokachica@yahoo.com 706-627-8000

Mandefro, Mehret mehret@truthaids.org 857-928-2711

Kogan, Misha healermisha@yahoo.com 267-258-9528

Kotwal Doshi, Rupali Rupali.k.doshi@gmail.com 917-817-0149

Widoff, Juliet

Sejdiu, Mentor

Wright, Manford (Alex)

Esposito, Darren

Ramsey, Kelly

Evans, Chris

Schlair, Sheira

Sabota, Mindy

Richards, Adam

Venegas, Marcello

 

 

 


 [N1]Now at NYU

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